Services
Specialist care for gynaecology, pelvic floor problems and pregnancy.
From routine specialist care to complex pelvic floor problems and advanced minimally invasive surgery, treatment is tailored to the condition, your symptoms, and your goals.
Service areas
Three core areas of care, with a more integrated view where problems overlap.
Some concerns fit clearly into one area. Others overlap across pelvic floor function, bladder symptoms, gynaecology, pregnancy, delivery, or recovery.
Subspecialist care
Urogynaecology & pelvic floor
Advanced care for bladder symptoms, urinary leakage, prolapse, and pelvic floor problems, including non-surgical treatment, reconstructive planning, and complex post-surgical review.
See full pelvic floor services
Assessment
Comprehensive pelvic floor evaluation, bladder function assessment where indicated, and referral for urodynamic testing when it is likely to change management.
Imaging and procedures
Transperineal ultrasound for selected prolapse and pelvic floor assessments, cystoscopy where clinically indicated, and structured procedural review when symptoms are complex or recurrent.
Recurrent symptoms pathways
Careful assessment of recurrent UTI-type symptoms, bladder pain syndromes, urgency, frequency, voiding dysfunction, and persistent symptoms where non-infective causes or overlapping pelvic floor factors may be contributing.
Non-surgical care
Pessary fitting and long-term pessary care, pelvic floor physiotherapy referral pathways, bladder retraining, behavioural and lifestyle strategies, and selected bladder instillation pathways where appropriate.
Surgery and reconstructive planning
Prolapse surgery planning including sacrocolpopexy where appropriate, uterine-sparing prolapse repair where suitable, selected mesh-free and non-mesh options, management of recurrent prolapse, and post-surgical reassessment or revision planning.
Complex referrals and second opinions
Mesh complications, failed sling procedures, persistent or recurrent incontinence after previous surgery, post-surgical voiding problems, recurrent prolapse, and patients needing a more careful stepwise review before further intervention.
Advanced therapies
Selected advanced options for refractory bladder conditions where appropriate, including referral-level planning and discussion of treatments such as sacral neuromodulation.
General specialist care
Gynaecology
Specialist care for bleeding and cycle problems, pelvic pain, fibroids, ovarian cysts, screening, fertility, menopause, and minimally invasive gynaecological surgery.
See full gynaecology services
Gynaecology
Specialist care for a broad range of gynaecological concerns, from structured assessment and ultrasound to procedures, fertility support, and minimally invasive surgery.
General gynaecology
Abnormal bleeding, cycle problems, pelvic pain, endometriosis, fibroids, adenomyosis, ovarian cyst assessment, and surgery planning where appropriate.
Ultrasound
Gynaecological ultrasound as part of structured assessment and follow-up planning.
Screening and cervix
Pap smears, colposcopy, and cervical biopsies; treatment planning for abnormal screening where indicated, including LEEP/LLETZ where clinically appropriate.
Endometrial assessment
Endometrial biopsy (pipelle) where indicated and targeted investigation of bleeding patterns and risk factors.
Vaginal and vulval health
Vulval pain and irritation, recurrent thrush-type symptoms, GSM and menopausal vaginal symptoms, and vulval dermatoses assessment and management pathways.
Contraception
Counselling and management; IUD insertion and removal; implant insertion/removal where offered; and management of bleeding or pain on contraception.
Fertility
Fertility assessment, basic fertility assistance including ovulation induction and IUI, with referral for advanced assisted reproduction when required.
Hysteroscopy
Diagnostic and operative hysteroscopy, including polyps and bleeding assessment, with curettage where indicated.
Surgery (open + laparoscopic + vaginal)
Laparoscopy for pelvic pain and endometriosis; laparoscopic myomectomy where appropriate; ovarian cyst surgery; hysterectomy where clinically indicated via open, laparoscopic, or vaginal route depending on the safest and most appropriate approach; and a wide range of vaginal procedures where indicated.
Sexual health
STI assessment where clinically appropriate and aligned with symptoms, screening needs, and risk.
Second opinions
Pre-operative counselling, careful risk-benefit discussion, and second opinions for complex or uncertain surgical decisions.
Perimenopause and menopause
Symptom assessment and bleeding patterns; counselling on hormone therapy and non-hormonal options; and management with attention to long-term health and pelvic floor symptoms.
Continuity through pregnancy
Pregnancy care
Structured care from early pregnancy onwards, including assessment of pregnancy concerns, antenatal monitoring, birth planning, and postpartum recovery.
See full pregnancy care services
Pregnancy care
Structured pregnancy care from early review through birth planning and postpartum follow-up, with attention to maternal safety, clear communication, and pelvic floor recovery where relevant.
Early pregnancy
Pregnancy confirmation, dating and viability assessment, and structured review of early pregnancy bleeding or pain, including risk-based triage for concerns such as miscarriage or ectopic pregnancy pathways.
Routine antenatal care
Scheduled follow-up and monitoring, screening for pregnancy-related conditions, and coordination of investigations and referrals as needed.
Risk-aware care
Identifying and managing higher-risk patterns early, and coordinating higher-level care when required, including clear planning around timing, investigations, and follow-up.
Birth planning
Evidence-based discussion around labour and delivery options, balancing safety, preferences, recovery, and longer-term health.
