Who to refer

Patients presenting with vaginal prolapse and/ or urinary incontinence:

UROGYNAE PATHWAY 

Urgent referral to Gynaecology-Urogynaecology

  • Complete procidentia
  • High post void residual urine, retention, symptoms of overflow incontinence associated with a prolapse
  • Complication after surgery for prolapse and/or incontinence
  • Mesh complications

Routine referral to Gynaecology

  • Patient already seen by physiotherapy or the continence clinic in last two years
  • Prolapse is visible out of the vagina on coughing/standing
  • Already has a pessary managed in Primary Care, but symptoms no longer controlled

For Physiotherapy- Pelvic and Obstetric or Continence Advisory and Treatment Service

  • All other patients can be referred to R5TG or R5T1 and will be jointly triaged by Continence Nurse and Pelvic Health Physiotherapist to identify the most appropriate clinic.

Who not to refer

  • Urinalysis has been performed and infection treated
  • Relevant swabs or investigations have been completed where indicated
  • Conservative measures have been trialled and documented

How to refer

SCI-Gateway/Continence Clinic OR  SCI Gateway/Gynaecology/Urogynaecology if Urogynaecology input required (Routine or Urgent as per pathway)

Alternative to Referral

SCI-Gateway Advice

Condition Description

Patients presenting with vaginal prolapse and/ or urinary incontinence are managed by our teams of Continence Nurses and Pelvic Health Physiotherapists (Continence Advisory and Treatment Service - ’CATS’), supported by Urogynaecology.

Referrals to SCI Gateway-Continence Service are jointly triaged by Continence Nurse and Pelvic Health Physiotherapist to identify the most appropriate clinic.

Where medical input is required refer directly to SCI Gateway/Gynaecology/Urogynaecology as per pathway.

Continence Advisory and Treatment Service (CATS)

Primary Care Management

  • As per pathway, initial assessment and where appropriate trial of conservative management.
  • Onwards referral to either gynaecology/physiotherapy as indicated/ appropriate.
  • Vaginal examination findings must be documented

Useful resources

  • NHS Tayside Pelvic Health website and PILs – links contained within pathway document (UROGYNAE PATHWAY)
  • CATS
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