Clinic Handbook: Women's Health (clinic Handbook)

Clinic Handbook of Women’s Health Clinic Handbook of Women’s Health Diana Hamilton-Fairley Consultant Obstetrician and Gynaecologist, Guy's and St Thomas' Hospitals NHS Trus t, London, UK Debra Holloway Consultant Gynaecology Nurse, Guy's and St Thomas' Hospitals NHS Trust, London, UK Gabriel Taylor Gynaecology Service Manager, Guy's and St Tshomas' Hospitals NHS Trus t, London, UK © BIOS Scientific Publishers Limited, 2003 First published in 2003 This edition published in the Taylor & Francis e-Library, 2005. “To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.” All rights reserved. No part of this book may be reproduced or transmitted, in any form or by any means, without permission. A CIP catalogue record for this book is available from the British Library. ISBN 0-203-42777-7 Master e-book ISBN ISBN 0-203-44157-5 (Adobe eReader Format) ISBN 1 85996 098 7 (Print Edition) BIOS Scientific Publishers Ltd 9 Newtec Place, Magdalen Road, Oxford OX4 1RE, UK Tel. +44 (0)1865 726286. Fax +44 (0)1865 246823 World Wide Web home page: http: //www.bios.co.uk/ Important Note from the Publisher The information contained within this book was obtained by BIOS Scientific Publishers Ltd from sources believed by us to be reliable. However, while every effort has been made to ensure its accuracy, no responsibility for loss or injury whatsoever occasioned to any person acting or refraining from action as a result of information contained herein can be accepted by the authors or publishers. The reader should remember that medicine is a constantly evolving science and while the authors and publishers have ensured that all dosages, applications and practices are based on current indications, there may be specific practices which differ between communities. You should always follow the guidelines laid down by the manufacturers of specific products and the relevant authorities in the country in which you are practising. Production Editor: Andrea Bosher. Contents Abbreviations xi Contributors xiii Preface xiv Section 1 Planning and management of outpatients 1. Planning and management of outpatients 2 Managing referral letters 2 Processing of referral letters 2 Responsibility for the process 3 Diagnostic management pre-appointment 5 Information for patients 5 Management of clinic appointments 6 Managing patients who fail to attend 10 Guidelines for dealing with patients who have failed to attend 10 Follow-up appointments 12 Communication with community services and patients 12 Equipping and designing outpatient clinics in gynaecology 15 One-stop clinics 17 Referral and clinic profile 18 Results management 19 Staffing 20 Business planning 21 The role of the rapid access clinic 24 v Section 2 Clinical gynaecological management of outpatients 2. Menstrual dysfunction 27 Menorrhagia 27 Introduction 27 Definition 27 Referral from primary care 27 Consultation and investigation 31 Benign causes of intermenstrual bleeding and post-coital bleeding Introduction 32 Definitions 33 Evaluation 33 Common causes of IMB and PCB 35 Fibroids 3. 32 37 Management of fibroids 37 Sites of fibroids 37 Subserosal fibroi