Dr Cario advises that it is best practice for women to have annual Urogynaecological check-ups. Generally these check-ups begin once patients reach an age where they have become sexually active and these check-ups should continue postmenopausally.

Adolescent years screening

A gynaecological check-up is necessary if the onset of the periods is delayed past the age of 16 or if there is delayed or unusual development of secondary sexual characteristics. It may also be relevant if there is abnormal pelvic pain or bleeding that is interfering with school or work or social activities. Blood tests and ultrasounds are usually the only investigations required and internal pelvic examination is not necessary in patients who have never been sexually active.

Reproductive years screening

Check-ups will include a Pap smear screening for pre-cancerous change affecting the cervix and in particular signs of HPV infection. Patients will be offered immunisation like Guardasil to prevent this infection which is now routinely offered in schools. The check-up will also include investigations for abnormal menstrual bleeding, pelvic pain and recurrent infection of the vulva, vagina, lower genital tract and the bladder. During the reproductive years there will be fertility screening and screening for common conditions like uterine fibroids, ovarian cysts, endometriosis and pelvic inflammatory disease. Generally women will experience problems with their menstrual cycle around the time of the onset of their periods and particularly after the age of 40 when they get closer to the menopause. Following childbearing a Urogynaecological check-up is essential to detect prolapse and manage urinary incontinence. Dr Cario is director of the St. George Urodynamic Centre which is now located in his rooms at the new Hurstville Private Hospital (See information on Urodynamics)

Postmenopausal years

Dr Cario places a lot of importance on his Well Woman screening program. As well as continued Pap smear screening and examination to detect prolapse and manage incontinence, he also performs ultrasound screening of the uterus, tubes and ovaries to detect early signs of cancer as well as bone density screening because patients can lose more than 1% of their bone mass per year once their periods stop. Hormone replacement therapy will be discussed and reviewed. Two yearly breast screening is recommended from the age of 45 or earlier from the age of 40 if there is any suggestion of familial cancer.

Please feel free to attend for check-ups between the routine screening intervals if there has been any change in your symptoms.