The practice staff includes Dr Al Donoghue and Mrs Maureen Rankin in the main office, and supplementary staff in the peripheral consulting clinics. Patients may obtain appointments by telephoning Maureen on the office freephone. Referrals from primary medical practitioners (GPs) are welcome.
We have a culture which elevates the interest of our patients to the highest consideration. It is the origin of our customer focus, and we are confident that you will find our relationship attitude attentive to full information transfer and your empowerment in terms of decision making affecting diagnosis and treatment.
Our appointment schedules allow prompt consultation avoiding distressing long wait times.
Please, call us on our freeline to Maureen, or email us if you have any questions, or wish to set-up an appointment.
Dr Al Donoghue was fully accredited in October 2000 by AAVIS (Australasian Association of Vaginal and Incontinence Surgeons) as a surgeon trained in the performance of operations according to the "Integral Theory" of Professors Petros and Ulmsten. Accreditation follows a personal course of post-graduate surgical instruction with Professor Petros in Perth in Western Australia.
Subsequent to further training and experience he was appointed as a Preceptor Surgeon for teaching Integral Theory operations in April 2002.
Click here to see a detailed account of the Integral Theory. (Suitable for doctors also) Use your back button to return to our homepage.
(The name "Kvinno" is given because it means "woman" in Swedish, and Professors Petros and Ulmsten did the research for the Integral Theory in Uppsala, Sweden).
This theory offers a complete concept of the function of the female pelvic floor including the role of the vaginal support tissues in normal and abnormal bladder function. The restoration of normal bladder function, treating involuntary loss of urine, pelvic pain, and prolapse, is accomplished by methods aimed at re-creating the anatomy of the vagina and its supporting tissues and ligaments (Restoration of Form provides Restoration of Function).
Emphasis is laid on the importance of preserving tissue rather than needless resection. For this reason hysterectomy is avoided if uterine preservation is consistent with any other needs in treatment. The uterus can be regarded as the keystone in the pelvic arch of structures, and its preservation avoids the long-term degenerative sequelae associated with interruption of the blood supply of the cardinal ligaments supporting the uterus and vault of the vagina.
Our Kvinno Clinic uses computerised urodynamic examination to determine the pressure reactions of the bladder during filling and emptying. This means that your bladder function can be studied in detail, together with clinical examination using ultrasound which clarifies the condition of the vaginal support mechanisms of the bladder, to diagnose the cause of involuntary loss of urine, or of abnormal flow rate or emptying.
Frequently significant help in bladder function can be gained by pelvic floor treatments, squatting, biofeedback etc. We also have a complete range of operative treatments based upon the Integral Theory for correction of problems not adequately helped by the conservative treatments.
We are able (using the ultrasound and with support to different areas of the vagina and bladder) to perform "virtual operation" tests in the office which indicate reliably the likely effect of proceeding to real operations.
Link to Professor Petros' website Patient Information page, "How the Integral Theory may help you". (Use browser "Back" button to return)
Colposcopy examination is needed when you have an abnormal cervix or vaginal smear report.
Dr Al Donoghue has twenty years experience of managing abnormal cervical cytology, including colposcopy assessment, and operative procedures in treatment of the various lesions which may be present. He is a member of the Australian Society for Colposcopy and Cervical Pathology (ASCCP) an active post-graduate society, which promotes quality standards, and whose web site presents much interesting data www.asccp.com.au.
At Lucanus Gynaecology we offer fully equipped colposcopy clinic services. Colposcopy is the study of the vagina and cervix by microscopy to identify areas of abnormal skin growth which may range from mildly atypical to pre-cancerous or invasive cancer. The procedure is relatively quick and not usually painful. Biopsies may be taken to correlate the smear and tissue study reports.
We have a digital camera on our colposcope with a high resolution monitor which means you can see your cervix during the examination, and features are pointed out to you. Image capture by the computer produces glossy photographic printouts for you and your referring practitioner for your records.
Our quality assurance program supplies selected anonymous images by digital transfer to another specialist colposcopist for examination. This allows review of specialist reporting, and is done for your reassurance and maintenance of quality standards.
Click the link for our Colposcopy Information File , which may be downloaded.
Click the link for a detailed information file on HPV genital infection from the International Infectious Disease Society for O&G of Europe.
Click the link for a detailed information file "Critical Guidelines" for Abnormal Pap smears courtesy www.medscape.com.
Click the link for a report from Drs McGoogan and Linder (2003) on the advantages of Liquid Based Cytology assessment.
