Gynaecology referrals

COVID-19 and Gynaecology referrals

During the next few months, we are changing the way we work to adapt to the COVID-19 pandemic and to enable us to protect our patients and staff.
In line with government guidance, we are cancelling all non-urgent benign elective operating and minimising our outpatient clinics.

During this time the following clinics will be functioning with limited service:
• Postmenopausal bleeding clinics
• Colposcopy clinics
• 2 Week Wait/Cancer clinics
• Early Pregnancy Assessment Unit
• Termination of pregnancy clinics
Please note that the referral criteria for these clinics have been modified during this period, as detailed below.

1) 2 Week Wait Clinics
Suspected Ovarian cancer
• If physical examination identifies ascites and/or a pelvic or abdominal mass (which is not obviously uterine fibroids)
• Raised Ca-125 (over 100) in a woman with symptoms suggestive of cancer of the ovary / with ultrasound suggesting cancer of the ovary
Suspected Cancer of Endometrium
• Post-menopausal bleeding – please refer directly to the PMB clinic

Suspected Cancer of cervix
• Recurrent intermenstrual or post-coital bleed, and on examination, the appearance of the cervix consistent with cervical cancer
• Check recent smear and smear history. If negative (even with HPV positive) the chances of malignancy are very low.

Suspected Vulval and Vaginal cancer
• Vulval – unexplained, vulval lump, ulceration or bleeding
• Vaginal – Unexplained palpable mass in or around the introitus

2) Early pregnancy assessment unit
• Patients between 6-16 weeks with vaginal bleeding or pain and a positive pregnancy test only
• During this time please do not refer for reassurance scans – e.g. recurrent
miscarriage, asymptomatic previous ectopic, anxiety, previous molar.
• Also, any bleeding before 6/40 without acute pain should be asked to do a UPT in 2 weeks and NOT referred for scan after the 6/40 point. Refer only if UPT is positive after 2 weeks.