Your visit to the urogynaecology clinic

You have been referred to the urogynaecology clinic. This information leaflet explains;

• What the urogynaecology clinic is.
• How to prepare for this clinic visit.
• What to expect during the consultation.

The urogynaecology clinic is a specialised clinic that deals with problems of lower part of the urinary tract (waterworks) and the genital tract (down below).

This clinic deals with problems like;

• Involuntary loss of urine, such as on coughing and sneezing.
• Having to go to pass urine urgently and / or frequently.
• Difficulty passing urine.
• Prolapse of the vagina or the uterus (womb).
• Pain in the bladder (waterworks) or urethra (tube that takes urine outside).

You will need to complete a bladder diary, a history sheet and a quality of life questionnaire, which will be sent to you by post before your appointment.

1. Frequency volume chart (bladder diary):

This diary provides an idea about the nature and amount of the fluids you drink, how often you pass urine as well as the amount of urine you pass. Completing this diary can be tedious. Nonetheless, it is one of the most valuable ways of assessing how your bladder (waterworks) works. This diary needs to be completed over 3 days, ideally including work and rest days. Please mark the time you get out of bed in the morning and the time you go to bed in the evening for each day on the diary.

2. Urogynaecology sheet:

This is a questionnaire about your health covering;

• Current problems and symptoms.
• Past medical problems.
• Previous treatment, including surgery.
• Medical problems in the family.
• Your goals and expectations.

The questionnaire is detailed and lengthy. However, this will ensure a thorough assessment of your condition. This will help reaching an accurate diagnosis of problem(s) and guide the best way to deal with it (them). Being in clinic can cause anxiety such that patients forget problems or get embarrassed to raise them. Completing this questionnaire at home will help you focus on your problem(s) and observe it / them so that you can document all your problem(s) before hand.

Quality of life questionnaire:

This is another questionnaire, with scores, that enables assessing the impact of your problem(s) on your life. This is a form of quality control to assess the effect of treatment, by comparing the score before and after treatment, especially surgery.

If you are not comfortable completing these questionnaires, feel free to leave them blank and your history will be obtained in the usual way in clinic.

During your visit to the urogynaecology clinic, a doctor will ask about your symptoms and check your completed diary and questionnaires with you. This is to ensure proper understanding of your condition.

After this, you may undergo an examination which could include;

• Looking at and palpating your tummy to check for scars and masses.
• Checking joint mobility as patients with very flexible joints (hypermobile) are prone to leakage of urine when coughing and / or sneezing and prolapse of the vagina and uterus (womb).
• Checking for hernias and varicose veins which are known to increase the risk of prolapse of the vagina and uterus (womb).
• Assessing nerve supply, as it can affect bladder (waterworks) function.
• Speculum examination which is when a small instrument is introduced into the vagina to see inside and assess the degree of prolapse. This will be carried out while you are lying down on your back on the examination cough and also on your left side.
• Examination of the pelvic floor muscles. This will entail some form of pressure on either side of the vagina, to assess the tone of the muscles that support the bladder (waterworks) and the vagina. You may be asked to contract your pelvic floor muscles (pull up) during this part of the examination.

The doctor will then explain the findings to you and discuss the various options for investigation and / or management with you. There are leaflets available about various conditions, investigations and treatment options available in clinic as well as online.

Some of these will be new to you. Feel free to take time to read the information and ask questions before you make any decision. The doctor and nurses in clinic are there to help you and answer any questions you might have.

We hope you will find your visit to the clinic comfortable, informative and helpful.

You will find information about urogynaecology services at the urogynaecology section of the Trust website.

If you scroll to the bottom of this page, you will find a link to patient information leaflets about various conditions and their treatment.

Princess Royal Hospital, Horsted Keynes Ward: 01444 441881 Extension 65686

Royal Sussex County Hospital, Level 11: 01273 523191

Urogynaecology Unit at Lewes Victoria Hospital: 01273 474153 Extension 2178

This patient information leaflet was prepared by Dr. Sharif Ismail, Consultant Subspecialist Urogynaecologist.

This leaflet is intended for patients receiving care in Brighton & Hove or Haywards Heath.

The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.