Click the link for
information about the New Zealand National
Cervical Screening Program, which maintains registers of cytology smear
results for each enrolled woman.
Osteoporosis is a generalised disease of bone which results in thinning of bones which are then prone to fracture under relatively minor stress. The disease may cause chronic back pain from vertebral body collapse. It affects women particularly after their menopause, and may be prevented or alleviated by treatment with estrogen hormone or some other treatments.
Lucanus Gynaecology is able to assess the state of the bones by scanning with our Myriad Ultrasound Bone Scanner which tests the tibia or shin bone for velocity of conduction of ultrasound energy. This method of testing has been approved by the USA Food and Drug Administration (FDA). Abnormal results can be supplemented by DEXA absorption densitometry.
Results are expressed in terms of comparison with the bones of young women (T score) and with the bones of aged-matched peers (Z score). The test is painless, and requires access only to the shinbones.
Call or email Maureen for an appointment or to get an explanatory pamphlet, or download it here.
Since the termination of the Womens Health Initiative (WHI) trial in the USA in mid-2002, significant changes in recommendations for Hormone Replacement Treatment have been promoted by the New Zealand Guidelines Group (NZGG) and Medsafe. Current recommendations from the NZGG may be viewed on their website.
Briefly the trial showed that in a randomised controlled trial (RCT) using Premarin and Provera in the treatment arm, the incidence of breast cancer, strokes, venous thrombo-embolism (clots), and heart attacks was raised in the treatment arm compared with controls. It was concluded that in such combined hormone treatment the risks outweighed the benefits. Other types of medication are available to modify symptoms of menopause or to protect bone.
Since the recommendations following the WHI study were announced many New Zealand women have terminated their HRT. Many have found however that intolerable effects have followed cessation of treatment, and many have restarted therapy, albeit some on different forms. To the current date gradual cessation of HRT has been observed by a large proportion of users.
The question as to risk/benefit ratio for a particular woman demands analysis of her individual factors, best done in consultation. Preliminary study of the literature may be done on the Internet.
OFFICE TELEPHONE (MAUREEN) 0800 600 444 OR 06 348 1150
OFFICE FACSIMILE 0800 600 444 OR 06 348 1151
DR AL DONOGHUE MOBILE 021 477 724
EMAIL AL DONOGHUE al@lucanus.co.nz
EMAIL MAUREEN lucanus@clear.net.nz
MAIL ADDRESS LUCANUS GYNAECOLOGY, PRIVATE BOX 4215, WANGANUI, NEW ZEALAND.
PHYSICAL FACILITY ADDRESSES
Click for anaesthetist information on the "Hospitals" page.
Dr Al Donoghue
Al Donoghue is a graduate of Otago University Medical School, and specialises in Gynaecology and Obstetrics with postgraduate training at Addenbrooke's Hospital in Cambridge, England. He holds the following degrees and diplomas:
He was a Consultant in Obstetrics and Gynaecology to the Otago Area Health Board for twelve years until 1992, then for the Manawatu-Wanganui Area Health Board until the formation of the Good Health Wanganui Ltd Hospital Company, at the time of the introduction of the Crown Health Enterprises in New Zealand Public Hospitals. In 1992 he founded the Lucanus Gynaecology practice, currently a division of Lucanus Corporation Ltd.
He is fully registered as a specialist Gynaecologist with:
He is a member of the following medical societies:
Social and Community Integration:
Al is married to Gael who is a pharmacist, and they have three sons. He is an active Rotarian with membership in the Rotary Club of Wanganui, and is a Paul Harris Fellow.
He is a licensed amateur radio operator ZL4QT. He has an interest in radio and electro-computer technology, which facilitates the technology foundation to Lucanus Gynaecology.
He also enjoys outdoor activity, utilising the proximity of Mt Ruapehu and Mt Egmont National Parks, and the Tararua and Ruahine Forest Parks, to maintain physical activity in the natural environment.
We are pleased to welcome Maureen Rankin to Lucanus Gynaecology since June 2001. Maureen is now our front office manager and friendly face to all our patients. She answers your phone calls, and makes all arrangements for patient appointments and surgical placements. She has a complete knowledge of the services offered and the procedures of our office. She will help with estimates for surgical treatments, and is happy to help negotiate with health insurers if required.
Maureen has brought her organisational skills from GHW Ltd, where she has worked in the Central Patient Administration department for ten years.
Please call (0800 600 444) or email Maureen for advice and help with appointments and to make operation arrangements.
