Welcome to the Urodynamics department
This is a purpose built unit within the Women's Hospital and can be found on the ground floor. It has its own entrance, reception and waiting areas, along with twin rooms for urodynamic investigation. There are 4 consulting rooms, 5 separate WC's including one with disabled access.

Staff in the department:
Mr D.Richmond Consultant
Ms.E.Adams Consultant
Mr J Sutherst Consultant
Mrs J.Bolderson Continence Advisor/Stoma care nurse

There is also a nursing sister, a staff nurse and a heath care assistant who form an important part of the team in the department. Physiotherapy plays a large part in treating patients with continence problems and there are 3 sessions of physiotherapy shared by a team of 2 physiotherapists.

Junior medical staff also attend clinics as part of their training.
The department sees more than 800 new patients each year, most women attending the clinic suffer with incontinence or some sort of bladder or bowel problem, Medical staff perform the majority of the cystometric testing as well as the urogynaecology clinics.

What is urodynamics?
Urodynamics is the investigation of the way in which the lower urinary tract works. It involves the use of a series of diagnostic tests which can identify the cause of continence problems.

What will happen in clinic?
A standard urogynaecological consultation consists of:

• A full medical history and quality of life questionnaire
  
• Physical examination
  
• Urine test
  
• Documentation of a frequency/volume chart

This is followed by a 2 hour pad test, free uroflowmetry and measurement of residual urine. The consultation is completed by filling and voiding cystometry. Treatment will vary according to the problem but often non-surgical help is given in the unit before surgical intervention is used.
Investigations performed within the Department include:

• Uroflow measurement
  
• Transvaginal ultrasound for measurement of post void residual urine volumes
  
• Filling and voiding cystometries
  
• Urethral pressure profiles and ambulatory urodynamics.

Continence Advisor
The continence advisor is responsible for managing the unit as well as some cystometric testing. She has her own continence clinic which provides advice, teaches clean intermittent self-catheterisation, and provides assessment and treatment of pelvic floor. She is available to provide advice on urinary and faecal problems to the Gynaecology and Obstetric wards. She is also a qualified stomatherapist and is able to provide a full stoma service including pre and post-operative counselling, siting of the stoma, advice on stoma products and follow-up care, both in the community and in the hospital.

Nursing staff
The other nursing staff supervise pad-testing and flow rate measurements, take urogynaecology histories which are put on to a computerised urodynamic database (in use since 1995), and provide help and support to patients about available continence devices. All staff are very aware of the embarrassment factor associated with incontinence and they treat each women with the sensitivity they need.

There is a weekly weight reduction clinic which began in response to the need for patient's to loose weight. This clinic has proven to be helpful to patients who need to lose weight before surgery. It has also been helpful for those patients who need to lose weight as a means of assisting in the treatment of their incontinence.

Ano-rectal dysfunction
There has been an increase in referral of patients with ano-rectal dysfunction.
This has prompted the development of two multi - professional clinics which will be held monthly These involve the combined expertise of a consultant gynaecologist from this hospital and a consultant colo-rectal surgeon from RLUHT. One clinic will be held monthly in the Urodynamics department and the second will be held each month at RLUHT.

Perineal clinic
The perineal clinic is held every second Thursday. This clinic provides postnatal advice for patients with perineal, urinary and bowel dysfunction.

Prolapse clinic
Following the appointment of Miss Adams we have begun seeing patients with prolapse in a specialist clinic within the department. At present this is held fortnightly but it is anticipated that the clinic will be held weekly in the near future. Patients can be referred directly by their G.P.

Research
There is considerable research undertaken within the department by both medical and nursing staff.

There are also strong research links with Liverpool University through collaboration with the Departments of Rheumatology, Immunology, Cell Biology, and also Manchester University.