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Introduction and hypothesis: The physiotherapy-led pelvic health clinic (PLPHC) is an advanced practice clinic that manages women from the urogynaecology waitlist with pelvic organ prolapse (POP) and/or urinary incontinence (UI) at Gold Coast Health, Australia. This study was aimed at determining re-referral rates and reasons for re-presentation of women previously managed and discharged from the PLPHC. We hypothesised that there would be low representation rates for the same condition within 12 months of discharge. Methods: A retrospective audit was undertaken of all (n = 209) patients discharged between 1 January and 31 December 2017. Re-presentation rates and reasons for re-referral for women seen in the PLPHC and discharged without requiring urogynaecology medical specialist review were analysed and descriptive analysis performed. Result: Of the 209 patients, 67 were referred to, or had, urogynaecology medical specialist review after their initial physiotherapy care and were removed from further analysis. Of the remaining 142 patients, who were initially managed by physiotherapy only, 10 (7.1%) women were re-referred to specialist medical outpatient gynaecology and urology out-patient departments, for management of a different diagnosis, and 10 (7.1%) for their original diagnoses, within 12 months of discharge. Of the latter, 1 patient required further physiotherapy and urogynaecologist management; 7 patients required ongoing pessary management; 1 patient continued with urologist medical management; and 1 failed to attend. Conclusion: This study presents novel data on low re-presentation rates in the 12 months following discharge for patients with POP or UI managed in a PLPHC; and provides further support for advanced scope of practice physiotherapy gynaecological service models. [ABSTRACT FROM AUTHOR]

It is possible that the controversy involving prostheses implanted into women with pelvic floor problems might result in the majority of, or even all such products being restricted, banned or withdrawn in certain jurisdictions. A clear distinction between "tapes" for urinary incontinence and "mesh" for prolapse has been made in the enquiries and subsequent rulings in Australia and New Zealand. Transvaginal "mesh" will be unavailable with the range of "tapes" much more restricted in those countries from January 2018. The Chair of the all-party parliamentary group on surgical mesh implants in the United Kingdom was reported as describing the New Zealand announcement as "hugely significant" and "it's precisely what we've been calling for the UK." The title of this article has changed from a hypothetical piece to a potential reality review. Where does that leave the clinicians treating stress urinary incontinence (SUI) and the large number of female sufferers? "Tapes" (synthetic midurethral slings-MUS) have become very popular over the last 20 years since their original development and introduction in Scandanavia. Evidence-based medicine has shown their advantages over previous surgeries, in terms of ease of use, safety and efficacy. This article outlines the options which countries potentially rejecting the use of tapes, must now resort to for women with SUI. Those countries considering such action need the note of caution that none of the options are as good as tapes., (© 2018 Wiley Periodicals, Inc.)