Gynaecology Clinic
Gynaecology Clinic

The Birth Clinics offers comprehensive care meeting the needs of women from late teenage years through menopause and beyond.

Screening

Our services include routine well woman checks – cervical smear screening, ovarian screening, pelvic and breast examinations in addition to advice on contraception, hormone replacement therapy and sexual health checks.

Common Gynaecological Problems

We are able to offer care for the full range of gynaecological problems including problematic periods (too many, too few, too painful), pelvic pain, fibroids, endometriosis, ovarian cysts, polycystic ovarian syndrome and troublesome vaginal discharge.

Fertility

We perform fertility health checks including an assessment of hormone status, ovulation confirmation, fallopian tube patency and semen analysis. We perform laparoscopic tubal surgery if scarring or distortion of the fallopian tubes is likely to be preventing pregnancy.

Specialist Services

Our doctors has a particular interest in disorders of the pelvic floor resulting in prolapses, urinary and faecal incontinence. He is trained in minimal access (keyhole) surgery and will use these techniques whenever possible in managing gynecological problems requiring surgery.

Gynaecology Ultrasound Scans

Our state-of-the-art scanning equipment provides the latest in ultrasound technology. You may attend for a gynaecology ultrasound on its own or in conjunction with a consultation and examination. The majority of gynaecology scans are performed using a vaginal probe (a small device inserted gently into the vagina) to obtain the clearest views of the pelvis. The most comprehensive scan is a full pelvic ultrasound scan. Most specifically we offer endometrium thickness scan and follicle tracking scan. In some circumstances pelvic scans may be performed through the tummy wall.

Full Pelvic Ultrasound Scan

This is performed for women with a variety of gynaecological complaints including infertility. In principal this is a transvaginal scan performed by one of our experienced sonographers This is done with an empty bladder. The uterus, cervix and both ovaries are visualised and measured.. Any cysts or abnormalities are noted. Normal fallopian tubes cannot be seen on scan. Any pathology is clearly documented. The position of an intra uterine device in the uterus can be seen.

Endometrial Thickness Scan

This is undertaken for women following an IVF programme. It may need to be done more than once. It gives guidance about the timing of IVF.

Follicle Tracking Scan

This is done to help women in monitoring their ovulation for fertility purposes. There will usually be three scans in one cycle.

Cervical Suture Also Called Cervical Cerclage

Our Doctor has a special interest and expertise in the treatment of women who have had recurrent miscarriages in the middle part of pregnancy. If this applies to you, the Doctor will carry out a full analysis to find out whether weakness of the cervix (cervical incompetence) is playing a role. Other causes of mid-trimester pregnancy loss and pre-term birth also have to be considered – for example, twins and higher order multiple pregnancy, abnormal shape of the womb, recurrent bleeding, infections, excessive amniotic fluid with foetal abnormality or monochorionic twins. A history of cervical cone biopsy and cervical amputation is also important as it can help decide the type of treatment needed.

What Is Cervical Suture?

Cervical Suture – also called Cervical Cerclage – can help prevent a miscarriage in certain cases where cervical weakness is playing a role. A cervical suture is a nylon tape stitch placed around the upper part on the cervix to lengthen and strengthen it. There are three types of cervical suture: McDonald Suture, Shirodkar Suture and Transabdominal Suture. A McDonald Suture is done by most doctors. It is the easiest suture to insert with the least risk. However, it is placed low down on the cervix and is probably the least effective in a difficult case. There is limited evidence about how effective this type of suture is. A Shirodkar Suture is placed in a higher position on the cervix. It requires greater expertise to carry it out, and there is a greater risk of bleeding. However, once it is in place it is likely to be more effective and there is less risk of infection compared with a McDonald suture. Some doctors use this type of suture when a previous McDonald Suture has failed. Dr Rii has extensive experience of doing a Shirodkar Suture in women who are at particular risk of miscarriage. A Transabdominal Suture is used for women who have had their cervix removed by extensive cone biopsy or amputation due to early-stage cancer. These women (some of whom may have had a suture inserted vaginally) may then have had a miscarriage in mid-pregnancy or a premature birth. A Transabdominal Suture is inserted by making an incision (cut) through the abdomen, above the pubic area. This type of suture can be inserted at 11-12 weeks of pregnancy, after an early scan has confirmed that the pregnancy is normal. After this operation, most women can then resume their normal life until a planned Caesarean section at 37 weeks. If serious pregnancy complications arise before the baby is viable (at 24 weeks), the suture can be removed through the vagina (rather than having a second abdominal operation). At Caesarean section for a healthy baby, the suture is left in place.