Pelvic floor lens
As a urogynaecologist, pelvic floor symptoms and risk factors can be considered during pregnancy and labour, with prevention and recovery planning where appropriate while prioritising maternal and fetal safety.
Postpartum care
Recovery review, symptom assessment including bladder and pelvic floor symptoms, and structured follow-up where indicated.
Surgical expertise
Advanced minimally invasive and endoscopic surgery
Minimally invasive surgery, sometimes called keyhole surgery, uses small incisions or a camera-based approach to treat selected gynaecological conditions with greater precision.
Where appropriate, this can mean less pain, smaller scars, a shorter hospital stay, and a more structured recovery compared with open surgery. In other situations, a vaginal or open approach may still be the safest and most appropriate option.
A significant part of the practice includes advanced laparoscopic and hysteroscopic surgery, including more complex cases where careful planning and surgical judgement matter as much as technical skill.
Pelvic floor, bladder & prolapse care
What is urogynaecology, and when does subspecialist care make a difference?
Urogynaecology focuses on pelvic floor disorders affecting bladder, prolapse, bowel function, and pelvic support. For many women, these problems are complex, overlapping, and highly treatable with the right expertise.
What is urogynaecology?
Urogynaecology sits between gynaecology and urology and focuses on pelvic floor disorders in women, including bladder symptoms, prolapse, pelvic floor dysfunction, and related bowel symptoms.
It is the part of medicine concerned with how the female pelvic floor functions and what happens when that support system is no longer working properly.
It includes conditions affecting the bladder and urethra, the vagina and pelvic support structures, the pelvic floor muscles, and often the rectum and anal sphincter as well.
This may include bladder leakage, urgency, frequent urination, difficulty emptying the bladder, prolapse, bowel emptying difficulties, pelvic floor pain, and symptoms that can develop after childbirth or previous pelvic surgery.
What is a subspecialist urogynaecologist?
After completing specialist training in obstetrics and gynaecology, Dr Jan Adlam obtained an additional subspecialist qualification in urogynaecology through further fellowship-level training.
This advanced training focuses on female pelvic floor disorders, prolapse, urinary incontinence, bladder dysfunction, and reconstructive pelvic surgery.
When does subspecialist care matter?
This level of expertise becomes especially important when symptoms are complex, persistent, affect quality of life, or have not improved with standard treatment.
It is especially helpful when prolapse, bladder control symptoms, pelvic floor pain, bowel symptoms, childbirth history, or previous surgery all form part of the same picture.
Frequently asked questions
Common questions about gynaecology, urogynaecology, pregnancy, pelvic floor care, and surgery
What is a urogynaecologist?
A urogynaecologist is a gynaecologist with advanced training in pelvic floor disorders, bladder symptoms, urinary incontinence, and prolapse.
When should I see a urogynaecologist?
It may be helpful to see a urogynaecologist if you have urinary leakage, urgency, prolapse, vaginal bulge symptoms, difficulty emptying your bladder, persistent pelvic floor symptoms, or ongoing problems after previous pelvic floor or incontinence treatment.
What is the difference between a gynaecologist and a urogynaecologist?
A general gynaecologist manages a broad range of women’s health concerns. A urogynaecologist has additional focused expertise in pelvic floor problems, bladder symptoms, prolapse, and related reconstructive care.
How does urogynaecology expertise help in pregnancy care?
Pregnancy and childbirth can affect pelvic floor support, bladder function, and recovery after delivery. A background in urogynaecology can add useful perspective when these issues form part of the overall picture.
Do I need surgery for pelvic floor or gynaecological symptoms?
Not always. Many conditions can be managed conservatively or monitored over time. When surgery is considered, the aim is to recommend it only when it is likely to be genuinely helpful and appropriate.
More questions
What does it mean to be a subspecialist urogynaecologist?
A subspecialist has completed additional advanced training in a focused area of practice. In urogynaecology, this means deeper expertise in pelvic floor disorders, prolapse, bladder symptoms, and complex or post-surgical problems.
Can a urogynaecologist help if I have had previous pelvic floor or incontinence surgery?
Yes. Subspecialist assessment can be especially helpful when symptoms persist after previous surgery, when prolapse or leakage recurs, or when a more careful review is needed before deciding on further treatment.
How does pelvic floor expertise help with general gynaecology?
Many symptoms overlap across gynaecology and pelvic floor care. Pelvic pain, pressure, prolapse, bladder symptoms, sexual discomfort, and the effects of previous childbirth or surgery can all influence assessment and treatment planning.
What is minimally invasive or endoscopic gynaecological surgery?
Minimally invasive or endoscopic surgery refers to techniques such as laparoscopy and hysteroscopy, which allow certain conditions to be treated through smaller incisions or through the cervix, depending on the procedure.
Do all women with bladder symptoms or prolapse need subspecialist care?
No. Some problems are straightforward and can be managed simply. Subspecialist care is often most helpful when symptoms are more complex, recurrent, or not improving as expected.
Next step
Not sure where you fit?
If you are unsure whether your concern is mainly gynaecological, pelvic floor-related, pregnancy-related, or overlapping across more than one area, that is completely fine. Start with an appointment and we can clarify the right path together.