Specialist Gynaecological Care
Conditions We Treat
Mr Kirana Arambage diagnoses and treats a comprehensive range of gynaecological conditions — from common presentations to the most complex cases referred from across the UK and internationally.
9+
Gynaecological
Conditions Treated
1 in 10
Women affected by
endometriosis
80%
Of women develop fibroids
by age 50
BSGE
Accredited Endometriosis
Centre — Oxford
UK & Int'l
Tertiary referrals
accepted
All Conditions
Comprehensive Women's Health Expertise
Every condition is assessed with a thorough clinical consultation, pelvic ultrasound where appropriate, and a personalised treatment plan. Mr Arambage's approach is always evidence-based, minimally invasive where possible, and sensitive to each patient's individual needs and fertility wishes.
01
Endometriosis
BSGE Specialist Centre
Tissue similar to the uterine lining grows outside the uterus, causing pain, inflammation and potential fertility problems. Mr Arambage is one of the UK's leading endometriosis surgeons.
Pelvic Pain
Fertility
Periods
02
Uterine Fibroids
Minimally Invasive
Non-cancerous growths in or around the uterus that can cause heavy bleeding, pelvic pressure and bladder symptoms. Multiple treatment options available from medical to keyhole surgery.
Heavy Periods
Pressure
Bloating
03
Ovarian Cysts
Diagnostic Ultrasound
Fluid-filled sacs on or within the ovaries. While most resolve naturally, some require surgical management. Mr Arambage offers expert assessment and minimally invasive cystectomy.
Pelvic Pain
Bloating
Periods
04
Heavy & Abnormal Bleeding
One-Stop Clinic
Heavy menstrual bleeding, irregular periods, intermenstrual bleeding and postmenopausal bleeding all require careful investigation. One-stop clinic with pelvic ultrasound available.
Heavy Flow
Clots
Irregular
05
Chronic Pelvic Pain
Multidisciplinary
Persistent pelvic pain lasting six months or more can have multiple underlying causes. Mr Arambage leads a multidisciplinary approach to accurately diagnose and effectively treat complex pelvic pain.
Daily Pain
Dyspareunia
Fatigue
06
Adenomyosis
Often Misdiagnosed
Endometrial tissue grows into the muscular wall of the uterus, causing severe period pain, heavy bleeding and an enlarged uterus. Frequently confused with endometriosis but requires different management.
Severe Cramps
Heavy Periods
07
Endometrial Polyps
Hysteroscopy
Benign overgrowths of the uterine lining that can cause irregular bleeding, intermenstrual spotting and occasionally impair fertility. Diagnosed and treated via hysteroscopy in a single visit.
Spotting
Irregular
Fertility
08
PCOS
Hormonal Management
Polycystic Ovary Syndrome affects hormone levels and ovarian function, causing irregular periods, excess androgens and small ovarian cysts. Comprehensive management addressing all aspects of the condition.
Irregular Cycles
Fertility
09
Pelvic Organ Prolapse
Surgical & Non-surgical
When pelvic floor muscles weaken, pelvic organs can drop and press against the vaginal wall. Both conservative management and minimally invasive surgical correction are available.
Pressure
Bladder
Discomfort
BSGE Accredited Specialist · John Radcliffe Hospital
Endometriosis —
Oxford's Leading
Specialist Centre
Mr Arambage has worked at the BSGE-accredited Endometriosis Care and Research Centre at John Radcliffe Hospital since 2012 — one of the busiest and most recognised endometriosis centres in the United Kingdom. He treats all stages of the condition including the most complex cases involving bowel, bladder and extra-pelvic organs.
1 in 10
Women of reproductive age affected
8–10
Years average delay to diagnosis
Stage 4
Complex cases managed via MDT
Key Symptoms to Watch For
- Painful periods that disrupt daily life or require strong painkillers
- Chronic pelvic pain throughout the month, not only during menstruation
- Deep pain during or after sexual intercourse (deep dyspareunia)
- Painful bowel movements or urination, particularly during periods
- Chronic fatigue, bloating, and generalised exhaustion
Disease Staging
I
Minimal
II
Mild
III
Moderate
IV
Severe
Condition 02
Uterine Fibroids
Minimally Invasive Treatment Available
Fibroids are non-cancerous growths that develop in or around the uterus. They are extremely common — affecting up to 80% of women by age 50 — though many cause no symptoms at all. When symptomatic, they can significantly impact quality of life.
