E F Nigel Holland
Consultant Gynaecologist and Obstetrician
Menu Clinical interests

I am a Consultant Gynaecologist at Warrington and Halton Hospitals NHS Foundation Hospitals.Private patient referrals are seen at the Spire Cheshire Hospital, Stretton, Warrington.

I qualified at Liverpool University. I was a Registrar on the Mersey rotation before going to work in as a Research Fellow at King's College and Dulwich Hospitals where I did my doctorate on HRT and osteoporosis. Thereafter I was appointed as a Senior Registrar in Yorkshire working firstly in Hull then at Leeds General Infirmary. I took up my post as a Consultant at Warrington Hospital in 1995.

I have a wide experience in all aspects of gynaecological care having worked in tertiary specialist centres for colposcopy and oncology, reproductive endocrinology including menopause and infertility, and urinary incontinence. I have published papers, articles on these subjects and have presented at national and international conferences.

I am a Fellow of the Royal College of Obstetricians and Gynaecologists. I am registered with the General Medical Council. I have completed the Royal College of Obstetricians and Gynaecologists Continuing Medical Education Programme (CME). I am appraised annually.

CLINICAL EXPERIENCE

I have been specializing in gynaecology for more than twenty-five years during which time I have developed a wide expertise. I am well versed with the management of period problems, hormonal dysfunction such as infertility and premenstrual syndrome, fibroids, endometriosis, ovarian cysts and gynaecological cancer. I have a lot of experience in abdominal and vaginal surgical procedures and also laparoscopy. Leaflets for the commonest procedures that I perform are provided on this website for your information. They can be printed out if you wish.

I do, however, recognise that in my profession that no one can do everything. I have therefore no problem referring patients to colleagues who provide a specific service when it is indicated.

One of the commonest problems I deal with involve period problems, especially heavy or painful loss. The commonest cause for this is dysfunctional uterine bleeding (DUB). This does need to be investigated often by hysteroscopy to exclude other causes such as fibroids. Thereafter it can be treated for example with tablets, mirena coil, Novasure endometrial ablation, or even hysterectomy (see leaflets).

Another common problem I deal with is ovarian cysts. These can sometimes resolve as part of the normal menstrual cycle. However sometimes they need removal by surgical means. Depending on their size and clinical circumstances it can be done by laparoscopy (key-hole) or open laparotomy (through an incision).

I am the Lead Consultant Colposcopist at Warrington Hospital and audit my practice regularly. I am a member of the British Society for Colposcopists and Cervial Pathologists. Abnormal smears are very common and are generally straight forward to treat. After referral the initial investigation is called a colposcopy (see leaflet) which is a close look at the neck of the womb with a special instrument called a colposcope. For mild conditions management is to see if it settles in time, as it often does. However when treatment is indicated the procedure most commonly used to remove the abnormality is called a large loop excision of the transformation zone (LLETZ). This can be done under local anaesthetic as an outpatient under general anaesthetic if necessary. Thereafter close follow-up is required to ensure everything remains normal.

There is now a vaccination for cervical cancer. The vaccine adopted by the NHS is called Cervarix which protects against two of the viruses that are associated with cervical cancer. The other vaccine is called Gardasil which protects against four viruses, the other two of which are associated with genital warts. Gardasil is provided as a fixed price package through the Spire Cheshire Hospital (see leaflet).

There are continuing controversies regarding HRT and it can difficult for women to decide issues regarding types of preparations, duration of use and the alternatives. Irregular bleeding is common and often needs to be investigated by assessing the inside of the uterus using a special instrument called a hysteroscope (see leaflet) together with a scrape of the wall called a D and C. This can be done as under general anaesthetic or as an outpatient. One of the risks of the menopause is osteoporosis (brittle bone disease). There are alternative treatments to HRT. The Spire Cheshire Hospital has a bone density scan service using the 'gold standard' of dual-energy x-ray absorptiometry (DEXA) to identify osteoporosis with the possible risk of fracture and to see if treatment is indicated.

I regularly audit my own practice. I am also audited independently at Warrington Hospital and the Spire Cheshire Hospital.

PERSONAL INTERESTS

I am a family man, married with three children. Outside my job I enjoy sport and generally socializing. I enjoy playing golf, being a member of Delamere Forest and Royal County Down Golf Clubs. I am season ticket holder of Warrington Wolves. I am also a Trustee on the Board of St Rocco’s Hospice.

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