Urogynaecology Clinic

Role of Service

This service is available for all women across WA who require urogynaecological care.

 

Clinical inclusion

Direct GP referral to the Urogynaecology Service is indicated for:

  • Procidentia – severe pelvic organ prolapse (uterus, vagina, bladder).
  • Pelvic Mesh complications
  • Urological complications of gynaecology surgery.
  • Recurrent stress incontinence or prolapse.
  • Urinary incontinence in association with high residuals, suspicion of fistula or urethral diverticulum.

 

Clinical exclusion

  • Malignancy of urinary tract – refer to general urology unit.
  • Upper urinary tract / renal tract issues – refer to general urology or renal medicine unit.
  • Patients referred with prolapse or incontinence will be seen by General Gynaecology first and then referred to Urogynaecology as indicated.
  • Faecal incontinence not associated with gynaecological disease – refer to Colorectal Unit via the CRS or direct contact with a Colorectal Unit.
  • Recurrent UTIs not associated with gynaecological problems.
  • Haematuria, malignancy, upper renal tract disease – refer to a Urology Clinic at a general hospital via the CRS.

 

Frequency of clinics

Clinic appointments are on Monday, Tuesday and Thursdays with different specialities provided on different days.

 

Referrals to include

Pre-requisite information for referrals:

  • Detailed history, including current medications, allergies and past surgical history.
  • Details of any mobility issues.
  • Details of pessary (if in situ).
  • Details about whether the woman has a current IDC or has had a past IDC.
  • BMI is required for urodynamics, as this cannot be done if BMI>40.

Pre-requisite tests for referrals

  • MSU mc&s recent result.
  • Bladder ultrasound and estimate of residuals.
  • Please include any other investigation results if available such as: pelvic ultrasound, IVP, MRI, CT, cystoscopy, full urodynamics chart and report.
  • Current CST within five years if age >25 years.

 

Urgent referrals

To discuss an urgent referral, contact the Urogynaecology Fellow through KEMH switchboard (08) 6458 2222, after hours contact On Call Registrar.

 

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 urogynaecology 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).

 

Contact information

Urogynaecology Clinic Specialist Nurse – contact via switchboard (08) 6458 2222 for pager 3587.

Support is available to GPs and patients via the urogynaecology clinic specialist nurse. This service is available to help patients while they wait on an appointment in the urogynaecology clinic. Contact can be made via email: KEMH.UrogynaecologyClinic@health.wa.gov.au – do NOT send referrals to this address.

Women who have concerns, complications or adverse side effects from the insertion of transvaginal mesh, can contact the dedicated Pelvic Mesh telephone line (1800 962 202) from 8:30am to 4:30pm Monday to Friday. More information about the pelvis mesh telephone line.

 

Useful links

Pelvic Floor First (external site)

Continence Foundation of Australia (external site)

RANZCOG: Patient information (external site)

 

Guide for GP management of stress and urge incontinence

Refer to HealthPathwaysWA website (external site)

RACGP Clinical Guide Silver Book: Urinary incontinence (external site)

It is recommended GPs initiate first line treatments of physiotherapy and medication which can provide a significant reduction in symptoms.

Women should only be referred to a qualified women’s health physiotherapist.

Weight loss and exercise for overweight or obese women with urinary incontinence should also be encouraged.

Recommended investigations:

  • All women should have an MSU to exclude infection.
  • Prior to starting anticholinergic medications, a bladder ultrasound is required to exclude high residuals. Up to 100mL is acceptable.
  • If initial management strategies for urinary incontinence or prolapse are unsuccessful, GPs should make a General Gynaecology referral via the CRS.
Last Updated: 16/07/2024