Pelvic pain services

Services available

General gynaecology (Gynaecology Clinics)

The Women’s Gynaecology Clinics provide a range of medical and surgical options for the assessment, diagnosis and treatment of gynaecological conditions.

Additional details:

• Suitable for patients requiring assessment and diagnosis of pelvic pain.
• Surgical treatment pathways including diagnostic laparoscopy and surgery for complex endometriosis.
• Eligible patients referred for pelvic pain/dysmenorrhea/suspected endometriosis will also be invited to participate in the Early Intervention Pelvic Pain Clinic (Connect Program).

For more information about referring to Gynaecology Clinics, visit General gynaecology.

Early Intervention Pelvic Pain Clinic (Connect Program)

We offer an early intervention program with a symptom management approach to optimise pelvic health as an alternative to, or prior to, laparoscopy. Patients see a multidisciplinary team including a nurse coordinator, pain specialist, pelvic health physiotherapist, dietitian and psychologist.

Additional details:

• Suitable for patients with pelvic pain/dysmenorrhea/suspected endometriosis who would like to manage symptoms with a multimodal, holistic approach before proceeding to surgical diagnostic procedures.
• Time limited program (6-12 months).
• Suitable for patients <40 years of age.
• Approach includes education about pain and pelvic pain conditions, clinical diagnosis of contributors to pelvic pain and holistic management with pelvic floor physical therapy, diet, exercise and stress management.
• Aims to improve symptoms and the impact of pain on functioning.

Chronic Pelvic Pain Clinic

The Chronic Pelvic Pain Clinic sees patients with persistent pain following diagnostic or operative laparoscopy, and all other forms of persistent pelvic pain including pelvic floor, post-surgical and pelvic neuropathies. Note: Referrals to this clinic are usually internal (referred by a gynaecologist at the Women’s following assessment and gynaecological management).

Additional details:

• Suitable for patients with complex pelvic pain.
• Multidisciplinary pain management including pain education, medical pelvic pain assessment, pelvic pain physiotherapist, pain psychologist and nurse coordinator/sexologist.
• The clinic can facilitate referral to the Royal Melbourne Hospital for regional nerve block if required (e.g. pudendal neuralgia).

Inclusion criteria

• The Women’s is the patient’s closest hospital with a pelvic pain service
• Pelvic pain/dysmenorrhoea

Urgent referral

If acute, severe pelvic or abdominal pain, please refer patient to their closest emergency department for immediate assessment.

For criteria suggesting urgent referral, please see General gynaecology.

For assessment or care due to concerning or deteriorating condition, consider the most appropriate of:

• re-refer with additional information for triage reassessment
• Women’s Emergency Care
• registrar review and contact via switch on (03) 8345 2000.

Exclusion criteria

Musculoskeletal lower back pain rather than pelvic pain.

Referral instructions

Essential information

All referrals must include essential demographic, medical and social history, and relevant information about the presenting complaint, including:

• comprehensive pain assessment
• current management to date, including medicine, surgery, analgesia regimen
• assessment of bowel, bladder and sexual function.

For more referral information, visit Women’s health referrals.

Investigations

• Pelvic ultrasound (within last 6 months)

Please also consider:

• if heavy menstrual bleeding: FBE, Ferritin
• most recent CST
• STI screen
• previous pathology testing (e.g. coeliac serology, calprotectin)
• other specialists seen
• relevant surgical or endoscopy reports
• other relevant imaging: abdominal or spinal if available.

Send referral

All pelvic pain referrals can be sent to our Gynaecology Clinics via Fast Fax: (03) 8345 3036.

Use our Women’s Health Referral Form – jump to Referral templates (Downloads).

Referrals will be reviewed and triaged to the most appropriate service depending on the patient’s clinical presentation, diagnoses and history of management.

Suitable patients participating in the Early Intervention Pelvic Pain Clinic (Connect Program) remain on the Gynaecology waiting list. GPs will receive a clinical handover letter from the treating medical specialist on completion of Connect Program consultations.

In detail: How referrals are processed

Appointments

Pelvic pain clinics are held on Mondays and Fridays.

Medical specialist and initial physiotherapy appointments are face-to-face. Telehealth is available for some physiotherapy, psychology, dietetics and clinical nurse consultant appointments.

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