botulinum toxin for pelvic pain

For those living with endometriosis, pelvic pain can prove to be one of the most difficult symptoms to ignore. The pain can be excruciating, affecting the patient’s quality of life. However, a new treatment could be on the horizon for sufferers of persistent pelvic pain in the form of Botulinum toxin.

A new study has shown that Botulinum toxin can provide relief from severe pelvic pain for months. Here, we’ll look at the new study and its results, alongside what it could mean for the future of Endometriosis treatment.

Understanding the new study into pelvic pain

The recent study carried out by the National Institute of Neurological Disorders and Stroke (NINDS), consisted of 13 patients. The women had been diagnosed with Endometriosis and they were aged between 21 and 51. All had experienced pelvic pain for a period of at least two years, including pelvic floor spasms. They had also undergone surgery as well as hormone treatments, but neither had provided relief.

They were given botulinum toxin injections directly into the pelvic floor. After four and eight weeks, all of the patients reported improvements within the level of pain experienced. A total of 11 out of the 13 patients, rated their pain levels after the treatment as mild or non-existent. The study also revealed that the pain subsided after treatment for a period of 5-11 months.

Some patients also reported they could have sexual intercourse without pain after the treatment. They also said they were able to generally function much better.

How does it work?

The Botulinum toxin blocks the acetylcholine molecule. This prevents it from signalling the nerve cells to contract. This keeps the muscle relaxed. The toxin is also thought to block chemical messages that would send pain signals to the brain.

It can provide relief for up to three months, where the injections will usually be required again. In some cases, the study showed relief can be provided for longer, but it isn’t a permanent solution.

Providing relief, but not a cure

While the new study shows how promising Botulinum Toxin injections could be in the treatment of Endometriosis, it’s important to realise it isn’t a cure.

The injections simply mask the problem, they don’t get to the root cause. Some experts argue it is no more effective than using physical and pelvic therapy. However, the results of the study do clearly show it provides long-lasting relief. So, even if it isn’t a cure, it could still be used to provide temporary relief from the symptoms of the condition.

Further research does need to be carried out to determine just how effective the injections could be. The study only involved a small group of women, so larger studies will need to be conducted. However, initial results are certainly promising. Thousands of women live with pelvic pain caused by Endometriosis. It has been shown to have a significantly negative impact on their everyday lives. So, an injection which could stop pain for up to three months or more will undoubtedly be welcomed by patients.

For more advice on Endometriosis and pelvic pain, call 07835 736627 to arrange a consultation.

fibroids diagnosis

A study has revealed that by the age of 50, approximately 80% of women will have experienced fibroids. While in some cases they don’t present any symptoms, for others they can prove debilitating.

Here, we’ll look at this unspoken disease affecting mid-life women and why it’s important to seek treatment if you have them.

What are fibroids?

Fibroids develop within the uterus and they’re classified as non-cancerous tumours. The cause of the condition is unknown, though they do affect the majority of women at some point throughout their lifetime.

Fibroids can vary in size and larger ones can cause more significant symptoms. They can also be referred to as myomas, fibromas and leiomyomas. Although the risk of them leading to infertility is rare, they can lead to a hysterectomy. It is thought that in the US there are 200,000 hysterectomies carried out due to fibroids. They also increase the risk of needing a C-section delivery.

Understanding the different types

Did you know that there are different types of fibroids you can develop too? The type of fibroid you’re suffering with will depend upon where it has developed.

The most common type is the Intramural fibroid. It develops on the muscular wall and they have the potential to grow large enough to stretch the womb. If the fibroid develops on the outside of the uterus, it’s known as a Subserosal fibroid. This type can cause the womb to grow larger on one side.

If you do develop the Subserosal type, it can also lead to Pedunculated fibroids. These occur when a stem grows from a Subserosal fibroid. Then finally, there are the Submuscular fibroids. These develop in the centre of the mid muscle layer of the uterus. They tend to be the lesser common types you can suffer with.

What symptoms do they produce?

The symptoms of fibroids differ depending upon the type and size of the tumour. Some women experience no symptoms at all, while others have severe symptoms such as heavy menstrual bleeding and pain.

The most common symptoms to watch out for include:

  • Frequent urination
  • Longer, heavier and more painful menstruation
  • Pain in the lower back or pelvis
  • Pain during intercourse
  • Swelling of the abdomen

If you have any of these symptoms and suspect it may be fibroid related, it’s important to seek a diagnosis.

