This is often a consequence of childbirth and menopause and millions of women worldwide continue to put up with it as a 'woman's lot'. There is no need to do this since highly effective options exist for alleviating the stress, embarrassment and hygiene issues that these problems cause. These treatments include physiotherapy, tablets, devices and operations.

New surgical techniques using minimally invasive slings have revolutionised the treatment with cure rates around 90%. Sometimes (for patients with urinary incontinence), detailed tests called urodynamics are organised which help to diagnose the exact problem. This aids in planning the most effective treatment with the least side-effects. Anil has his own state of the art urodynamics facility with a highly trained and empathic nurse in attendance. Referral to expert pelvic floor physiotherapists is also worthwhile and in some cases can alleviate the need for surgery.

One of the symptoms of this is the feeling of 'something coming down' or indeed a laxity in the vagina. Again, childbirth is the main culprit and women often put up with the problems that prolapse causes for many years. Many patients report difficulty emptying their bowels effectively when they defecate and others have co-existing urinary difficulties including incontinence. Others report difficulty with intercourse or the protrusion of a lump from the vagina.

A thorough assessment will lead to effective therapy being offered and this will include the option of using mesh to fix the prolapse. The pros and cons of traditional and mesh surgery will be discussed in detail and of course your views will be considered too. Sometimes, bowel symptoms will need thorough assessment by a doctor specialising in bowel problems and a referral will be arranged.

Heavy periods cause major disruption to a woman's working and social life by causing embarrassment, tiredness, pain and anaemia. Management has come a very long way and it is no longer a case of hysterectomy for everyone. There are a variety of safe and effective treatments including Mirena®, Novasure® endometrial ablation and hysterectomy.

Anil will discuss the investigation and treatment options with you so that care can be tailored to your individual needs and requirements. Where a hysterectomy is considered, all the pros and cons are discussed including the options of preserving the cervix and the ovaries. The route of the hysterectomy is also discussed in detail (options include vaginally, laparoscopically and abdominally).

This is when vaginal bleeding recurs after the menopause ('the change') has occurred. It can be quite alarming and although in most cases is due to benign changes, it does need thorough investigation, since not only can more serious problems be quickly diagnosed, but effective treatments can be undertaken in a timely manner. A pelvic scan is a useful starting point and Anil has many years of experience with PMB.

This is when the lining of the womb is also present in places other than the inside of the womb itself e.g. inside the lower tummy, or behind the lower uterus or on the ovaries. As knowledge about endometriosis has spread, women are realising that they do not have to put up with debilitating pelvic pain every month. Anil believes in a full discussion of all the options available including lifestyle techniques, medications, devices and operations. The treatment of this debilitating condition has advanced considerably with the advent of laparoscopic surgery. Anil trained in endometriosis treatment techniques at the University Hospital in Cardiff, UK. It should be noted that surgery is not always the answer and other managements will also be discussed.

Being told that your recent routine smear was abnormal can come as quite a shock. A clear explanation about an abnormal smear goes a long way to alleviate the major anxiety that these cause. Colposcopy is the detailed examination of the cervix and serves to reassure the majority of women with an abnormal smear. Anil has successfully undergone the thorough assessed training programme of the British Society of Colposcopy and Cervical Pathology and has 15 as a colposcopist. Colposcopy is a straightforward, well-tolerated procedure that enables an accurate diagnosis of the underlying problem and subsequent safe effective treatment.

A diagnosis of polycystic ovaries can leave a woman feeling bewildered and anxious. Knowledge is the key to reducing anxiety and Anil can offer individually appropriate options for management of this problem. PCOS is a very common condition that leads to many symptoms including irregular periods, infertility and weight gain. Anil will discuss these in a sensitive and empathic manner including natural management and drug therapy to protect your health in the future.

Although men in New Zealand have a very high rate of uptake of vasectomy, women still often seek permanent forms of contraception. The established procedure is called a Laparoscopic Sterilisation (done with 'keyhole surgery') and it makes the Fallopian tubes become blocked to prevent the egg and sperm from meeting. Anil will assess patients thoroughly and this includes discussion of the alternatives in detail, so that the decision to have a permanent sterilisation is made carefully. A newer method of female permanent contraception is hysteroscopic sterilisation that can be done under local anaesthetic. This involves blocking the Fallopian tubes via a small telescope that is placed inside the uterus without any cuts or incisions.