Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • acute painful enlargement of a Bartholin’s gland/cyst
  • acute trauma including:
    • vulva/vaginal lacerations
    • haematoma and/or
    • penetrating injuries
  • Bartholin’s abscess

Please contact the gynaecology on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Women's and Children's Health Network


  • vulval disorders without a trial of first-line treatment

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • suspicion of malignancy
  • unexplained vulval lump/ulceration/bleeding
  • post-menopausal women with abnormal vulval lesions
  • immunosuppressed women with vulval lesion/s

Category 2 (appointment clinically indicated within 90 days)

  • Bartholin’s/vulval cysts in women greater than 40 years of age
  • suspected vulval dysplasia
  • vulval dermatoses, including Lichen Sclerosus
  • vulval warts where:
    • the diagnosis is unclear
    • the patient is immunocompromised
    • there is atypical presentation including pigmented lesions

Category 3 (appointment clinically indicated within 365 days)

  • Bartholin's / vulval cysts in women less than 40 years of age
  • vulvar dermatitis
  • vulval lesions with any of the following:
    • treatment is not tolerated
    • unresponsive to first-line treatment
  • vulval warts

For more on outpatient referrals, see the general referral information.

Central Adelaide Local Health Network only accept referrals for people greater than 18 years of age.

Due to limitations in infrastructure and resources, the Women's and Children's Hospital cannot accommodate referrals for individuals with a body mass index (BMI) equal to or greater than 45, as well as individuals over the age of 69 years of age.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • past medical/surgical/obstetric/psychosocial history
  • current medications and allergies
  • hormonal contraception use
  • onset, duration and course of presenting symptoms
  • presenting symptoms history, including:
    • pain
    • swelling
    • pruritus
    • dyspareunia
    • localised lesions, pigmented or non-pigmented lesions
    • sexually transmitted infection (STI) or other vaginal infection/s
    • trauma where appropriate
    • medical management to date
  • pelvic examination findings
  • height/weight
  • BMI
  • relevant diagnostic/imaging reports including location of company and accession number


  • an up-to-date cervical screening test as per the cervical screening guidelines
  • sexually active people – please complete a STI screen, including:
    • human immunodeficiency virus and syphilis serology
    • chlamydia and gonorrhoea which requires:
      • endocervical swab for culture and
      • endocervical polymerase chain reaction (PCR) swab or urine sample
      • herpes simplex virus and varicella-zoster virus PCR screen

Vulval ulceration present

  • wound swab M/C/S and
  • PCR screen for herpes simplex virus and varicella-zoster virus
  • exotic travel history including location, date and length of stay

Vulval dermatitis present

  • allergy skin testing results
  • fungal swab/scraping if suspicion of candidiasis

Clinical management advice

The primary causes of vulval disorders commonly include vulvovaginal candidiasis, dermatological conditions like Lichen Sclerosus and irritant or contact dermatitis. These conditions can often be effectively managed with first-line treatments provided by a general practitioner within the community.

It is important to note that relying solely on antibiotics may not result in complete resolution of Bartholin's cysts, particularly when they are large or recurring. Surgical marsupialisation, a procedure to drain the cyst and prevent future recurrences, may be necessary. Therefore, it is recommended to seek medical advice for accurate diagnosis and treatment.

Clinical resources

Consumer resources