Prolapse

​​​​​​​Emergency

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

  • Irreducible procidentia
  • Prolapse with acute urinary retention
  • Severe pain
  • Systemic infection
  • Uncontrollable bleeding​

When public outpatient services are not routinely provided

  • Asymptomatic prolapse
  • Obstructive defecation associated with rectal prolapse
    Note: referral to colorectal surgeon is indicated
  • Prolapse where the symptoms are well-controlled with a vaginal pessary and patient does not desire surgery
  • Recurrent urinary tract infections not directly attributable to pelvic organ prolapse​

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Difficulty voiding with acute kidney injury or impairment due to prolapse
  • Impacted pessary
  • Procidentia with ulceration​
​Category 2
Recommended to be seen within 90 calendar days.
  • ​Difficulty voiding with or without significant residuals on bladder scanning without renal impairment
  • Mesh erosion with or without bleeding
  • Pessary related complications
  • Recurrent urinary tract infections due to prolapse
  • Urinary retention due to prolapse requiring indwelling catheter

Category 3
Recommended to be seen within 365 calendar days.

  • Inadequate symptom control with vaginal pessary
  • Obstructive defecation associated with genitourinary prolapse
  • Prolapse with painful intercourse
  • Uncomplicated, symptomatic genitourinary prolapse

Note: patients are recommended to undertake a trial of pelvic floor physiotherapy concurrent to gynaecology referral

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition, including symptoms and their duration
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • Obstetric and gynaecological history
    • History of prolapse symptoms, protruding lump, dragging sensation, difficulty with defecation (requiring manual evacuation) or micturition (including incontinence)
    • History of prolapse surgery
    • Midstream urine (MSU) test result
    • Pelvic examination findings
    • Pelvic ultrasound to exclude a pelvic mass
    • Renal ultrasound (if major procidentia)
    • Cervical screening test within the last 5 years

If available

  • Body mass index
  • Menstrual history (cycle, day/months, days of bleeding, blood loss, previously trialled treatments)​

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.​

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing