Imperial College London

DrRuwanFernando

Faculty of MedicineDepartment of Metabolism, Digestion and Reproduction

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 3312 1959r.fernando Website

 
 
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Location

 

Department of Obstetrics & GynaecologyMint WingSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
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144 results found

Asfour V, Gibbs K, DaSilva AS, Fernando R, Digesu GA, Khullar Vet al., 2019, Validation study of ultrasound bladder wall thickness measurements, INTERNATIONAL UROGYNECOLOGY JOURNAL, Vol: 30, Pages: 1575-1580, ISSN: 0937-3462

Journal article

Purwar B, Cartwright R, Cavalcanti G, Digesu GA, Fernando R, Khullar V, Purwar B, Cartwright R, Cavalcanti GDA, Digesu GA, Fernando R, Khuallr Vet al., 2019, The impact of bariatric surgery on urinary incontinence: a systematic review and meta-analysis, INTERNATIONAL UROGYNECOLOGY JOURNAL, Vol: 30, Pages: 1225-1237, ISSN: 0937-3462

Journal article

Tailor V, McHayle A, Morris E, Gore M, Turner J, Bhide A, Patel M, Rahim A, Fernando R, Digesu A, Khullar Vet al., 2019, PERINEOMETER AND DIGITAL EXAMINATION VARIATION WITH THE LEVATOR ANI HIATUS SIZE, 49th Annual Meeting of the International-Continence-Society (ICS), Publisher: WILEY, Pages: S48-S49, ISSN: 0733-2467

Conference paper

Asfour V, Gibbs K, Franklin L, Digesu GA, Fernando R, Regan L, Khullar Vet al., 2019, Ultrasound technique for the assessment of urethral descent assessment technique (UDAT) in healthy volunteers, Journal of Obstetrics and Gynaecology, ISSN: 0144-3615

Bladder neck descent (BND) has been implicated in the pathophysiology of stress incontinence and prolapse. The aim of this study was to evaluate a novel 2D technique for the evaluation of BND, the Urethral Descent Assessment Technique (UDAT). UDAT involves measuring BND during dynamic manoeuvres in live 2D ultrasound, by using the geometrical properties of parallel lines. The internal urethral meatus and distal end of the urethra are used as reference points. Y1 is the urethral height at rest (also the urethral length when the urethra is straight). Y2 is the urethral height on Valsalva. Y1 and Y2 are parallel lines. Y1–Y2 = BND. A horizontal line (X) connecting Y1 and Y2 is the forward movement of the bladder neck.Y1 mean 30.4 mm (95% CI ± 1.36 mm). Y2 mean 24.2 mm (95% CI ± 2.58 mm). X mean 12.1 mm (95% CI ± 1.66 mm). BND mean 6.2 mm (95% CI ± 1.47 mm). Bland–Altman plots and linear regression showed that UDAT is repeatable and reliable.

Journal article

Tailor V, Digesu A, Khullar V, Fernando R, Gore M, Bhide A, Elneil S, Van Kerrebroeck P, Heesakkers Jet al., 2019, Results of a prospective, multicenter study evaluating impact of a wireless implantable tibial nerve stimulator at 3 years in subjects with overactive bladder symptoms (OAB), British Congress of the RCOG, Publisher: WILEY, Pages: 227-228, ISSN: 1470-0328

Conference paper

Da Silva AS, Asfour V, Digesu GA, Cartwright R, Fernando R, Khullar Vet al., 2019, Levator Ani avulsion: The histological composition of this site. A cadaveric study, NEUROUROLOGY AND URODYNAMICS, Vol: 38, Pages: 123-129, ISSN: 0733-2467

Journal article

Asfour V, Gargasole C, Fernando R, Digesu GG, Khullar Vet al., 2018, Urodynamics are necessary for patients with asymptomatic pelvic organ prolapse, NEUROUROLOGY AND URODYNAMICS, Vol: 37, Pages: 2841-2846, ISSN: 0733-2467

Journal article

Ford A, Asfour V, Tailor V, Gibbs K, Fernando R, Digesu A, Khullar Vet al., 2018, Diamine oxidase and mast cell count; Two separate roles in the pathogenesis of bladder pain syndrome, International Urogynaecology Association Meeting, Publisher: SPRINGER LONDON LTD, Pages: S24-S24, ISSN: 0937-3462

Conference paper

Bhide A, Digesu A, Fernando R, Khullar Vet al., 2018, Can urinary BDNF be a useful biomarker in lower urinary tract symptom assesment? A meta-analysis, International Urogynaecology Association Meeting, Publisher: SPRINGER LONDON LTD, Pages: S270-S271, ISSN: 0937-3462

Conference paper

Bhide A, Digesu A, Fernando R, Khullar Vet al., 2018, Evaluation of urinary symptoms and urodynamic abnormalities in HTLV-I infected individuals with associated myelopathy, International Urogynaecology Association Meeting, Publisher: SPRINGER LONDON LTD, Pages: S271-S271, ISSN: 0937-3462

Conference paper

Veit-Rubin N, Mahboobani KS, Cartwright R, Ford A, Asfour V, Digesu A, Fernando R, Khullar Vet al., 2018, RELATIONSHIP BETWEEN THE URINARY, UROTHELIAL AND VAGINAL MICROBIOME IN OVERACTIVE BLADDER, Meeting of the International-Continence-Society (ICS), Publisher: WILEY, Pages: S41-S42, ISSN: 0733-2467

Conference paper

Asfour V, Digesu GA, Ford A, Fernando R, Khullar Vet al., 2018, Re: Ultrasound bladder wall thickness and detrusor overactivity: a multicentre test accuracy study Is it fair to assess new imaging techniques against a poor gold standard?, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 125, Pages: 395-395, ISSN: 1470-0328

Journal article

Bray R, Cacciatore S, Jimenez B, Cartwright R, Digesu A, Fernando R, Holmes E, Nicholson JK, Bennett PR, MacIntyre DA, Khullar Vet al., 2017, Urinary metabolic phenotyping of women with lower urinary tract symptoms, Journal of Proteome Research, Vol: 16, Pages: 4208-4216, ISSN: 1535-3893

Lower urinary tract symptoms (LUTS), including urinary incontinence, urgency and nocturia, affect approximately half of women worldwide. Current diagnostic methods for LUTS are invasive and costly, while available treatments are limited by side effects leading to poor patient compliance. In this study, we aimed to identify urine metabolic signatures associated with LUTS using proton nuclear magnetic resonance (1H NMR) spectroscopy. A total of 214 urine samples were collected from women attending tertiary urogynecology clinics (cases; n = 176) and healthy control women attending general gynecology clinics (n = 36). Despite high variation in the urine metabolome across the cohort, associations between urine metabolic profiles and BMI, parity, overactive bladder syndrome, frequency, straining, and bladder storage were identified using KODAMA (knowledge discovery by accuracy maximization). Four distinct urinary metabotypes were identified, one of which was associated with increased urinary frequency and low BMI. Urine from these patients was characterized by increased levels of isoleucine and decreased levels of hippurate. Our study suggests that metabolic profiling of urine samples from LUTS patients offers the potential to identify differences in underlying etiology, which may permit stratification of patient populations and the design of more personalized treatment strategies.

Journal article

Da Silva AS, Asfour V, Digesu A, Fernando R, Sorrentino F, Khullar Vet al., 2017, A QUANTITATIVE HISTOLOGICAL EVALUATION OF THE PUBOVISCERAL ENTHESIS COMPARISON WITH OR WITH SONOGRAPHIC APPEARANCE OF LEVATOR ANI AVULSION., 47th Annual Meeting of the International-Continence-Society (ICS), Publisher: WILEY, Pages: S58-S59, ISSN: 0733-2467

Conference paper

Purwar B, Cartwright R, Cavalcanti G, Digesu A, Fernando R, Khullar Vet al., 2017, THE EFFECT OF BARIATRIC SURGERY ON URINARY INCONTINENCE: A SYSTEMATIC REVIEWAND META-ANALYSIS, International Urogynaecology Association Meeting, Publisher: SPRINGER LONDON LTD, Pages: S11-S12, ISSN: 0937-3462

Conference paper

Ford AA, Bray R, Asfour V, Fernando R, Digesu A, Khullar Vet al., 2017, OVERACTIVE BLADDER AND BLADDER PAIN SYNDROME; PAIN OF THE SAME SPECTRUM?, International Urogynaecology Association Meeting, Publisher: SPRINGER LONDON LTD, Pages: S65-S66, ISSN: 0937-3462

Conference paper

Purwar B, Cartwright R, Ford AA, Bray R, Veit-Rubin N, Digesu A, Fernando R, Khullar Vet al., 2017, IMPACT OF PELVIC ORGAN PROLAPSE ON THE SIZE OF UROGENITAL HIATUS - A COMPARATIVE STUDY OF WOMEN WITH AND WITHOUT PROLAPSE, International Urogynaecology Association Meeting, Publisher: SPRINGER LONDON LTD, Pages: S142-S142, ISSN: 0937-3462

Conference paper

Bray R, Hendicken C, Ford A, Digesu A, Fernando R, Khullar Vet al., 2017, Should our approach to continence surgery differ depending on ethnicity?, EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, Vol: 211, Pages: 204-204, ISSN: 0301-2115

Journal article

Bray R, Cartwright R, Digesu A, Fernando R, Khullar Vet al., 2017, A randomised controlled trial comparing immediate versus delayed catheter removal following vaginal prolapse surgery, EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, Vol: 210, Pages: 314-318, ISSN: 0301-2115

Journal article

Bray R, Cartwright R, Digesu A, Fernando R, Khullar Vet al., A randomised controlled trial comparing immediate versus delayed catheter removal following vaginal prolapse surgery, European Journal of Obstetrics and Gynecology and Reproductive Biology, ISSN: 0028-2243

OBJECTIVE: It is unclear if any catheterisation is necessary after vaginal surgery for pelvic organ prolapse. The aim of this study was to determine if indwelling catheterisation is necessary after these procedures. STUDY DESIGN: A randomised controlled trial of immediate post-operative removal of catheter compared to a suprapubic catheter (SPC) after vaginal prolapse surgery. In the Suprapubic group the catheter was left on free drainage until a voiding trial was commenced at 48hrs. Women in the immediate removal group underwent in/out catheterisation only if they had not voided by 8hrs after surgery to ensure the bladder did not over-distend. RESULTS: 55% (n=17) of patients in the immediate removal group did not require catheterisation postoperatively. A further 13 (42%) patients only required one in/out catheterisation 8 hours post operatively. In the immediate removal group duration of catheterisation was significantly shorter (median 0hrs, IQR 0-8 hours, range 0-16 hours) vs (6 days (IQR 2-8 days, range 2-19 hours) p=0.001). The duration of hospital stay (7 days (range 3-16) vs. 9 (range 3-27) p=0.014), day of first mobilisation (Day 1, range 0-2, vs. Day 2, range 1-4, p=0.001), and rate of Symptomatic bacturia (16% vs. 52%, p<0.01) were all significantly better with immediate catheter removal. CONCLUSIONS: After vaginal surgery for pelvic organ prolapse, the majority of patients do not require extended catheterisation. Early removal of a catheter reduces urinary tract infection and significantly decreases hospital stay. Such a policy should result in improved patient satisfaction and reduced hospital costs.

Journal article

Vijaya G, Cartwright R, Bhide A, Derpapas A, Fernando R, Khullar Vet al., 2016, Reliability and validity of urinary nerve growth factor measurement in women with lower urinary tract symptoms, NEUROUROLOGY AND URODYNAMICS, Vol: 35, Pages: 944-948, ISSN: 0733-2467

Journal article

Veit-Rubin N, Cartwright R, Singh AU, Digesu GA, Fernando R, Khullar Vet al., 2016, Association between joint hypermobility and pelvic organ prolapse in women: a systematic review and meta-analysis, Publisher: SPRINGER LONDON LTD, Pages: 1469-1478, ISSN: 0937-3462

Conference paper

Bray R, Derpapas A, Fernando R, Khullar V, Panayi DCet al., 2016, Does the vaginal wall thin as prolapse increases?, International Urogynecology Journal, Vol: 28, Pages: 397-402, ISSN: 1433-3023

