Gynaecology
NHS Tayside RefGuide
Specialty description
Gynaecology is the branch of medicine that focuses on the female reproductive system including diagnoses and treatment of reproductive system disorders that include the ovaries, uterus, cervix, vagina and vulva. Common conditions seen are endometriosis, infertility, ovarian cysts and pelvic pain.
The Gynaecology Department is a multi-disciplinary team comprising consultants, registrars and specialist nurses. The service provides a full range of in-patient and out-patient gynaecology services in a variety of settings across Tayside.
Who to refer
Current services include:
- Emergency gynaecology
- Gynaecological oncology
- Elective surgery
- Colposcopy
- Urogynaecology
- Benign gynaecology
- Vulval disorders
- Postmenopausal bleeding
- Outpatient hysteroscopy
- Infertility/assisted conception unit
- Termination of pregnancy
- Early pregnancy assessment (pregnancies of up to 13+6 weeks gestation)
Who not to refer
Planned care
Refer to Genito-Urinary medicine in SCI Gateway for the following:
- Sterilisation request in patients less than 30 years for complex contraception clinic
- Coils for HRT/contraception
- Coil removals
- Recurrent vulvovaginal candidiasis/bacterial vaginosis
- Nexplanon removal
- Lost coil thread.
Refer to Genito-Urinary - Menopause for menopause HRT advice in SCI Gateway.
Refer to Physiotherapy - Pelvic and Obstetric in SCI Gateway for the following:
- Prolapse as per pathway based on examination findings
- Urinary symptoms based on pathway.
Absorbent Containment Products
In line with best practice recommended by NICE, containment products cannot be provided until full assessment has taken place. GPs/Surgeries are kindly requested to advise patients that they cannot call the CATS or Pelvic Floor Physiotherapy Service to self-refer or request products following referral until they have been assessed and completed full continence assessment. For frail patients, you may wish to consider whether referral to the District Nursing Service for a holistic assessment would be appropriate.
Refer to Dermatology - Vulval Clinic in SCI Gateway for patients with complex lichen sclerosis/lichen planus etc as per the referral guidance.
Emergency care
Please consider the following differentials, which may result in a non-gynaecological cause of pelvic pain:
- GI symptoms suggestive of appendicitis or gastroenteritis.
- Urinary symptoms relating to pyelonephritis, cystitis, renal stones, urethral caruncle with severe pain.
- Symptoms more likely indicating a groin swelling/abscess or perianal abscess.
How to refer
Emergency/Urgent same day advice
All gynaecology emergencies and EPAC (Early Pregnancy Assessment Clinic) patients are reviewed centrally in Ninewells.
Early pregnancy problems
Open 9.00am - 4.30 pm Monday to Friday (closed public holidays) Tel: 01382 632069.
For early pregnancy advice at other times please contact Ninewells Hospital - 01382 660111 and ask for the Gynae Suite.
Urgent admission requests or same day urgent advice
Bleep the on-call Gynae Reg on #5610 (available 24 hours)
If unavailable, the on-call consultant is #3156 (Monday to Friday 08.00-17.00)
Urgent/emergency reviews would include the following presentations:
- ectopic pregnancy
- miscarriage
- ovarian cyst complications such as torsion
- heavy menstrual bleeding resulting in severe anaemia
- bleeding gynaecological malignancies
- infected Bartholin's abscess
- procidentia with urinary retention
- gynaecological postoperative complications
- severe vomiting in early pregnancy.
Outpatient referrals/routine advice
Urgent suspected cancer/urgent/routine/advice
Please refer patients via SCI Gateway to the relevant clinic, as detailed in our referral pathways.
Abortion care
All patients can now self-refer directly into the Abortion (Termination of Pregnancy) Service by phoning 01382 496762. For more information on self-referral, please see Abortion Care.