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Urogynaecology

The urogynaecology service has a close liaison with other health care professionals, including GPs, physiotherapists and continence advisers to enhance communication channels and provide a holistic approach to promotion of continence and prevention of incontinence. 

Urodynamic studies are focused on the lower urinary tract to investigate bladder filling and voiding function, to define bladder storage disorders accurately and to assess objectively the severity of voiding dysfunction. Many urodynamic techniques are used to assess bladder function.

  • Uroflowmetry
  • Filling Cystometry
  • Voiding Cystometry
  • Urethral Pressure Profilometry
  • Bladder Ultrasound Scans

Flow study clinics are held to diagnose patients with voiding problems, including post-operative patients and patients with neurological symptoms. Intermittent self-catheterisation procedure is taught to patients who have voiding difficulties.

Urodynamic studies are performed by an Advanced Midwife Practitioner (AMP) in Women's Health. The AMP performs a nursing/midwifery assessment, plans, initiates care and treatment modalities within agreed interdisciplinary protocols to achieve patient centred outcomes and evaluates continence programmes for women.

Referral to the Urodynamics Clinic

Patients must have a referral letter from a GP. The letter may be posted or faxed for the attention of Dr. D Keane, Consultant Urogynaecologist. As there is a waiting list for Dr. Keane's Urogynaecology Clinic, direct referrals may be made to the Urodynamics Clinic in the interim while awaiting appointment to see Dr. Keane. Appointments for both Urodynamics and Urogynaecology Clinics are given solely on the basis of a referral letter by the GP.

 The following are guidelines when referring patients for urodynamic studies:

  • Patients with significant mixed urge and stress urinary incontinence.
  • Patients with recurrent incontinence, i.e incontinence following previous failed surgery.
  • Patients with incontinence and evidence or neurological disease.
  • Any patient who will be having a surgical procedure for incontinence.

Prior to referral, patients with frequency, nocturia, urgency or urge incontinence should be treated with an anticholinergic first and only referred for urodynamics if this does not succeed. Currently, there is a wide range of anticholinergic drug therapy available for symptoms or urge urinary incontinence. Patients who have symptoms of recurrent urinary tract infections are not suitable for urodynamic studies. The performance of urodynamics may exacerbate their symptoms.

The Physiotherapy Department works closely with urogynaecology services. Following urodynamic studies, patients are referred directly for physiotherapy.

Service Provider
Dr Declan Keane
Dr Gerard Agnew
Ms. Mary Jacob
Ms. Maria O'Connell

Clinic Details
Monday - Friday 08.00 - 16.00 hrs
Tel: (01) 637 3502 or (01) 637 3504
Fax: (01) 637 3191