Dr Len Kliman
Dr Len Kliman OAM, MBBS, FRANZCOG is an Obstetrician and Gynaecologist practising in Melbourne, Australia.
Dr Kliman won a Commonwealth Scholarship from The University of Melbourne and graduated from there in 1977. He was a Resident Medical Officer at The Royal Melbourne Hospital for two years. He completed his Obstetric and Gynaecology training at The Royal Women’s Hospital and then spent two years at The Royal Hampshire County Hospital in the United Kingdom.
In 2017 Dr Kliman received a Medal of the Order of Australia for service to medicine in the field of obstetrics and gynaecology.
Dr Kliman has been a Member of the RANZCOG (Royal Australian College of Obstetrics and Gynaecology) since 1983 and a Fellow of the RACOG since 1985. He was a Consultant Obstetrician & Gynaecologist at The Royal Women’s Hospital from 1986 – 2000.
Awarded The Tracy Maud Travelling Scholarship in 1987, he worked in a number of hospitals in New York specializing in High Risk pregnancies, Chemical Dependency and HIV management in pregnancy.
Dr Kliman established and was Obstetrician in Charge of the Chemical Dependency Unit, Royal Women’s Hospital. He was Head of an Obstetric Unit at Royal Women’s Hospital for eight consecutive years running. This was a unit that specialized in high risk pregnancies. He also established, and was Obstetrician in Charge of The Fetal Management Unit at Royal Women’s Hospital. (A multidisciplinary unit specializing in High Risk pregnancies.) Dr Kliman is Chairman of Obstetrics at the Epworth Freemasons Hospital. He is also the Deputy Chairman of the Epworth Clinical Institute – a research and education body.
Dr Kliman is constantly upgrading his education with regular attendances at national and international conferences and was a senior lecturer for the University of Melbourne from 1986 to 2000. He then became Clinical Supervisor in Obstetrics and Gynaecology of Medical Students for the Epworth Group until 2016.
Dr Len Kliman has extensive experience in the following areas:
- High Risk and complicated pregnancies
- Multiple pregnancies
- Normal pregnancies
- General Gynaecology
- Abnormal pap smears and colposcopy
- Diagnostic / Laparoscopic (keyhole) surgery
- Management of pelvic pain
- Menstrual dysfunction (heavy, painful or irregular periods)
- Polycystic ovary syndrome (PCOS)
- Vulval and vaginal disorders including skin disorders
Dr Kliman is married with two children. He is a keen supporter and member of the Collingwood Football Club and in his spare time enjoys spending time with his family, scuba diving and riding his Vespa.
Dr Kliman’s practice is supported by five highly experienced midwives/registered nurses and a medical receptionist. Their role is to support, advise and guide women throughout the stages of their pregnancy. They can provide you with expert advice and assistance with any query that you may have regarding your health needs. Their extensive knowledge and training qualifies them to provide personalised services to our obstetric and gynaecological patients, strictly observing the principles of confidentiality.
Kellie has worked at the practice since 1998, initially as a midwife and then Practice Manager since 2001.
If you would like to contact Kellie for advice, information regarding costing, account queries or any other concerns, please call the office on 9419 2372 or e-mail firstname.lastname@example.org
Sarah, Jannette, Louise are our friendly, experienced midwives who have extensive knowledge and training in all aspects of obstetrics and gynaecology. They are able to provide you with honest, reliable advice, information and reassurance. All of the girls are regularly attending in-service education and seminars to update their knowledge and skills. If Dr Kliman is called away to attend a delivery or emergency situation, one of the midwives is able to assist with antenatal consultations.
Natalie and Lisa, our friendly and helpful Medical Receptionists have worked at our practice for the past five years. They are able to assist you with appointments, accounts and general queries.
A few days prior to your initial antenatal consultation, gynaecological, post operative or postnatal checkup, an SMS reminder is sent via text to your mobile phone.
If you are unable to keep your appointment, please contact our office and we will reschedule to another time.
Epworth Pathology is located on the same level as Dr Kliman’s office so that all blood tests, urine tests or swabs can be attended to at the same time as your appointment.
We have a separate, comfortable and peaceful room set aside for mothers to feed in privacy if they wish.
The room is also used for “one on one” chats with one of our midwives or post natally if you require assistance with feeding or settling techniques.
Do I need a referral?
Yes. A referral from your local general practitioner is required. These referrals will last for a twelve month period. If, however, you become an obstetric patient after seeing Dr Kliman as a gynaecological patient, you will need a new referral. Referrals from medical specialists, eg: IVF specialists, gastroenterologists, last for three months only.
