Vulva lesion/ lump/genital warts/ boil/ swelling/ abscess/ ulcer/ Bartholin’s cyst
Adult

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Emergency Referrals

Useful Management Information

For paediatric and adolescent gynaecology patients, please refer to  Gynaecology
- <14 years refer to Queensland Children's Hospital
- >14 years refer to Royal Brisbane and Women’s Hospital or local adolescent Gynaecology service
Antibiotic treatment of Bartholin's cyst is of no value
In women where a vulva cancer is strongly suspected on examination, urgent referral should not await biopsy.
Vulva cancers may present as unexplained lumps, bleeding from ulceration or pain.
Vulva cancer may also present with pruritus or pain. For a patient who presents with these symptoms and where cancer is not immediately suspected, it is reasonable to use a period of ‘treat, watch and wait’ as a method of management. However, this should include active follow-up until symptoms resolve or a diagnosis is confirmed. If symptoms persist, the referral may be urgent or non-urgent, depending on the symptoms and the degree of concern about cancer.

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	Vulva disease with suspicion of malignancy. For optimum care, patient should be seen within 2 weeks. Unexplained vulval lump, ulceration or bleeding. For optimum care, patient should be seen within 2 weeks. Postmenopausal women with abnormal vulval lesions Pregnant or immunosuppressed
Category 2 (appointment within 90 calendar days)	Suspected vulval dystrophy Bartholin’s cysts or other vulval cysts in patients >40 years old Vulva warts where: the patient is immunocompromised (e.g. HIV positive, immunosuppressant medications) the diagnosis is unclear atypical genital warts (including pigmented lesions) there are positive results from the screen for other STIs
Category 3 (appointment within 365 calendar days)	Vulva lesion where: there is treatment failure or where treatment cannot be tolerated due to side-effects there are problematic recurrences Vulva rashes Vulva warts Bartholin’s cyst/labial cysts
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

History of:
- pain
- swelling
- pruritus
- dyspareunia
- localised lesions (pigmented or non-pigmented lesions)
- STIs or other vaginal infections
- local trauma
Elicit onset, duration and course of presenting symptoms
Date of last menstrual period
Medical management to date
Cervical screening if referral for warts

Additional Referral Information

BMI
Vulva ulcers – swab M/C/S and viral PCR result
Vulva rashes – scraping, swabs or biopsy (as appropriate)
STI screen result -endocervical swab or first catch urine for chlamydia +/- gonorrhoea NAA (as appropriate)
Syphillis HIV serology (as appropriate)

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

Send to: Gold Coast Health Service District

Internal Referrals

Gynaecology (E-Blueslips)
Colposcopy (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 Graeme Walker

Medical Director Gynaecology

Facilities

Gold Coast University Hospital

Robina 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.

Vulva lesion/ lump/genital warts/ boil/ swelling/ abscess/ ulcer/ Bartholin’s cystAdult