Mr Arambage offers the full spectrum of fibroid management, from medical treatment to laparoscopic myomectomy (keyhole removal of fibroids) and hysteroscopic resection for submucosal fibroids, always with fertility preservation in mind where appropriate.
Common Symptoms
- Heavy menstrual bleeding, often with large clots, leading to anaemia
- Pelvic pressure, fullness or a sensation of bloating
- Urinary frequency or difficulty emptying the bladder
- Constipation or discomfort during bowel movements
- Lower back pain or pain during intercourse
- Visible abdominal enlargement in larger fibroids
Treatment Options
Fibroids
Medical Management
Hormonal treatments to reduce fibroid size and control bleeding
Laparoscopic Myomectomy
Keyhole removal — preserves the uterus and fertility
Hysteroscopic Resection
For fibroids inside the uterine cavity — same-day procedure
Total Laparoscopic Hysterectomy
For women who have completed their family, if appropriate
Ovarian Cysts
Cyst over 5–6cm
Larger cysts are less likely to resolve and may require removal
Persistent cyst
Not resolving after 2–3 menstrual cycles of watchful waiting
Endometrioma
Chocolate cysts often require excision, especially if impacting fertility
Suspicious features
Solid components or complex appearance on ultrasound require assessment
Condition 03
Ovarian Cysts
Expert Ultrasound Assessment
Ovarian cysts are fluid-filled sacs that develop on or inside the ovaries. They are very common — most are benign and resolve spontaneously without treatment. However, certain types — particularly endometriomas (chocolate cysts associated with endometriosis), dermoid cysts, and persistent functional cysts — may require surgical management.
At Oxford Women's Clinic, Mr Arambage offers expert one-stop pelvic ultrasound assessment to characterise cysts accurately and provide clear, personalised guidance on management. Laparoscopic cystectomy is performed with meticulous care to preserve ovarian function and fertility.
Types Treated
- Endometriomas (chocolate cysts) — related to endometriosis
- Functional cysts — follicular and corpus luteum cysts
- Dermoid cysts (teratomas) — containing tissue such as hair or skin
- Cystadenomas — fluid-filled cysts arising from ovarian surface
- Paraovarian cysts — adjacent to but separate from the ovary
Heavy & Abnormal Bleeding
One-Stop Clinic
Heavy menstrual bleeding (HMB) affects 1 in 3 women at some point in their lives and is a leading cause of iron-deficiency anaemia. Abnormal bleeding — irregular, intermenstrual, or postmenopausal — always warrants investigation to exclude important underlying causes.
Oxford Women's Clinic runs dedicated one-stop clinics combining consultation and transvaginal ultrasound in a single appointment, enabling same-day assessment and personalised treatment planning.
Causes investigated include:
Daily Pain
Endometrial Polyps
Adenomyosis
Endometrial Pathology
Hormonal Causes
Coagulation Disorders
Chronic Pelvic Pain
MDT Approach
Chronic pelvic pain — defined as pain lasting six months or more — affects approximately 1 in 6 women and is one of the most complex presentations in gynaecology. It is frequently caused by endometriosis, but may also have musculoskeletal, bladder, bowel or psychological components requiring a multidisciplinary approach.
Mr Arambage works within a dedicated MDT at John Radcliffe Hospital including colorectal surgeons, urologists, pain specialists and physiotherapists to deliver comprehensive, holistic care.
Pain types assessed:
Cyclical Pain
Dyspareunia
Non-cyclical Pain
Bladder Pain
Bowel-related
Adenomyosis
Often Under-Recognised
Adenomyosis occurs when endometrial tissue grows into the muscular wall of the uterus (myometrium). During menstruation, this embedded tissue bleeds within the uterine wall, causing severe cramping, heavy periods and an enlarged, tender uterus.
It is often confused with endometriosis or fibroids, and is frequently underdiagnosed. Modern MRI and high-resolution ultrasound have greatly improved diagnosis. Treatment ranges from hormonal management to laparoscopic or hysteroscopic surgery, or hysterectomy in selected cases.
