Pelvic Mesh

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Useful Management Information

Patients deemed unsuitable for the QPMS may be directed to alternative care pathways for management and support
If your patient does not meet all criteria and is experiencing a gynecological issue, please refer the patient to Gynaecology for assessment

Clinician resources

Patient resources

Information for patients

Minimum Referral Criteria

Category 1	Vaginal bleeding related to mesh exposure Offensive vaginal discharge
Category 2	Recurrent urinary tract infections or unexplained haematuria potentially related to mesh within the bladder
Category 3	Stable mesh related pelvic or vaginal pain Asymptomatic mesh exposure Dyspareunia
If your patient doesn't meet the minimum referral criteria If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service.

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Confirmation of type of mesh product i.e whether for prolapse or incontinence and when it was inserted if at all possible*
Name of commercial pelvic mesh product inserted i.e. Prolift mesh, Elevate mesh, tension free vaginal tape (TVT) etc
Patient symptoms, onset and treatment to date
Quality of life affected by mesh related issues
FBC
LFTs
U&E’s
Urine microscopy, culture and sensitivity/susceptibility

* In order to progress your patient’s referral through the service in a timely manner it is essential to try to obtain confirmation of type of mesh product and when it was inserted if at all possible. This should occur before communicating with the QPMS. Without this information being provided there may be a lengthy delay in your patient being seen in the service

If a specific test result cannot be obtained due to access, financial, religious, cultural or consent reasons a clinical override may be requested. This reason must be clearly articulated in the body of the referral.

Additional Referral Information

BMI
Provide and other relevant history, clinical examination findings and treatment to date (if required)
Provide social factors and impact on patient
Provide Mental health history
What are the patient’s goals of care?
Imaging reports (if available)

Send Referrals To

Smart Referrals

Not available

Internal Referrals

QPMSReferralsGCHHS@health.qld.gov.au

Fax

5619 0677

Post

Queensland Pelvic Mesh Service
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

5619 0772

Service Availability

Facilities

Varsity Lakes Day Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.