Patients of Lucanus Gynaecology have access to specialist anaesthetists for care during surgical procedures. It is important that the relationship between the patient's surgeon and anaesthetist is based on a high degree of mutual understanding and trust, which arises from long experience in collaborating to deliver synergistic care to patients at operation.
At Aorangi Hospital anaesthetic services are provided to our patients by doctors who are specialist anaesthetist Fellows of the Australian and New Zealand College of Anaesthetists.
Your assurance of up-to-date diagnosis and treatment at Lucanus Gynaecology lies in our attention to customer focus. We seek to empower our patient clients by being fully informative about our qualifications and methods. This patient satisfaction is the real driver of our patient service.
Royal Australian and New Zealand College of Obstetricians and Gynaecologists. (RANZCOG) http://www.ranzcog.edu.au/
The means of professional updating is by continued medical education with specific requirements laid down by regulatory bodies. RANZCOG is the body governing training and Fellowship certification in the practice of Obstetrics and Gynaecology. In 1987 it was at the forefront of continuing professional improvement when it instituted five-yearly audit cycles of its Fellows.
Today the audit cycle is reduced to three years, during which fellows must attain at least 150 cognate points allocated by RANZCOG, with at least 25 points derived from practice improvement (quality assurance) activities. Other activities to obtain cognate points include seminars, conferences, personal surgical training, teaching, or peer review quality assurance sessions. Continuance of Fellowship recognition within the College is dependent on success in this assessment.
Dr Al Donoghue has attained the total of required CME points in the three years to April 2008, and has entered a new cycle to April 2011.
Click here to see Dr Donoghue's current FRANZCOG diploma.
Australasian Association of Vaginal and Incontinence Surgeons. http://www.aavis.org
AAVIS confirms approved surgeons following personal attachment training in the 'new paradigm' of the Integral Theory.
Al Donoghue is listed as an accredited New Zealand practitioner surgeon in the AAVIS website above (now under re-development), following a personal attachment to Professor Petros in Perth, WA, in October 2000.
In April 2002 he was appointed to Preceptor Surgeon status in AAVIS. Click on the AAVIS link above to view AAVIS recommendations.
Australian Gynaecological Endoscopy Society. http://www.ages.com.au
The Australian Gynaecological Endoscopy Society is the leading body effectively regulating the post-graduate practice of endoscopic surgery. Al Donoghue has attended many conferences and surgical seminars of the Society over the last ten years. He is a practising surgeon utilising laparoscopy and hysteroscopy when clinically indicated. Click on the AGES link above to see surgeon members and recommendations.
Colposcopy Practice
Australian Society of Colposcopy and Cervical Pathology. http://www.asccp.com.au
Membership of the Australian society offers more update meetings and exposure to international experts. The website contains data on quality assurance, and discussion on developing proposals.
Al Donoghue has developed, together with Dr Bernie Brenner of Auckland, quality assurance procedures for colposcopy skills by anonymous image transfer over the internet. This allows surgeons of consultant level to remotely "sit-in" on colposcopy examinations. This allows a measure of peer review which happens rarely elsewhere even in big hospital clinics. It is a means of preventing undetected skills decay which might otherwise slowly impair the quality of service. Patients' confidentiality is maintained by this technology.
New Zealand Society of Colposcopy and Cervical Pathology (NZSCCP).
Al Donoghue has held membership following approved training in 1985. This society is now inactive when compared to the ASCCP.
Update Meetings 2000 and since.
Al Donoghue has attended the following Continuing Medical Education and other meetings.
The delivery of specialist surgery demands fastidious care to make correct diagnoses, and constant upgrading of skills to maintain the application of the most effective treatment methods. As methods are improved by better technology or perfected understanding of problems, it is natural that solutions offered to patients will undergo changes year by year. The challenge to the doctor is to offer modern treatment methods while resisting unproven or doubtfully effective solutions.
This improvement is a result of research which is carried out internationally, and which is shared by doctors in societies and at international meetings. This is why Lucanus Gynaecology lays heavy stress on participation in specialist scientific meetings held around the world. The emergence of the "Integral Theory" (see Kvinno above) and its integration into clinical practice is one example of such progress.
Thus it is natural for a specialist company like Lucanus Gynaecology to modify treatments offered in light of the continuing knowledge base we are working with. This change illustrates our fidelity to continuing improvement. Updating of the operative methods we employ to correct tissue abnormalities or deficiencies will follow this improvement, making our services more valuable to our patient clients. We are very open to discuss this with clients.
This site revision is up to date at June 2010.