Fibroids diagnosis and treatment

A gynaecologist can diagnose fibroids via a pelvic scan. This scan is used to detect the fibroids, as well as establish their size and position. You may also need to undergo an ultrasound scan and a pelvic MRI.

Once the fibroids have been assessed, a treatment plan can be produced. This can include home remedies such as yoga, acupuncture and heat packs. It could also include medication, and in severe cases, surgery may be recommended. There are also newer, less invasive treatments available.

If you’re concerned you may have fibroids, it’s important to seek a fibroids diagnosis. Booking a consultation with a gynaecologist or women’s health specialist will help you to determine the type and size of the fibroids, following the best course of treatment to eliminate them. Call 07835 736627 to arrange an appointment at SureScan.

On 10 February 2020, the government launched a new inquiry into the impact of Endometriosis. The aim of this inquiry is to establish the challenges those with Endometriosis face and the steps that can be taken to improve the standard of care.

Patients were advised to fill in a survey, which will be used in conjunction with evidence gathered through hearings in March, to compile a report in July 2020. Here, we’ll look at why this new inquiry is important and the current diagnosis and treatment options available for Endometriosis.

Why is this new inquiry important?

The importance of this new inquiry into the diagnosis and treatment of Endometriosis becomes apparent when you take a look at the statistics.

The condition is said to affect 1 in 10 women within the UK. However, despite how common it is, statistics show that it takes an average of seven years to get a diagnosis. Considering how severe symptoms can be, this is a shocking statistic and the government is now hoping to improve the rate of Endometriosis diagnosis and the treatments available.

The reasons behind the poor diagnostic rate are said to be down to two main factors. Firstly, the symptoms associated with Endometriosis are similar to those developed due to other conditions. The other reason is said to be down to assumptions placed on female health.

Many GPs are said to be unaware of what normal menstrual pain is, making it difficult for them to determine whether a patient does have Endometriosis or standard period pain.

There was a report carried out a couple of years ago by the All-Party Parliamentary Group (APPG), which highlighted 42% of women said they felt they hadn’t been treated with respect and dignity. They felt that women’s symptoms were often dismissed by GPs.

Agreeing that seven years is far too long to receive an accurate diagnosis, MPs are now carrying out an inquiry to further investigate the issues. The APPG will lead the inquiry, with the hope they can identify the steps which need to be taken to resolve the issues presented.

How is Endometriosis diagnosed?

A laparoscopy is the only way to currently diagnose Endometriosis. This involves placing a small camera into the pelvis close to the naval. The surgeon then looks for signs of the condition in the pelvic area. If it is discovered, the surgeon may treat the problem right away or carry out further investigation.

The Endometriosis diagnosis is difficult due to how similar the symptoms are to other conditions. Blood tests, scans and internal examination isn’t known to be a conclusive way to diagnose the condition either. For this reason, it is important for patients to share as much information about their symptoms as possible.

Although scans aren’t a conclusive way to diagnose Endometriosis, they can still prove useful to determine whether there is an issue. Therefore, patients are advised to undergo a women’s health scan if they suspect the condition is responsible for their symptoms.

This new inquiry provides hope that better diagnosis and treatment will become available for women suffering with Endometriosis. In the meantime, documenting symptoms and requesting a laparoscopy is the only real way to receive an accurate diagnosis.

treatment for PCOS

PCOS (Polycystic Ovarian Syndrome), is said to affect one in five women in the UK according to the NHS. Caused by an imbalance of the reproductive hormones, this common condition can lead to a number of health worries, including infertility.

Now, researchers have discovered that the hormone Kisspeptin can control ovarian stimulation in rats. Here, we’ll look at this new study and what it could mean for patients dealing with PCOS.

Understanding the study

The new study carried out by researchers in Turkey has revealed that Kisspeptin could be a solution for PCOS. There are a number of hormones which contribute to fertility health, and Kisspeptin-1 is thought to be one of the main ones.

The anti-Müllerian hormone is directly related to female reproductive function. So, the researchers carried out the study to investigate the role it plays in PCOS in rats. They also looked into controlled ovary stimulation which aims to increase fertility. They looked at histopathological, immunohistochemical and hormonal controlled ovarian stimulation.

