Pelvic Mesh (referral to Queensland Pelvic Mesh Service (QPMS) Only)

Red flags

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) 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

The Queensland Pelvic Mesh Service (QPMS) provides interdisciplinary care to women who have experienced pelvic mesh complications, including chronic pelvic pain, mesh exposure, infection, bleeding, dyspareunia, incontinence, bladder or bowel perforation, and difficulty sitting or walking.

The QPMS will be delivered by Gold Coast Hospital and Health Service using existing facilities which may include facilities at the Varsity Lakes¹, Robina Health Precinct² and Gold Coast University hospitals³

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

Fistula (constant urinary or faecal incontinence per vagina)
Mesh in viscus
Unexplained haematuria potentially related to mesh within the bladder

Category 2

Appointment within 90 days is desirable

Recurrent urinary tract infections or unexplained haematuria potentially related to mesh within the bladder
Vaginal bleeding related to mesh exposure
Offensive vaginal discharge

Category 3

Appointment within 365 days is desirable

Stable mesh related pelvic or vaginal pain
Asymptomatic mesh exposure
Dyspareunia

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

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

Other important information for referring practitioners

Not an exhaustive list

Refer to HealthPathways for assessment and management information if available
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 her local service for assessment.
If you would like to discuss QPMS further or require assistance with the referral process please phone 07 5619 0772 or email QPMSReferralsGCHHS@health.qld.gov.au
Clinical resources
- QPSM GP Referral form: QPMS General Practitioner referral form
- Information for Clinicians

Patient resources
- Information for patients

Referral requirements

A referral may be rejected without the following information.

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

Additional referral information (useful for processing the referral)

Body mass index (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)

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Clinical Modifiers (where relevant)

Impact on employment
Impact on education
Impact on home
Impact on activities of daily living
Impact on ability to care for others
Impact on personal frailty or safety
Identifies as Aboriginal and/or Torres Strait Islander

Reason for Referral (essential)

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

Clinical Information (essential)

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
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use