Monitoring
Specialist Referral
Immediate specialist referral should be considered in the following
conditions:
- Incontinence with abdominal and/or pelvic pain
- Hematuria in the absence of an infection
- Suspected fistula
- Complex neurological conditions (eg Parkinson’s disease, spinal cord injury)
- Abnormal findings (eg pelvic mass or symptomatic organ prolapse beyond the hymen, palpable bladder after voiding on abdominal or bimanual exam)
Elective
referral to a specialist should be considered in the following conditions:
- Persistent symptoms after an adequate therapeutic trial
- Uncertain diagnosis and lack of reasonable treatment plan
- Significant increase in PVRV that does not resolve after treatment of possible precipitants (eg medications, stool impaction)
- Prior pelvic surgery or pelvic irradiation
- Desire for surgical treatment
- Concurrent surgery for stress UI and pelvic organ prolapse may be considered in women with both stress UI and anterior and/or apical prolapse