The results of the study revealed that controlled ovarian stimulation wasn’t impacted by KISS1 density in rats with PCOS. However, it did show that Kisspeptin did play a role in the development of controlled ovarian stimulation in rats without the condition.

As the recent study was conducted on rats, further research will need to be carried out in humans to determine whether Kisspeptin could be the solution for PCOS.

Helping to boost quality of life

Another study has revealed that those who do suffer from PCOS, report the same quality of life as those living with other chronic health conditions. The findings of the study were published in The Journal of Clinical Endocrinology and Metabolism.

Previous studies into the quality of life for PCOS patients have been quite small. They have largely centred around reproductive age women from PCOS clinics. They also never followed up on the patients included in the study. The effects individual symptoms of the condition have on patients has also never been looked into.

This new study, carried out by researchers in Finland, assessed follow-up data from women aged 31 and 46 years old. They had taken part in the Northern Finland Birth Cohort 1966. After analysing the data, the researchers discovered quality of life scores were worse in women aged 31 and 46 with PCOS. In particular, they reported a higher level of mental distress.

What current treatments are available?

PCOS is diagnosed through pelvic exams, blood tests and an ultrasound. If you are diagnosed with the condition, there are numerous treatments available. You may be recommended to make lifestyle changes or take medications depending upon the symptoms of the condition. Due to the mental distress that the condition can cause, patients are also advised to seek counselling or other therapy to help them deal with the symptoms of PCOS.

In order to receive the correct treatment, it is crucial patients undergo a proper diagnosis. The treatments provided will focus on eliminating or reducing the individual symptoms experienced. Book a consultation at our clinic today to discover the diagnostic tests available. Call 07835 736627 to arrange an appointment at SureScan.

treating menopausal symptoms

The menopause is one of the biggest health events women go through in their lifetime. While it can be a relief to see the back of the menstrual cycle, that can soon fade once the side effects of the menopause kick in.

There are different stages of the menopause and each woman will experience them slightly differently. Here, we’ll look at the different stages of the condition and what you can expect from each one.

The Perimenopause

The first stage is known as the Perimenopause. It tends to occur around five years before the actual menopause begins. It is the lead-up stage, and it can trigger the common symptoms associated with the menopause such as hot flushes and mood swings.

The ovaries start to produce fewer follicles, and the menstrual cycle starts to become irregular. Approximately 12% of women at this stage experience a complete halt to their periods. The other 88% experience fluctuations within their cycle, with it lasting longer or shorter than usual. There may even be spotting experienced between cycles and the start date will change with each passing month.

It is the drop in progesterone hormones that causes symptoms to start developing. These can include sleep troubles, mood swings and anxiety.

The Menopause

The menopause itself tends to occur between the ages of 45 and 50. However, some women experience early menopause in their 20s and 30s. It is diagnosed when you haven’t had a menstrual cycle for at least 12 months.

When the menopause occurs, additional symptoms kick in. You may start to find your joints become more stiff and painful. This is particularly true for the hips and knees. Other symptoms include vaginal dryness, more frequent urination, more severe mood swings and hot flushes.

The symptoms of the menopause can last for years after periods have stopped completely, which leads us onto the last stage.

Post-Menopause

The final stage is known as post-menopause. Your adrenal glands continue to produce oestrone, only in much smaller quantities. The hormone levels are much lower than they were pre-menopause. So, you can continue to experience symptoms such as thinning hair, mood swings and depression.

During this stage, it’s really important to focus on ways to reduce the effects the limited hormones have on the body. Eating a healthy diet, exercising and keeping an eye on cholesterol and blood sugar levels is recommended. You’ll also want to look at strengthening the bones as the menopause increases the risk of osteoporosis.

As you can see, the different stages of the menopause contribute to different symptoms. There are things you can do throughout each stage to limit its impact on your health.

If you suspect you are going through menopausal symptoms, it’s important to seek a diagnosis. Testing for the menopause is limited, with many patients feeling like they are let down by their GP due to a dismissal of the symptoms. Therefore, it’s a good idea to seek a diagnosis from a specialist women’s health clinic. They will also be able to recommend treatment options to manage the menopausal symptoms. Call 07835 736627 to arrange an appointment at SureScan.

miscarriage prevention

A new study has revealed that over 8,000 miscarriages could be prevented through a simple daily pill.

