Download Rapid Access Ambulatory Diagnostic (RAAD) Hysteroscopy Clinic

Rapid Access Ambulatory Diagnostic (RAAD) Hysteroscopy Clinic
Checklist before referring
PATIENT DETAILS
GP DETAILS
Surname
Forename
Address
Name
Address
Tel No
Date of birth:
Telephone – home:
work:
National Health No:
GP code
1.
Postmenopausal bleeding
2.
Persistent (≥ 4-6 months duration) unscheduled bleeding on HRT /
Tamoxifen treatment
3.
Persistent (≥ 4-6 months duration) intermenstrual bleeding in premenopausal
women ≥ 40 years of age
4.
Women ≥ 40 years with regular heavy periods (menorrhagia or ovular
dysfunctional uterine bleeding (DUB)) who have failed to respond to ≥ 6
months of medical treatment, see below:
the patient should have been treated with at least one of the following drugs
for at least 6 months for appropriate referral
(please tick one or more boxes)
a. tranexamic acid (cyclokapron) 0.5-1.5g t.d.s. during menses
(drug of choice)
b. mefenamic acid (Ponstan) 500mg t.d.s. during menses
c. combined oral contraceptive pill
d. continuous danazol 100-200mg daily
e. progestogens
- if you have ticked only this box, please do not refer,
until one or more of the above treatments has been prescribed for ≥ 6
months duration
5.
For irregular heavy periods (anovular DUB), at least 6 months treatment with
progestogens (usually in second half of cycle)
+ either drugs a, b, c or d as shown above
Professor J K Gupta - Consultant Gynaecologist
Tel: 0121 607 4751
Fax: 0121 607 4795
Email: [email protected]