Patient information

Reasons for referral

Adam specialises in the diagnosis and management of a range of gynaecological conditions, including cancers of the female reproductive system. You may be referred to Adam because of one or more of the following complaints:

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  Abnormal uterine bleeding
  

  Abnormal uterine bleeding refers to abnormally heavy or prolonged menstrual bleeding, or bleeding after menopause. It can also mean bleeding that does not follow a normal pattern, such as ‘spotting’ between periods.

  There are many potential causes for abnormal uterine bleeding, so a diagnosis may require various tests. An ultrasound can be very useful in the first instance, to determine the appropriate investigation and management of any underlying problem. An endometrial biopsy can diagnose many conditions and help guide treatment. If a biopsy is required, Adam can perform this procedure during your appointment in his consulting suites.

  Abnormal uterine bleeding can often be managed with medical (i.e. non-surgical) treatments. When medical treatments are not successful, a minimally invasive hysterectomy may be considered.

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  Abnormal cervical screening (colposcopy) and other cervical problems
  

  The Pap test (also called Pap smear), and its new counterpart the HPV test, are designed to detect potentially abnormal cells on the cervix that may lead to cervical cancer if untreated. An abnormal cervical screen can provoke much anxiety. However, statistically, it only rarely means that cervical cancer is present.

  If your results require further assessment, your GP will refer you for a colposcopy, which can be performed in Adam’s consulting suites. This test uses a special instrument called a colposcope to magnify the cells of the cervix – a bit like a microscope – in order to determine if any treatment is required. In the vast majority of cases, a simple procedure is all that is needed to remove any abnormal cells. This is done either with a laser beam (‘laser ablation’) or thin wire loop (‘LLETZ’).

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  Ovarian cyst or uterine mass
  

  A mass (lump) in the ovaries or uterus can cause pelvic symptoms such as pain and discomfort, which your GP may initially investigate by sending you for an ultrasound.

  An ovarian or uterine mass may be a simple cyst (a fluid collection that is almost always benign), a cyst with more concerning features or, very occasionally, a cancer. Sometimes surgical assessment is the only way to tell whether a mass is benign or malignant.

  Fibroids, which are benign lumps in the uterus, are another common problem. They may be asymptomatic (i.e. not causing any symptoms) or may cause problems such as pelvic pain or discomfort, abnormal bowel or bladder function, or abnormal uterine bleeding. Medical treatment is often appropriate for fibroids, but if this is ineffective then a hysterectomy (i.e. removal of the uterus) may be considered.

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  Family history of gynaecological and breast cancer
  

  When one or more family members have been diagnosed with cancer, it is normal to want to prevent this from happening to other family members in the future. In this case, your doctor can talk to you about the likely risk of cancer in your family. In certain circumstances, minimally invasive hysterectomy may be recommended to prevent the development of cancer in those family members deemed to be at high risk.

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  Gynaecological cancers: ovarian, endometrial, vulval or cervical cancer
  

  Gynaecological cancers require prompt, specialised treatment.

  If you have a suspected or confirmed gynaecological cancer, Adam will see you promptly, with the aim of commencing treatment as soon as possible. He works closely with medical oncologists and radiation oncologists to ensure that comprehensive, multidisciplinary care is available to all women with cancers involving the reproductive system.