General Gynaecology Clinic

Role of service

The General Gynaecology clinics at WNHS provide care for women across the broad range of gynaecological issues. Patients may be referred internally to other specialty gynaecology clinics and allied health services from the General Gynaecology Clinic. Patients referred for gynaecology review may receive an appointment from the Physiotherapy Department at WNHS before the gynaecology clinic appointment, as for some conditions the involvement of a specialist women’s health physiotherapist early in the management pathway may improve outcomes.

Further information about referral pathways is available via Clinicians Assist WA (external site).

Refer to local health service provider in the first instance via the WA Central Referral Service – gynaecological outpatient clinics are also available at South Metropolitan Health Service and East Metropolitan Health Service hospitals.

Clinical inclusion

• Heavy, irregular or absent menses
• Intermenstrual or postcoital bleeding
• Post-menopausal bleeding
• Investigation of pelvic masses
• Pelvic pain
• Endometriosis investigation and management
• Dyspareunia and sexual dysfunction
• Prolapse
• Urinary incontinence
• Cervical and endometrial polyps
• Subfertility requiring investigation
• Recurrent miscarriage
• Polycystic Ovarian Syndrome (PCOS).

Clinical exclusion

• Reversal of tubal ligation.
• Menopause symptoms after cancer – refer to Menopause Symptoms after Cancer clinic.
• Menopause symptoms – refer directly to General Menopause Clinic.
• Vulval itch / pain / skin problems – refer directly to Vulvoscopy Clinic.
• Cervical screening test result advising colposcopy – refer directly to Colposcopy Clinic.
• Unplanned pregnancy – refer to Abortion clinic.
• Severe endometriosis – refer directly to Endoscopy Clinic.

Frequency of clinic

Daily.

Referral to include

• Current CST test and history for each referral (if age >25yrs – CST History available via PRODA (external site)).
• The following pre-requisite investigations:
  • Endometriosis, dysmenorrhoea, pelvic pain
    Pelvic ultrasound, cervical screen and recent STI screen.
  • Fibroid
    Pelvic ultrasound.
    If associated heavy menstrual bleeding, include FBE and Ferritin.
  • Molar pregnancy
    BHCG, US, STI screen and blood group/antibodies.
  • Ovarian and other adnexal pathology
    Pelvic ultrasound, if has had CT, include result but add pelvic ultrasound if not done.
    If suspected malignancy or post-menopausal ovarian cyst, cancer antigen 125 (CA 125).
  • Heavy menstrual bleeding
    Pelvic ultrasound, FBE, Ferritin and TFT.
  • Intermenstrual or post coital bleeding
    Pelvic ultrasound and STI screen.
  • Polycystic Ovarian Syndrome (PCOS)
    Pelvic ultrasound.
  • Polyp (cervical or uterine)
    Cervical screen and pelvic ultrasound.
  • Post-menopausal bleeding
    Pelvic ultrasound and STI screen.
  • Prolapse
    Pelvic Ultrasound, MSU if urinary symptoms.

Urgent referral

Ring and discuss case with:

• Gynaecology Registrar On Call on (08) 6458 2222.
• If the case is complex, discuss with the On Call Consultant Gynaecologist from 8am to 4pm Monday to Friday.

Referral process

All referrals from GPs to this clinic are sent to the Central Referral Service WA (CRS) (external site). Ensure you provide the relevant information in the referral to enable appropriate triage, including required investigation results and letters from treating medical practitioners if relevant and request general gynaecology clinic at WNHS.

Referrals using GP software that include all the relevant history and information are also welcome using CRS referral form templates (external site).

Useful links

WNHS at KEMH Physiotherapy

RANZCOG: Patient Information (external site)