Endometrial Polyps
Same-Day Hysteroscopy
Endometrial polyps are benign overgrowths of the uterine lining that attach to the inner wall of the uterus. They are common and can cause irregular or heavy bleeding, bleeding between periods, and occasionally difficulty conceiving.
Mr Arambage is an expert hysteroscopist — co-author of the European guidelines on operative hysteroscopy — and removes polyps during outpatient or day-case hysteroscopy procedures, often without the need for general anaesthesia. He authored internationally recognised guidelines on operative hysteroscopy safety.
Polycystic Ovary Syndrome (PCOS)
Hormonal Management
PCOS is one of the most common hormonal disorders in women of reproductive age, affecting approximately 1 in 10 women. It is characterised by irregular or absent periods, elevated androgen levels, and polycystic ovaries on ultrasound.
Symptoms can include irregular cycles, acne, excess hair growth, weight gain, and difficulty conceiving. Assessment includes pelvic ultrasound and hormonal blood tests, followed by a personalised management plan addressing all aspects of the condition including fertility, metabolic health, and symptom control.
Pelvic Organ Prolapse
Surgical & Conservative
Pelvic organ prolapse occurs when the pelvic floor muscles and tissues weaken, allowing the bladder, uterus or bowel to press into or out of the vagina. It is common after childbirth and around the menopause, causing a sensation of heaviness, bulging, and bladder or bowel symptoms.
Management ranges from pelvic floor physiotherapy and vaginal pessaries to laparoscopic surgical repair. Mr Arambage assesses each patient holistically, recommending the least invasive appropriate treatment tailored to symptom severity and lifestyle.
Patient Questions
How do I know if I need a specialist gynaecologist?
If your symptoms are affecting your daily life — severe period pain, heavy bleeding, persistent pelvic pain, or difficulty conceiving — it is worth seeking a specialist opinion. Mr Arambage sees both NHS referrals and self-referring private patients.
What happens at a one-stop clinic appointment?
A one-stop clinic combines a full clinical consultation with a pelvic ultrasound scan in the same appointment. This means you receive a thorough assessment and — in most cases — a diagnosis and personalised treatment plan on the same day, avoiding multiple visits.
Is surgery always required to treat endometriosis?
No. Many women with endometriosis are effectively managed with hormonal treatments without surgery. However, for those with moderate to severe disease, significant pain unresponsive to medical treatment, or fertility concerns, laparoscopic surgery often delivers the best outcomes.
Does Mr Arambage offer virtual consultations for overseas patients?
Yes. Virtual consultation clinics are available for patients across the UK and internationally. These are particularly useful for second opinions, reviewing scan or MRI results, and planning treatment for patients who cannot easily travel to Oxford.
What happens at a one-stop clinic appointment?
A one-stop clinic combines a full clinical consultation with a pelvic ultrasound scan in the same appointment. This means you receive a thorough assessment and — in most cases — a diagnosis and personalised treatment plan on the same day, avoiding multiple visits.
Which health insurers does the clinic accept?
Mr Arambage is recognised by all major UK health insurers including BUPA, AXA Health, Aviva, WPA, Vitality, Cigna and Allianz Care. Self-pay options are also available. Please contact the clinic for a fee quotation.
Take the Next Step
Don't Wait to Seek Help
Pain, heavy bleeding and other gynaecological symptoms should never simply be accepted as "normal." Early assessment and treatment leads to better outcomes. Please seek specialist advice if any of the following apply to you:
- Your periods regularly prevent you from work, school or daily activities
- You have been experiencing pelvic pain for more than three months
- You have been told you have an ovarian cyst, fibroid or thickened endometrium
- You have been trying to conceive for over 12 months without success
- You experience pain during sexual intercourse
- You have any unexplained abnormal or postmenopausal bleeding
- You would like a second specialist opinion on a previous diagnosis
Nuffield Health · Oxford
In-Person Oxford Appointment
Book a clinic appointment at Nuffield Health The Manor Hospital, Oxford. In-person consultation with Mr Arambage. Insurance & self-pay accepted.
Top Doctors · Online
Virtual & All Other Appointments
Virtual consultations for UK & international patients, second opinions and any appointment outside Oxford. Secure online booking via Top Doctors.