Urogynaecology

What we do

Urogynaecology deals with dysfunction of the pelvic organs and the pelvic floor. Problems such as prolapse, urinary incontinence, recurrent urinary tract infections, anal incontinence, constipation and sexual problems frequently co-exist.

At Mayday we have an integrated service (Lancaster Suite) that provides a holistic approach to these problems to avoid multiple consultations. We are at the forefront of research, provide an urogynaecology subspecialty training programme and hold international courses in perineal trauma and ultrasound (www.perineum.net). Our team was awarded the prestigious 2005 UK Hospital Doctor Continence Team of the Year. 

How we do it

Patients suffering from prolapse of the uterus or vagina (cystocele, rectocele, enterocele) with incontinence can be referred directly to the Urogynaecology clinic (which is under Gynaecology in the Choose and Book system) and will be seen either by Miss Ranee Thakar or Mr Abdul Sultan.

Patients referred to the Lancaster suite are seen in any of the following:

Nurse led triage clinic

To reduce the patient journey from time of referral to initiation of treatment we introduced a nurse led triage clinic to which any health professional can refer directly. The nurse specialist assesses and institutes conservative management and only refers selected cases onward to consultant clinics. Within our approved and implemented PCT care pathways, patients come directly to the The Lancaster Suite rather than the consultant outpatient clinic. This in itself has reduced administration time, outpatient appointments and patient’s journey time. All female patients are seen within a month by a nurse specialist who undertakes triage and classifies them within an approved multidisciplinary team framework. If the patient needs an operation the nurse specialist performs urodynamics and refers to the urogynaecology consultant

Pelvic floor clinic

These joint clinics (urogynaecologist, colorectal surgeon and nurse specialist) are run monthly by 2 teams  (Mr Abdul Sultan/ Mr Muti Abulafi and Miss Ranee Thakar/ Mr Ian Swift). Joint evaluation of complex pelvic floor disorders lead to a more pragmatic approach in treating patients’ symptoms. Combined surgery leads to a single recuperation period. Our audit revealed that patients rated this service very highly.

Perineal clinic

This is a dedicated one-stop postpartum clinic that is open to women suffering from bowel, bladder or sexual dysfunction after the birth of their baby. We also see women before they deliver if they have any perineal injuries so we can counse them on the best mode of delivery. This clinic is an exceptional service model that is being adopted by many units.

Urodynamic clinic

This is a one-stop clinic for assessment, investigation and management plans for women with bladder problems. Investigations include, uroflowmetry, cystometry, bladder ultrasound and pad testing.

Pelvic floor exercises and bladder retraining class

In contrast to conventional practice we introduced the concept of group therapy classes as opposed to one to one therapy that was still available on request. This has proved very effective because it enabled larger numbers of women to be trained in a shorter space of time and has been proved very successful

Bowel re-education clinics

This clinic is conducted by Wendy Ness and patients suffering from bowel problems such as incontinence, obstructed defaecation, constipation and irritable bowel are managed. Biofeedback is also offered.

TVT class

The TVT is the commonest continence operation and we perform more than 100 a year. In order to improve patient information, counselling and save out-patient time, we developed a nurse-led group information class that includes an ex TVT “expert” patient. 

Pessary Clinic

We have initiated a twice monthly pessary clinic for prolapse and we have the largest variety of pessaries in the UK. We have also trained the community continence advisors so that they could make domiciliary visits to change pessaries in women with health and mobility restrictions.

Who we are

Miss Ranee Thakar, Consultant Obstetrician and Urogynaecologist

Kirstan Goodman Secretary to Miss. Ranee Thakar

Mr Abdul Sultan, Consultant Obstetrician and Gynaecologist

Ginny Dalgado Secretary to Mr. Abdul Sultan

Mr Ray Addison Nurse  - Consultant in Bladder and Bowel Dysfunction

Anne Phillimore- Nurse Specialist in Bladder Dysfunction

Wendy Ness- Colorectal Nurse Specialist

How to contact us

Telephone:

Miss Thakar’s Secretary 020 8401 3154

Mr. Sultan’s Secretary    020 8401 3161

The Lancaster Suite       0208 401 3647

E Mail:

ranee.thakar@mayday.nhs.uk

abdul.sultan@mayday.nhs.uk

Useful Links

www.perineum.net

NHS Direct Department of Health

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