Urogynaecology & Menopause
The Urogynaecology Unit at Kings College Hospital NHS Foundation Trust is the largest tertiary referral centre in London and has an established national and international reputation for active clinical research, clinical practice, teaching and training. It currently employs three full-time Consultant Urogynaecologists (Cardozo, Robinson, Bidmead), one subspecialty trainee, two clinical research fellows, two senior urogynaecology nurse specialist, one specialist nurse and two women's health physiotherapists.
Current research funding is from industry grants, competitive grants and private sponsorship. Grants and funding pay for the salaries and overheads of research fellows and specialist additional equipment.
The Menopause Research Unit was established in 1991 by Professor Rymer and commenced with a collaborative study with the Guy's Osteoporosis Unit to investigate the first "nonbleeding" hormone replacement therapy (HRT), the primary outcome being bone density. This 15-year follow up study was the longest running HRT trial in the UK. The Unit collaborates with many other disciplines in GSTFT: radiology, nuclear medicine, neuropharmacology, cardiology, cytology, histopathology, breast medicine, oncology, biochemistry and psychiatry. Research fellows in the unit have focussed on the following areas: HRT and osteoporosis, HRT as add back therapy with GnRH analogues, and cardiovascular effects of different nonbleeding HRTs. A major collaboration with the Institute of Psychiatry is ongoing, investigating the effect of sex hormones on brain function. The Unit has been involved in many pharmaceutical multicentre trials.Current research includes a trial on women who have had premature ovarian failure (POF). If the women choose to have treatment they are randomised to HRT or the oral contraceptive pill. The primary outcome measure is bone density. We are also collaborating with the Daisy Network (a support group for POF sufferers). The research fellow responsible for the trial (her MD project) has also started up an innovative NHS Premature Ovarian Failure Clinic with support from the Guy's & St Thomas' Charity and has established a database. This is an example of a research idea evolving into the delivery of a specialty clinic that is both service and research-orientated.
In the laboratory setting, Professor Kevin O'Byrne is studying the neural mechanisms underlying hot flushes, using a radio-telemetry system to monitor rat tail skin temperature (TST); a relevant animal model, which has been extensively validated. His is the only unit in Europe with this capability and are currently studying the effects of selective ER-alpha and ER-beta agonists and antagonists on the vasomotor disturbances that underlie hot flushes. We are also interested in the potential use of phytoestrogens as "alternative" therapies for hot flushes.
The latest trial is investigating women with premature ovarian failure and randomising them to HRT or OCP. Main outcome measure is bone density.
Having recently established Guy's and St Thomas' as an endometriosis centre with the colorectal surgeons the potential is there to commence research into women who have severe endometriosis.
Being the lead for Reproductive and Sexual Health taching within King's College educational research has centred around the presence of medical students in the gynaecology clinic, chaperones, the introduction of the Gynaecology Teaching Associate Programme and more recently Breast Teaching Associates.
Urogynaecology is currently carried out on two sites within King’s Heath Partners, Kings College Hospital and St Thomas’ Hospital. The Urogynaecology Unit at Kings College Hospital NHS Foundation Trust is the largest tertiary referral centre in London and has an established National and International reputation for active clinical research, clinical practice, teaching and training. The Unit currently employs three full time Consultant Urogynaecologists (Cardozo, Robinson, Bidmead).
Current research funding is from industry grants, competitive grants and private sponsorship. Grants and funding pay for the salaries and overheads of research fellows and specialist additional equipment. Whilst individual grants are not large they have covered the costs of highly successful and innovative research for the last twenty five years.