Introduction and hypothesisThe pathophysiology of prolapse is not well understood. However, two main theories predominate: either the fibromuscular layer of the vagina develops a defect/tears away from its supports, or its tissues are stretched and attenuated. The aim of this study was to assess how vaginal wall thickness (VWT) is related to vaginal prolapse.MethodsThe study group comprised 243 women with symptomatic prolapse recruited from the Outpatient Department of a tertiary referral centre for urogynaecology. A history was taken and women were examined to determine their POP-Q score. Using a previously validated technique, ultrasonography was used to measure the mean VWT at three anatomical sites on the anterior and posterior walls. Scores were then compared using t tests, the Kruskal-Wallis test and the Friedman test.ResultsThe mean age of the patients was 59.7 years (SD 12.0 years range 38 – 84 years). For each measurement VWT reduced as prolapse grade increased until the prolapse extended beyond the hymen. Women with grade 3 prolapse had a significantly higher mean VWT than women with grade 1 or 2 contained prolapse. Menopause status did not have a significant effect on the VWT.ConclusionsVWT is lower in women with vaginal prolapse until the prolapse extends beyond the hymen and then VWT is thicker and comparable with women without prolapse. This may be explained by changes in the vaginal tissue including reduction of collagen, elastin and smooth muscle, as well as fibrosis in exposed tissues, rather than by defects in the vagina.

Journal article

Veit-Rubin N, Cartwright R, Purwar B, Bray R, Ford A, Digesu A, Fernando R, Khullar Vet al., 2016, THE AS SOCIATION BETWEEN JOINT HYPERMOBILITY AND URINARY INCONTINENCE IN WOMEN: A SYSTEMATIC REVIEW AND META-ANALYSIS, International Urogynaecology Association Meeting, Publisher: SPRINGER LONDON LTD, Pages: S88-S89, ISSN: 0937-3462

Conference paper

Ford AA, Bray R, Purwar B, Cartwright R, Fernando R, Digesu A, Khullar Vet al., 2016, MANNOSE BINDING LECTIN AND A PREDISPOSITION TO RECURRENT URINARY TRACT INFECTIONS IN WOMEN, Publisher: SPRINGER LONDON LTD, Pages: S41-S42, ISSN: 0937-3462

Conference paper

Bray R, Ford AA, Purwar B, Fernando R, Khullar V, Panayi DCet al., 2016, DOES THE VAGINAL WALL THIN AS PROLAPSE INCREASES?, Publisher: SPRINGER LONDON LTD, Pages: S130-S131, ISSN: 0937-3462

Conference paper

Veit-Rubin N, Cartwright R, Rahmanou P, Gopalan V, Bray R, Purwar B, Digesu A, Fernando R, Khullar Vet al., 2016, EPIDEMIOLOGY, DIAGNOSIS, PROGNOSIS AND MANAGEMENT OF BLADDER TUMOUR IN NEURO-UROLOGICAL PATIENTS: A SYSTEMATIC REVIEW OF THE LITERATURE, NEUROUROLOGY AND URODYNAMICS, Vol: 35, Pages: S162-S163, ISSN: 0733-2467

Journal article

Veit-Rubin N, Cartwright R, Purwar B, Bray R, Digesu A, Fernando R, Khullar Vet al., 2016, CURRENT PERCEPTION THRESHOLDS OF PERINEAL AFFERENTS IN WOMEN WITH LOWER URINARY TRACT SYMPTOMS, NEUROUROLOGY AND URODYNAMICS, Vol: 35, Pages: S87-S88, ISSN: 0733-2467

Journal article

Cavalcanti G, Bray R, Ford A, Bhawana P, Cartwright R, Fernando R, Khullar V, Digesu Aet al., 2016, CLINICAL AND URODYNAMIC FEATURES ASSOCIATED WITH DETRUSOR OVERACTIVITY IN WOMEN WITH LOWER URINARY TRACT SYMPTOMS, NEUROUROLOGY AND URODYNAMICS, Vol: 35, Pages: S219-S220, ISSN: 0733-2467

Journal article

Ford A, Bray R, Fernando R, Digesu A, Khullar Vet al., 2016, DEFICIENCY OF MANNOSE BINDING LECTIN AND DIAMINE OXIDASE AND A PREDISPOSITION TO RECURRENT URINARY TRACT INFECTIONS IN WOMEN, Annual Meeting of the International-Continence-Society (ICS), Publisher: WILEY-BLACKWELL, Pages: S279-S280, ISSN: 0733-2467

Conference paper

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