The research, carried out by the University of Birmingham and Tommy’s National Centre for Miscarriage, involved analysing two different clinical trials entitled Promise and Prism. The results of the study have proven promising, leading to hope it could improve the current miscarriage rate.

Here, we’ll look at what these two new trials revealed and whether a daily pill could prevent thousands of miscarriages.

Understanding the miscarriage prevention research

Both the Promise and the Prism clinical trial results were assessed as part of the new research.

Promise included 838 women who had suffered recurrent miscarriages across 45 different hospitals in the UK and Netherlands. When the hormone progesterone was inserted into the vagina, it was revealed that the birth rate was increased by 3%.

Prism was a larger clinical trial, consisting of 4,153 women who had experienced early pregnancy bleeding. Some were provided with progesterone, while others received a placebo pill through until 16 weeks into the pregnancy. It was discovered that those who had already suffered a miscarriage who were given progesterone, saw the number of babies born increase by 5%. For the women who had experienced three or more miscarriages, the birth rate increased by an impressive 15%.

These results have proven to be extremely promising, suggesting the progesterone drug could prevent 8,450 miscarriages each year.

Could a daily pill be the key to miscarriage prevention?

So, could a daily progesterone pill really be the key to preventing miscarriages? Well, there are a lot of reasons why miscarriages can occur. However, for those suffering recurrent miscarriages, or bleeding early in their pregnancy, progesterone is certainly proving promising as an effective treatment option.

The debate over using the drug to help reduce miscarriages has actually been ongoing for 60 years. However, up until now there has been little in the way of evidence to support the claims. Now, experts are urging the NHS to offer the hormone as a standard treatment for those who are at risk of miscarriage.

What current treatment options are available for recurrent miscarriages?

If you have experienced one or more miscarriages, it’s understandable you’ll be seeking out ways to prevent them. While Progesterone is currently being recommended as a treatment option, what can you do now to reduce your risks?

At SureScan, we offer a recurrent miscarriage service to help provide peace of mind and reduce the likelihood of suffering another one. You’ll undergo a comprehensive appointment, and an ultrasound scan will be performed, along with blood tests.

Recurrent miscarriages are diagnosed when you suffer three or more miscarriages. They affect approximately one in every 100 couples who are trying to get pregnant. Suffering a miscarriage can be devastating, but with our recurrent miscarriage service, it can provide peace of mind and identify the risks early on.

Discover more about our recurrent miscarriage service here.

ovarian cysts screening

Ovarian cancer is one of the most difficult to detect, but a new MRI tool could be about to make it much easier. Researchers at the APHP Sorbonne University, alongside the Imperial College London, developed the new tool which has shown to be effective at distinguishing between malignant and benign ovarian cysts.

Here, you’ll discover more about the new tool and how it could improve the detection of ovarian cancer.

What is the new tool and how does it work?

The new MRI tool is being recommended as a triage test by researchers. Known as Ovarian-Adnexal Reporting Data System Magnetic Resonance Imaging, it is said to be able to help triage patients who present as low risk. It could also be potentially used to identify high-risk patients, enabling to seek treatment early on.

In the recent study, the tool was assessed to see how effective it was at identifying the risk of a malignant ovarian cyst in 1340 women. It was carried out between 2013 to 2016 across 15 different centres in Europe.

Each woman underwent an MRI pelvic examination. This was used to look for specific features within the cysts which couldn’t be picked up during an ultrasound scan. The researchers then worked on a risk stratification scoring process which could be applied to score ovarian cysts based upon five different factors. The tool was then used by radiologists to score the cyst.

Scores which ranked 1-3 were identified as being benign. A score of 4-5 on the other hand, pointed to a high risk. The women who were identified as high risk, underwent surgery or attended two-year follow up appointments if the cyst was discovered to be benign.

It was revealed that the new tool was 90% accurate at identifying both benign and malignant cysts. It was also shown to outperform existing diagnostic methods.

Could it help patients to avoid surgery?

One of the most exciting revelations of this new study, was the indication that it could help to reduce surgery rates. As it stands, patients often need to undergo surgery to determine whether a cyst is malignant or benign. However, through the use of this new tool, a benign cyst could be identified before surgery, eliminating the need for surgery.

