Pelvic Organ Prolapse

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply with referral standards and include in particular:

  • History of condition – urinary or faecal incontinence or both
  • Patient symptomatology – lump, something coming down, dragging
  • Previous and current treatment including surgery
  • Obstetric and gynaecological history – including parity
  • Details of the incontinence – stress, urge, nocturia
  • Vaginal examination findings – prolapse

Tests

  • Pap smear
  • MSU –m/c/s and cytology
  • Pelvic ultrasound – if acute symptoms or associated symptoms of pain or bleeding
  • Renal ultrasound – post void residual if associated voiding dysfunction
  • Bladder/voiding diary*

Interim/GP management

To refer a patient with this condition, please see the Gynaecology clinic page for the full referral process and templates.

If prolapse is asymptomatic and patient is not bothered it does not need referral.

* Bladder diary is essential for referral

Referral to Community Continence Clinic may be appropriate.

Consider the use of vaginal oestradiol for six to eight weeks prior to referral.

Referral to Physiotherapy should be considered.

For more information please see the Tasmanian Health Pathways website.

Urgent / category 1

Severe prolapse with cervical ulceration or significant voiding dysfunction

Routine / category 3

Symptomatic/bothersome urinary/anal incontinence

  • or bothersome urinary frequency, nocturia
  • or bothersome voiding difficulty, bladder pain,
  • recurrent UTIs; haematuria

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340 Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:
Routine:

Will be seen in turn.