For Doctors

Understanding how the Continence GPs work in our practice

 

Our Continence GP services

Our Continence GP’s can liaise with a patient’s usual GP and our surgeons in the management of patient’s bladder and pelvic conditions.  No referral is required and Medicare rebates apply. Their involvement can;

  • Reduce the number of specialist appointments required, reducing costs to patients.
  • Move patients further along a treatment pathway between specialist consultations.  For example, after evaluation by the surgeon they may see the Continence GP for pelvic floor exercise training and review of overactive bladder medication for dose adjustment or switching medication.  Then by the time they next see the surgeon it is determined if conservative and medical therapy is adequate or if further investigation such as urodynamics and alternative treatment options are indicated.  Patients can even be referred directly to urodynamics with the surgeon, when reviewed by the GP, without having to wait for another review appointment with the surgeon.
  • Patients can be reviewed by the Continence GP while waiting for their initial specialist appointment.  This can result in completion of various investigations and trial of nonsurgical therapies prior to their initial specialist appointment so patients are further along the evaluation and treatment pathway by the time they see the surgeon. E.g. bladder diary, flow rates, bladder scan post void residual, pelvic floor exercise education, trial of a pessary for prolapse, trial of overactive bladder medication.
  • Some patients may experience adequate improvement following management by the continence GP and then wish to cancel their initial or review appointment with the surgeon.  The case is discussed with the surgeon and the usual GP notified.
  • The surgeon may schedule patients for some therapies with the Continence GP such as intravesical instillations for interstitial cystitis or Percutaneous Tibial Nerve Stimulation for office based neuromodulation for Overactive Bladder.
  • Continence GPs can schedule patients directly for cystoscopy with one of our surgeons.  For example for microscopic haematuria.
  • Fit pessaries for non-surgical management of pelvic organ prolapse.
  • Provide assistance with applications for CAPS funding.
  • Provide programming review and programming adjustments for patients with a sacral nerve neuromodulation device implanted.
  • Reschedule patients who have had previous successful treatment with Botox bladder injections, for repeat injection with the surgeon.

Triaging referrals by surgeons:

After our surgeons review a referral they may recommend;

  • Scheduling a new patient appointment with the surgeon
  • Booking directly for local anaesthetic flexible cystoscopy combined with new patient consult e.g. microscopic haematuria
  • Booking directly for Fluoroscopic Urodynamics combined with new patient consult e.g. patients failing conservative and medical therapy.
  • Review by Continence GP prior to their specialist appointment to arrange investigations or start therapy.  E.g. bladder diary, ultrasound, flow rates, urine tests.

Our Continence Nurse can provide;

  • Bladder scans to check bladder emptying after bladder botox injections
  • Application for CAPS funding
  • Education on intermittent self-catheterisation
  • Education for managing urethral or suprapubic catheters at home
  • Advice on continence pads and aids
  • Pelvic floor exercises training
  • Education for using bed wetting alarm
  • Diet and behavioural therapy for bladder and bowel problems.
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