The research also revealed that the risk of a benign cyst which scored 1-3, becoming malignant was extremely low. By carrying out testing through this new tool, patients will be able to make a more informed choice over the treatment they receive. Surgery to diagnose ovarian cysts can result in fertility issues. So, eliminating the need for it for those with a low-risk cyst can help to prevent a lot of heartache.

While the new tool isn’t yet available to patients, there are currently scans which can help. Ovarian scans are a non-invasive option, helping to identify cysts and determine their severity. You can book an ovarian scan through us if you are concerned about any cysts you may have. Learn more about our ovarian cancer screening here.

private gynaecological scan

Gynaecological scans can prove invaluable at the detection and prevention of numerous conditions. However, if you do decide to undergo one, it can be a daunting process.

The good news is gynaecological scans are a quick and painless process. Learning as much as you can about them and what to expect can also really lower your apprehension. Below, we’ll reveal everything you can expect when you attend a private gynaecological scan.

What is a private gynaecological scan?

There are different types of gynaecological scans you can undergo. All of them aim to diagnose a number of conditions, helping patients to identify the best course of treatment.

The scans are carried out by gynaecology consultants, and they can include:

  • Transvaginal scans
  • Abdominal scan
  • Transabdominal scan

A Transvaginal scan is where a small probe roughly the size of a tampon, is inserted into the vagina. It can only be carried out on patients who have had sexual intercourse.

An abdominal scan is an ultrasound scan which looks for issues with the bile ducts, liver, kidneys, pancreas, spleen and gallbladder. A transabdominal scan, on the other hand, externally looks at the size and position of the uterus, the ovaries and the thickness of the womb lining.

These scans are carried out alongside a general assessment of your health.

How is a private gynaecological scan carried out?

The majority of private gynaecological scans involve a pelvic ultrasound scan. An image will be produced of the ovaries and uterus to try and identify any abnormalities. Occasionally both a transvaginal and transabdominal scan will be required in order to give a clear idea of any issues present.

Is there anything you need to do to prepare for the scan?

There are a few things you’ll need to do to prepare for your gynaecological scan. If you’re undergoing the transabdominal scan, for example, you’ll need to have a full bladder. It is recommended you drink at least two pints of water an hour before the scan is due to take place.

If you’re undergoing a transvaginal ultrasound, you’ll need an empty bladder. It is recommended you empty the bladder right before the scan takes place. If you’re menstruating, you’ll still be able to have the scan, but you will need to remove your tampon if you use one.

What should you expect?

When you arrive at the clinic, the scan will be explained to you, so you have a good idea of what to expect. You can also find out more at your initial consultation.

You will be asked to lie down and remove or move the lower portion of your clothing so that the pelvis can be assessed. A tiny amount of ultrasound gel will be placed onto the skin before a transducer is moved forwards and backwards over the lower abdomen.

For transvaginal scans, a small probe will be inserted and moved in various directions to capture images. After the scan has been carried out, the results will be discussed with you and you’ll be provided with a report.

Most patients find gynaecological scans a painless and fast process. You can learn more about our private gynaecological scans here.

ovarian cysts

Ovarian cysts are a very common health problem which doesn’t typically produce any symptoms. While they are usually classed as harmless, sometimes they can be potentially cancerous. They can also be linked to conditions which can make it more difficult to get pregnant.

So, what exactly are ovarian cysts and how can they be treated? Below, you’ll discover everything you need to know.

What are ovarian cysts?

Ovarian cysts develop within the ovaries and are basically sacs that are filled with fluid. They occur naturally and tend to disappear on their own within a few months.

These cysts can either affect one, or both ovaries. The majority occur due to the menstrual cycle and these are known as functional cysts. There are two types of functional cysts including Follicular and Corpus luteum cysts. These types of cysts rarely cause any discomfort or pain and they will clear up on their own.

Other types of cysts are less common and aren’t caused by the menstrual cycle. These include:

  • Dermoid cysts
  • Endometriomas
  • Cystadenomas

Dermoid cysts are also referred to as teratomas and they develop from embryonic cells. These types of cysts can contain tissue and they are rarely cancerous.

Endometriomas are cysts caused by the condition Endometriosis. Tissue can attach to the ovaries, causing a growth to develop. Finally, Cystadenomas tend to develop on the ovaries surface and can be filled with mucous or a watery material.

Are there any symptoms?

