Gynaecology
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Emergency
If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
- Ectopic pregnancy
- Ruptured haemorrhagic ovarian cyst
- Torsion of uterine appendages (ovarian)
- Acute/severe pelvic pain
- Significant or uncontrolled vaginal bleeding
- Severe infection
- Abscess intra pelvis or PID
- Bartholin's abscess / acute painful enlargement of a Bartholin's gland/cyst
- Acute trauma including vulva/vaginal lacerations, haematoma and/or penetrating injuries
- Post-operative complications within 6 weeks including wound infection, wound breakdown, vaginal bleeding/discharge, retained products of conception post-op, abdominal pain
- Urinary retention
- Acute urinary obstruction
- Unstable molar pregnancy
- Inevitable and / or incomplete abortion
- Hyperemesis gravidarum
- Ascites, secondary to known underlying gynaecological oncology
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CPC in scope Not an exhaustive list
Please note this is not an exhaustive list of all conditions for outpatient services and does not exclude consideration for referral unless specifically stipulated in the CPC out of scope section.
- Abnormal cervical screening / cervical dysplasia / abnormal cervix ADULT
- Cervical polyp ADULT
- Dyspareunia (deep or superficial) ADULT
- Elective Tubal Ligation ADULT
- Fibroids ADULT
- Heavy menstrual bleeding (HMB) ADULT
- Infertility/RPL ADULT
- Intermenstrual bleeding ADULT
- Known or suspected endometriosis ADULT
- Mirena®/progesterone releasing IUD Insertion or removal, for HMB or HRT ADULT
- Ovarian cyst / pelvic mass ADULT
- Pelvic floor dysfunction (e.g. prolapse and/or incontinence) ADULT
- Pelvic mesh (referral to Queensland Pelvic Mesh Service (QPMS) ONLY) ADULT
- Pelvic pain/dysmenorrhea/PMS ADULT
- Polycystic Ovarian Syndrome (PCOS) ADULT
- Post-coital bleeding ADULT
- Post-menopausal bleeding (vaginal bleeding more than 12 months following last menstrual period) ADULT
- Primary/ secondary amenorrhoea ADULT
- Removal of Implanon NXT® ADULT
- Termination of Pregnancy ADULT
- Vulva lesion/ lump/genital warts/ boil/ swelling/ abscess/ ulcer/ Bartholin’s cyst ADULT
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CPC out of scope
The following are not routinely provided in a public Gynaecology service.
- Elective cosmetic surgery e.g. labiaplasty
NB labial hypertrophy in paediatric and adolescent patients: refer to Statewide Paediatric and Adolescent Gynaecology Services (SPAG) at Queensland Children's Hospital/RBWH.
- Elective tubal ligation but will be accepted as a category 3, if :
- patient cannot use/trialled other contraceptive methods
- patient does not want to pass on any genetic disorders or disabilities
- indicated for women suffering from medical or obstetric conditions that would contraindicate future pregnancy
- within the scope of the health service
- Routine contraceptive counselling
- Routine Implanon/Mirena®/progesterone-releasing IUD insertion for contraception
- unless within the scope of the local health service
- Primary menopausal care
- Cervical screening test
- Postnatal check-up
- Reversal of tubal ligation
- IVF services
From 3 December 2018 the Termination of Pregnancy Act 2018 ensures a termination of pregnancy is treated as a health issue rather than a criminal issue in Queensland. The Act supports a woman's right to health and autonomy, provides clarity for health practitioners, and brings Queensland in line with other Australian jurisdictions.
Information for health practitioners can be found on the Clinical Excellence Queensland website or by contacting 13HEALTH.NB It is recommended to see your regular GP for continuity of care and alternatively where available recommend referral to True – relationships and reproductive health (formerly known as Family Planning Queensland) or Women's Health speciality primary care provider/service
The following are not routinely provided in the Queensland Pelvic Mesh Service(QPMS)
- Recurrent isolated symptoms of incontinence, bladder dysfunction or prolapse following mesh implantation in the absence of other mesh related issues, such as pelvic or vaginal pain
- Patient reassurance in the absence of characteristic mesh-related symptoms
- Assessment of morbidity following the implantation of other mesh products, such as hernia mesh or mesh related to colorectal disease
- The routine tracing or confirmation of past mesh implantation by contacting hospitals or previous providers