Which hospitals does Dr Kliman attend?
For pregnancy, Dr Kliman delivers at
Epworth Freemasons Hospital
Frances Perry House (high risk pregnancies only)
For gynaecological surgery, Dr Kliman operates at
Epworth Freemasons Hospital
Who are Dr Kliman’s staff?
Dr Kliman has five experienced midwives / registered nurses in his office who are able to assist you with any medical questions or concerns that you may have.
What do I need to bring with me to my first appointment?
Please bring along your doctor’s referral letter, Medicare card and Private Health fund details.
Are my medical records kept private and confidential?
Your medical files are handled with respect for your privacy. All of our staff are bound by strict confidentiality requirements as a condition of their employment. Your personal and medical information is handled in accordance with federal and state privacy laws.
Your personal information will only be used or disclosed for purposes directly related with providing you with quality health care.
Dr Len Kliman offers the following obstetric services:
- Pre pregnancy counselling – especially important if you have a medical condition or have experienced a difficult pregnancy or birth in the past
- High Risk / Complicated pregnancies
- Multiple pregnancies
- Normal pregnancies
You will be seen at your initial consultation at about 8-9 weeks gestation. A thorough assessment of your past medical and surgical history will be taken as well as your current general health. If you are seeing other Specialists for any medical issues, please bring along their name and contact details as it is sometimes necessary to obtain information from them. If you are on any medication, please bring a list along including the dosage.
Dr Kliman will give you advice regarding tests that are available to diagnose the well being of the fetus, including the most current genetic screening available. At this time, an ultrasound will be performed by Dr Kliman that accurately assesses your gestation and ensures that your pregnancy is progressing well according to your dates. This information enables us to organise blood tests and further ultrasounds at the optimal time.
You will also be seen by one of the Midwives at the practice who will outline how the practice is run, the services that are available to you during your pregnancy, costing and help with administrative details such as confirmation of your hospital booking and advice on medical claims with your private fund and Medicare.
An information folder that includes notes about the practice, brochures and information on many aspects of the pregnancy journey and a full costing sheet will also be provided. Patients are encouraged to contact us with any concerns or alternatively, simple questions may be handled via e-mail through this web page.
Dr Kliman offers the following gynaecology services:
- general gynaecology
- abnormal pap smears and colposcopy
- management of pelvic pain
- diagnostic/laparoscopic (keyhole)surgery
- menstrual dysfunction (heavy,painful or irregular periods)
- Polycystic ovary syndrome (PCOS)
- Vulval and vaginal disorders including skin disorders
Dr Kliman feels that it is vital that you are extensively informed what to expect pre, during and after surgery. Before having your surgery, one of the nursing staff will give you information about the choice of hospital and dates that best suit your needs. You will be given a complete package that consists of :
- preparation prior to surgery
- admission time and advice regarding fasting
- information regarding the anaesthetist and assistant surgeon (if required)
- detailed information of what the surgery involves and what to expect in the post operative period
- Instructions for after care with advice on activity, bathing and care of your dressing/wound
- costs involved in your surgery
The day following your discharge from hospital, one of Dr Kliman’s nursing staff will call you at home to ensure that you are comfortable and not experiencing any difficulties. She will be able to give you further advice regarding pain relief, wound care and your follow up post operative appointment.
Clinical Obstetric Services
Dr Kliman has state of the art ultrasound equipment in his office.
He is certified in the clinical practice of ultrasound from the Australian Society for Ultrasound in Medicine (ASUM). He is therefore able to keep a close eye on the growth and health of your developing pregnancy.
Our practice is NATA certified with respect to the safety and sterilization of our equipment.
A CTG or fetal monitoring is done to measure the wellbeing of the baby in utero. It uses a microphone strapped to the abdomen and the baby’s heartbeat is recorded on graph paper over a 10 – 20 minute period.
There are many indications for fetal monitoring but the most commonly being post dates, gestational diabetes, hypertension or decreased fetal movements.
This facility is staffed by Dr Kliman’s experienced midwives so that patients are able to attend anytime outside their schedule visits.
Our midwives liase with Dr Kliman so that full assessment can be made and if necessary, prompt and appropriate action taken.
We have a large reclining armchair in a private room available for CTG monitoring.
Clinical Gyneacological Services
A colposcopy is a procedure that is recommended following an abnormal pap smear result. The procedure itself is not much more different than having a regular pap smear and takes only 5-10 minutes.
A colposcopy is an examination of the cervix with a special microscope and allows us to find any abnormal cellular changes and assess the extent of these changes.