With the majority of ovarian cysts, no symptoms do occur. However, if it is a large cyst or if it ruptures for example, this can cause a number of symptoms. The most common symptoms linked to ovarian cysts include:

  • Pain in the pelvic area
  • Swollen or bloated tummy
  • Difficulty when emptying the bowels
  • Heavy or irregular periods
  • Pain during intercourse

As some of these symptoms can also link to other health problems, it is important for patients to seek a diagnosis from their doctor.

What problems can ovarian cysts cause?

Again, the majority of ovarian cysts don’t cause any health problems. However, as there is a small chance they could be cancerous, they do need to be checked out as quickly as possible. It is estimated that just 1 in 1000 ovarian cysts are cancerous in women aged under 50.

The cysts can also potentially rupture, which can lead to heavy bleeding and other dangerous symptoms. If you have been or are going through the menopause, cysts can also present an increased chance of cancer.

If the cysts are caused by endometriosis or Polycystic Ovary Syndrome, there is also a chance it could make getting pregnant more difficult. However, this is more to do with the conditions themselves, rather than the cysts.

Can you prevent them?

Unfortunately, it isn’t possible to prevent ovarian cysts, particularly functional ones. However, if you are found to develop cysts frequently, your GP may recommend putting you on hormonal birth control to prevent you from ovulating.

If you do have ovarian cysts, they won’t usually require any treatment. However, in some cases, surgery may be required. So, if you suspect you have ovarian cysts, it is worth getting checked over by a specialist. This will help to determine the type of cysts you’re dealing with and whether any treatment will be required. Call 07835 736627 to book your consultation.

adenomyosis treatment

Adenomyosis is just one of the many conditions that can affect women. Causing the uterine walls to become thicker, it can cause a range of unpleasant symptoms such as pain during intercourse and heavier menstrual bleeding.

It isn’t a condition that is widely talked about, so how exactly do you know if you’re suffering with it? Here, you’ll discover more about Adenomyosis, its symptoms and how to get diagnosed.

What is Adenomyosis?

Adenomyosis is a condition where the endometrial tissue presents in places it shouldn’t. This leads to the uterine walls becoming thicker. It isn’t yet known what causes the condition, although there are some known factors which appear to contribute.

It is thought that the condition largely presents due to an increase in oestrogen levels. It tends to disappear after women go through the menopause when oestrogen levels naturally begin to drop.

Another potential cause includes excess tissue within the uterine walls which were present even before birth. The tissue begins to grow throughout adulthood. It could also be down to stem cells within the walls of the uterine muscle, or due to uterine inflammation which occurs after giving birth.

What symptoms does it produce?

The symptoms of Adenomyosis can vary from mild to severe, and some women may not even experience any symptoms. The most common symptoms of Adenomyosis include:

  • Heavier, more painful menstrual cycles
  • Pain during intercourse
  • Spotting between periods
  • Tenderness within the abdomen
  • Longer menstrual cycles

As these symptoms can also point to other conditions, it’s easy for them to go misdiagnosed. This is why women who are suffering from Adenomyosis don’t often receive a diagnosis right away.

Diagnosing the condition

So, how is the condition diagnosed? Well, firstly you’ll need to undergo a full medical evaluation. This will include a physical examination which will detect whether the uterus has become swollen. The majority of women suffering with the condition, tend to have a uterus that is at least double the size that it should be.

You may also need to undergo other tests, such as an ultrasound. This would help to determine whether there are any tumours on the uterus and help to diagnose Adenomyosis if it is present. If the ultrasound doesn’t produce clear results, an MRI scan may need to be carried out. This produces a high-resolution image, giving the doctor a better look at the health of the uterus.

Can it be treated?

If you are diagnosed with Adenomyosis, you may not require any treatment if the condition is mild. However, if the symptoms interrupt your daily life, various treatment options may be recommended.

Common treatments include anti-inflammatory medications, hormonal treatments, endometrial ablation and surgery.

Overall, very few patients have even heard of Adenomyosis. However, it can have a debilitating effect on your life if you do have the condition. If you suspect you have the symptoms of Adenomyosis, it’s worth seeking a diagnosis from your GP or from a women’s health clinic. Book a consultation with one of our specialists today to discover whether this condition could be the cause of your menstrual troubles.

To book your scan, call 0121 308 7774.