Ambulatory Gynaecology: A New Concept in the Treatment of Women

Ambulatory Gynaecology or ‘see and treat clinics’ or office gynaecology or one-stop clinics: the names are many but the objective is the same – to minimise delay in diagnosis and improve early management of both benign and malignant gynaecological conditions, allay patient anxiety and take the National Health Service (NHS) into the 21st century. This book addresses the many questions that are asked about ‘ambulatory gynaecology’. How do you start a unit? How can you offer patients maximum satisfaction with fewer hospital visits? How and where should staff be trained? Can you practise this abroad? This is a clearly written, introductory book targeting a UK NHS-based readership but can be easily modified to suit an international clientele depending on available resources. The book provides tips on application, availability and access to office gynaecology and contains useful websites on information and training. It is evidence-based and has up-to-date references and appendices towards the end of each chapter providing valuable information for further reading. Written in a lucid language, it has many flow charts, algorithms, scan images and photographs of equipment, giving the reader useful and retainable information. The book has nine chapters, of which the first is an introduction about the NHS framework and the need for change, i.e. NHS Plan and pressure on training needs in the background of improving outpatient gynaecology. The second chapter on anaesthetics and analgesics provides insight into a topic rarely discussed in gynaecology textbooks. It provides practical tips for patient selection, equipment needed and monitoring. Particular reference is made to local anaesthesia, which is often used in outpatient settings. Chapter 3 introduces colposcopy services while Chapter 4 on abnormal uterine bleeding is comprehensive with information on national algorithms, training websites and college programmes. This leads very nicely to Chapter 5 on endometrial ablation with second-generation techniques and equipment, which can be easily applied in the outpatient setting. Interestingly, there is a business case template that can be used as a guide for the introduction of any such service in the outpatient department, theatres or wards. Chapters 6 and 7 focus on urogynaecology and infertility while Chapter 8 deals with early pregnancy and emergency gynaecology. Chapter 9 is particularly interesting because of the discussion of the role of pelvic ultrasound in the management of acute pelvic pain. Overall, this book is ideal for general practitioners, specialist trainees, consultants, nurses, managers, and the college/hospital library. It would also be a useful tool for undergraduate and postgraduate examinations.