7: Obstetrics, gynaecology and urinary tract disorders

For non-vaginal HRT preparations refer to Section 6.4.1

Treatment of vaginal infection with oral fluconazole 150mg (as a single dose) is also effective

Not listed in Formulary – see BNF

Once fully investigated for other causes of unscheduled bleeding with progestogen-only contraception (Mirena or Nexplanon) the following can be used:

Benign Prostatic Hyperplasia (BPH) is treated either surgically or medically with alpha-blockers or with the anti-androgens (e.g. finasteride): section 6.4.2

Ureteric colic may be relieved with pethidine (section 4.7.2) or NSAIDs (section 10.1.1).

Alkalinisation of urine

Drug treatments (other than generically available phosphodiesterase type-5 inhibitor sildenafil) for erectile dysfunction may not be prescribed on the NHS except in men who:

• have diabetes, multiple sclerosis, Parkinson's disease, poliomyelitis, prostate cancer, severe pelvic injury, single gene neurological disease, spina bifida, or spinal cord injury;
• are receiving dialysis for renal failure;
• have had radical pelvic surgery, prostatectomy (including transurethral resection of the prostate), or kidney transplant;
• were receiving Caverject®, Cialis®, Erecnos®, MUSE®, Uprima®, Viagra®, or Viridal® for erectile dysfunction, at the expense of the NHS, on 14 September 1998;

The prescription must be endorsed ‘SLS’.

As stated within the Gloucestershire 'Do Not Prescribe List', generically available Phosphodiesterase type-5 inhibitors are recommended locally