You will be taken into an examination room and then positioned on the motorised colposcopy couch. Your legs are placed into leg supports that can be adjusted for comfort. A speculum like those used for pap smears is gently placed into the vagina to hold the walls of the vagina open so that the cervix can be clearly viewed. A more accurate pap smear is taken. The cervix is then washed down with a mild acetic acid (vinegar like solution). This solution shows up any abnormal cells on the cervix which will be visible through the colposcope.
A colposcope is like a small microscope with a bright light that can magnify an area of abnormal cells. It is positioned between the patient’s legs and does not enter the vagina. From here a tissue sampling or biopsy can be taken and sent to the laboratory for assessment. This biopsy of tissue taken is very small (usually about 1-2mm) and is taken only from the area that looks abnormal via the colposcope. This process is not painful.
You may have a small amount of spotting from the biopsy and this is sealed by placing a dry chemical stick on the area. One of the nurses assisting Dr Kliman will give you a pad as you may notice some continual spotting for an hour or so after the procedure or have some excess acetic acid leak away for a short period of time.
A colposcopy is not a painful procedure – no more so than a pap smear.
It is important not to use any vaginal creams or pessaries (such as thrush treatment) for 24 hours prior to your colposcopy and if you have your period, the procedure cannot be performed as any blood present will obscure the view of the cervix.
There are no restrictions following your colposcopy. You may swim, use a tampon and have intercourse.
The pap smear and biopsy will be sent to the pathology lab for evaluation. You will be contacted as soon as the results are available (usually within3-5 days) and Dr Kliman will explain the findings and a decision can be made about any ongoing treatment and when follow up is recommended. Dr Kliman will also contact your GP so he or she is aware of the findings.
A vulvoscopy is a similar procedure as a colposcopy but is focused on detecting abnormalities of the vulva which is the external area of the female genitalia. The skin on the vulva is sensitive and makes it susceptible to a variety of conditions.
The most common reasons for performing a vulvoscopy are:
- excessive itching, burning or general soreness of the vulval skin
- thickened, raised, red, white or dark patches on the vulva
- a sore or ulcerated area on the vulva
- a lump, swelling or wart like growth
During the procedure, you will be placed on the reclined colposcopy couch and your legs will be placed into leg supports. The vulva will be washed with diluted acetic acid (like vinegar) which will help to identify and highlight any areas of abnormal cells. The colposcope will magnify the suspect area on the vulva and if an abnormal area is identified, a small sample of tissue (biopsy) will be taken.
If a biopsy is deemed necessary, the area will be numbed with local anaesthetic . Sometimes, several small biopsies are taken. This should not feel painful but some slight stinging may be experienced.
These biopsies are sent to a specialised laboratory and once the results are available (usually within 3-5 days), Dr Kliman will contact you and advise you of the appropriate treatment and follow up.
Following a biopsy of the vulva, some discomfort may be felt for a day or so and if necessary, some mild pain relief such as Panadol may be taken.
Ring pesssary fitting
A ring pessary is sometimes used to support a prolapse of the uterus, vagina or bladder. A prolapse can be the result of pregnancy and childbirth, hormonal changes associated with menopause, ageing and genetics.
A ring pesssary is not suitable for everyone but can be useful for the elderly patient, those not suitable for surgery or as a temporary measure for those with a severe prolapse who are pregnant.
The ring pessary acts like an upside down umbrella. It is designed to support the prolapse and minimise symptoms by sitting high in the vagina.
There are various sizes of ring pessaries and it may take a few attempts to correctly fit the appropriate size. Initially a little discomfort may be experienced but this usually settles down after a short period of time.
The most common problem with a ring pessary is that it may cause ulceration of the vaginal skin if the skin is dry. Dr Kliman suggests regular (at least twice yearly) reviews to ensure that the skin is healthy, the pessary is fitted well and has not dislodged. A ring pessary can give a great result for many years.
Oestrogen and Testosterone implants
Hormone implants are for many women a convenient way of taking HRT (hormone replacement therapy). Whilst most commonly prescribed as on oral medication, oestrogen implants are very effective when inserted under the skin (subcutaneously) as they provide a steady release of oestrogen. There is also the advantage of the implant lasting for many months before it requires replacement. However its effectiveness depends upon the dose and rate of absorption which will vary amongst individuals.
The hormone implant is approximately the size of a grain of wheat and is inserted into the fat under the skin usually in the abdominal wall. The area is numbed with local anaesthetic prior to the insertion. A small incision is made and the implant is inserted with a small surgical instrument called a trocar. The incision is closed with either a single dissolvable stitch or an adhesive surgical tape.
The benefits of an oestrogen implant are the loss or reduction of symptoms associated with menopause and the prevention of the onset or worsening of osteoporosis.
