University Hospitals of North Midlands NHS

Department of Gynaecology & Obstetrics

Royal Stoke University Hospital
Our Ref: GM/CM/03132890
Newcastle Road
Stoke-On-Trent
Date of Clinic: 14/06/2022
Staffs
Date Typed: 08/11/2022
ST4 6QG
Tel: 01782 715444
Mrs Ho Yee Edge
33 Belton Drive
Secretary: 01782 672379
Cheshire
CW1 4TX
Department of Gynaecology

Dear Dr Flower

Ho-Yee EDGE D.O.B. 13/01/1973

33 Beltony Drive Hospital No. 03132890
CW1 4TX NHS No. 630 236 2857

This is regarding her the Multidisciplinary Team involvement regarding a deep infiltrating
endometriosis. We have reviewed your MRI pelvis and it does suggest a large plaque of
endometriosis in the posterior lower uterine segment is tending into the serosal of the rectosigmoid,
this seems to be a full thickness involvement of the bowel for about 3.5 cm, this several small
endometrioma on the left ovary and there is a 2.5 cm endometriotic cyst on the right ovary.

We had discussed about options of management given the fact that your symptoms have been going
on we had discussed about radical surgery with laparoscopy /robotic hysterectomy + bilateral
salpingo-oophorectomy + urethrolysis plus excision of endometriosis +/-cystoscopy ureteric stenting
+ excision of endometriosis from the bowel (shaving, disc resection, segmental resection and
anastomosis). We have made you aware of the risk with small risk of infection, bleeding, and injury
to internal organs such as bladder, bowel, vessels, ureter and venous thromboembolism and a small
chance of a temporary stoma.

We discuss the case along with our urology colleague (Mr Golash) and colorectal consultant (Mr
Garimella) and we feel as a team that you should be offered surgery at Royal Stoke Hospital which is
a recognised Endometriosis Centre and logistically it would be easier for 3 us to be present there. I
have spoken to our hospitals Private Patient Department and they have confirmed that the centre is
recognised by AXA and the provide a number is 11863.

The codes for surgery would include: P3191 or P3196, Q0752, M2580, M1130.

I hope this is helpful and we will be looking forward to organising the date for surgery preferable at
University Hospital of North Midlands

Thanking you

Yours sincerely

Mr Gourab Misra MBBS MRCOG Dip Advanced Gynae Endoscopy,

MCh Robotic & Minimal Access Surgery, Consultant Gynaecologist
Mr Golash
Consultant Urologist
Urology Department
Lyme Building
UHNM

Sarah Powell
Private Patient Office
Private Patient Office
Main Building
UHNM

Mr Garimella
Consultant Colorectal Surgeon
Colorectal Department
A Block
UHNM

Dr JA Flower
Eagle Bridge H & W Centre
Dunwoody Way
Crewe
Cheshire
CW1 3AW