Pelvic floor dysfunction (e.g. prolapse and/or incontinence) (Urogynaecology)
Adult

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Emergency Referrals

Useful Management Information

Patients with chronic pelvic pain, bladder or bowel dysfunction following mesh procedures can be referred to the Queensland Pelvic Mesh Service (QPMS) for assessment. This service offers comprehensive, interdisciplinary assessment and treatment for women with complications from pelvic mesh.

Further information is available on the Qld Health website
Queensland Pelvic Mesh Service (QPMS) website
Clinical resources
QPMS Referral form
Patient resources

Medical management

Consider referral to women’s health physiotherapist for the following:
prolapse – consider pessary
stress urinary incontinence – physiotherapist for pelvic floor exercises and bladder retraining for 3 months prior to referral
urinary urgency - exclude infection
Consider trial of anticholinergics – ensure post-void residuals have been assessed prior to commencing
Treat constipation
Consider topical vaginal oestrogen in post-menopausal women
Lifestyle modification (Increased activity, dietary, weight reduction, smoking or alcohol cessation)

Clinical resources

Patient resources

Urogynaecology society of Australasia – Patient information
The ACSQHC information on stress urinary incontinence and pelvic organ prolapse
IUGA patient leaflet : Leaflets - Your Pelvic Floor

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category Category 1 (appointment within 30 calendar days)	Uterine procidentia Difficulty voiding with renal impairment
Category Category 2 (appointment within 90 calendar days)	Difficulty voiding +/- significant residuals on bladder screening (without renal impairment) Recurrent UTIs Genital fistulae
Category Category 3 (appointment within 365 calendar days)	Any other prolapse or incontinence Obstructive defecation
If your patient does not meet the minimum referral criteria Assessment and management information may be found on a range of conditions at HealthPathways If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Obstetric and gynaecological history
History of:
- prolapse or urinary symptoms
- protruding lump
- dragging sensation
- difficulty with defecation (requiring manual evacuation)/micturition including incontinence
MSU M/C/S results

Additional Referral Information

BMI
Previous failed or complicated prolapse surgery
Pelvic USS (TVS preferable) if available
Bladder diary
Renal USS if major uterine procidenta

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

Send to: Gold Coast Health Service District

Internal Referrals

Urogynaecology (E-Blueslips)

Fax

(07) 5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Related HealthPathways

No directly related pathways found

HealthPathways home page

Service Availability

Dr Vivien Wong

Medical Director Queensland Pelvic Mesh Service (QPMS)

Facilities

Varsity Lakes Day Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Pelvic floor dysfunction (e.g. prolapse and/or incontinence) (Urogynaecology)Adult