Testosterone is a hormone that is responsible for the libido (sex drive) in both men and women. Prior to menopause, Testosterone is a hormone that is produced during the process of oestrogen production by the body. Testosterone implants are primarily used for women suffering from a low or absent libido following menopause. They do not cause masculine traits and their presentation and insertion is the same as the oestrogen implant.
Hormone replacement therapy by implant is not suitable for every woman. There are some medical conditions that are contraindicated to this form of treatment.
The most reliable method of assessment for replacement of the implants is the return of symptoms and this can be confirmed by measuring oestrogen+/- testosterone levels via a blood test.
Insertion of Implanon Implant
Implanon is a contraceptive implant that releases progesterone slowly into the bloodstream to prevent pregnancy. It is a small flexible rod (4cm x 2mm) and is inserted under local anaesthetic directly under the skin of the inside of the upper arm. Following insertion, the use of condoms is recommended for the two weeks before the implant can be relied on to prevent pregnancy.
Implanon works by preventing ovulation, thickening the mucous of the cervix to inhibit sperm from entering the uterus and by altering the lining of the uterus making it unsuitable for pregnancy.
Implanon has a 99.9% success rate and lasts for three years. As with any hormone treatment, there are some patients whom Implanon is unsuitable and there can be side effects such as abnormal bleeding, mood changes and breast tenderness. Certain medications may reduce the effectiveness of the implant.
Implanon can be easily removed at any time. Once removed, there is a rapid return to usual fertility and women usually ovulate within the first month following removal.
Specific training is mandatory for practitioners who prescribe Implanon and Dr Kliman has certification in its use.
Intra Uterine Device (IUD)
The IUD is a small contraceptive device that is placed into the uterus and used as a form of contraception or for heavy, painful periods.
There are two types of IUD’s available. The most commonly used is the Mirena IUD which releases small amounts of a hormone, progesterone directly into the uterus. It is one of the most effective forms of contraception (98-99%), lasts for five years and effectively treats heavy periods in 90% of cases. The Mirena IUD is a small T-shaped device with a cylinder containing progesterone around its stem.
The copper IUD has been used for more than 30 years as a form of contraception. It is a small plastic device that has copper wrapped around its stem.
Dr Kliman will individually assess you to ensure that the appropriate IUD is prescribed to meet your needs. He will also discuss the advantages and possible side effects or complications associated with an IUD. An IUD can be inserted any time during your cycle.
The advantages of IUD’s are that they are effective for long term contraception (up to 5 years), cost effective and you may try for pregnancy as soon as the IUD is removed.
If you have not had a child or are experiencing abnormal bleeding and require a curette to rule out any underlying abnormalities within the lining of the uterus, the IUD will need to be inserted as a day case under a general anaesthetic.
If it is suitable to insert the IUD in our office, you will be offered some mild pain relief such as Naprogesic, as you may experience some “period like” cramping after insertion. You will be placed in the reclining chair and your legs placed into leg supports.
A speculum will be placed into the vagina (like when having a pap smear) and the IUD is inserted through the cervix (the opening of the uterus). The IUD has a string attached to the end (like the end of a tampon) and this string is cut so that it is well up in the vagina. Neither you or your sexual partner should notice the string but you will be able to feel the string if you insert your finger into the vagina.
After the IUD is inserted, you will be asked to remain in the chair for 10 -15 minutes to ensure that you are feeling comfortable before you are able to go home. You are able to drive home and you will not require any time off. We will give you a small pack containing a pad, some pain relief and some instructions. Please do not use tampons and abstain from intercourse for the first 24 hours.
It is important to have a follow up appointment with Dr Kliman six weeks after your IUD has been inserted to ensure that it is correctly located and that you are not experiencing any problems with it.
After that time, follow up is advised every 12 months.
Our practice welcomes patients from different ethnic backgrounds where English is not the first language spoken. We utilize the Translating and Interpreting Service (TIS National) which is an interpreting service provided by the Department of Immigration and Border Protection.
- RANZCOG – The Royal Australian and New Zealand College of Obstetricians and Gynaecologists
- ASUM – Australasian Society for Ultrasound in Medicine
- SOMANZ – Society of Obstetric Medicine of Australia and New Zealand
- ADIPS – Australasian Diabetes in Pregnancy Society
- ASCCP – Australian Society for Colposcopy and Cervical Pathology
- AGES – Australasian Gynaecological Endoscopy and Surgery
- ISSVD – The International Society for the Study of Vulvovaginal Disease
- ANZVS – The Australian and New Zealand Vulvovaginal Society