
Patient Information
Dr Elizabeth Goulding accepts referrals for gynaecological cancers, pre-cancers, endometriosis, fibroids, heavy bleeding and pain, abnormal Pap smears, vulval conditions and other general gynaecological conditions.
Her areas of expertise include but are not limited to complex surgical cases; minimally invasive surgery; minimally invasive surgery for large fibroid uteri; vulval disorders; vulval, vaginal and cervical dysplasia; survivorship and sexual health
Dr Goulding is committed to providing state of the art and evidence-based care to her patients. As both a specialist gynaecologist and subspecialist gynaeoncologist she has had years of extensive training in advanced pelvic surgery. She is a proud founder of the Grace Gynaeoncology Group, the largest private Gynaecological Oncology centre on the Gold Coast, and the only service offering its patients a private multidisciplinary meeting to ensure the highest quality of care is delivered to every patient
COMMON REFERRALS INCLUDE:
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Gynaecological cancer and pre-cancer diagnosis and surgical management
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Endometriosis, dysfunctional uterine bleeding and fibroids
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Complex benign gynaecology (uterine, pelvic and ovarian masses)
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Advanced laparoscopic surgery (benign and cancerous disease)
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Advanced open surgery (benign and cancerous disease)
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Counselling and management of women with an increased risk of gynaecological cancer (eg. BRCA and Lynch mutations)
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Hysteroscopy
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Colposcopy and the management of cervical dysplasia
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Vulval disorders and vulvoscopy
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The most common reasons you may be referred to see Dr Goulding are listed below:
Gynaecological cancers and pre-cancers: ovarian/fallopian tube, endometrial, vulval/vaginal, or cervical cancers
Gynaecological cancers require immediate, specialised treatment.
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If you have a suspected or confirmed gynaecological cancer or pre-cancer, Dr Goulding will see you promptly, with the aim of commencing treatment as soon as possible. She works closely with medical oncologists and radiation oncologists to ensure that efficient, high-quality, multidisciplinary care is available to all women with cancers involving the reproductive system.


Endometriosis
Endometriosis affects around 1 in 10 women. It often causes severe pain in the pelvis, especially during menstrual periods. It can also cause pain during sex or when using your bladder or bowels. It can cause fertility problems, bloating, nausea, fatigue, heavy periods and bleeding between periods, depression and anxiety. It has significant social, economic and public health impacts.
Dr Goulding is an experienced and skilled endometriosis surgeon and is able to excise advanced disease, remove scar tissue and fibrosis, and remove endometriosis outside of the pelvis. She works within a multidisciplinary team at her rooms, being able to tailor a patients treatment moving forward aiming to address the many facets of this disease and optimise your care.
Fibroids
Fibroids (leiomyoma) are non cancerous growths of the muscle layer of your uterus (womb). They are a common cause of painful and heavy periods.
The symptoms of fibroids can be managed with a variety of treatments including medical (hormonal medications) radiological (embolization) and surgical.
Dr Goulding specialises in the medical and surgical management of fibroids, particularly, minimally invasive (key hole) surgery for very large fibroids (through using a power morcellator to reduce the size of the fibroid and remove it through a small incision) and the hysteroscopic resection of fibroids.


Family history of gynaecological and/or breast cancer
When one or more of your family members have been diagnosed with cancer, it is advisable to investigate the implications for yourself and other close family members. In this case, your GP or a genetic specialist can talk to you about the likely risk of cancer in your family. In certain circumstances, you may be eligible to undergo genetic testing to help determine your risk. If you are estimated to have a higher risk of developing a gynaecological cancer, Dr Goulding can discuss the options to reduce your risk (these may include minimally invasive surgery).
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If you have a personal history of breast cancer, you may also be referred to discuss the options to reduce your risk of other cancers or the options for hormonal manipulation to reduce your risk of breast cancer recurrence.
Abnormal uterine bleeding
Abnormal uterine bleeding is defined as very heavy or longer than usual menstrual bleeding. It can also mean bleeding that does not follow a normal pattern, such as lighter bleeding between periods, bleeding after intercourse or bleeding after menopause.
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There are many conditions that result in abnormal uterine bleeding, so a diagnosis may require various tests. An ultrasound can be very useful first step to determine the appropriate sequence of investigations and treatment options. Another useful investigation is a biopsy from the lining of the uterus (endometrium). This can diagnose many causes of abnormal uterine bleeding and help guide your treatment. If a biopsy is required, Dr Goulding can often perform this procedure during your appointment in their consulting suites, and if not have rapid access to a biopsy under a general anaesthetic (via a hysteroscopy, dilation and curettage).
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Treatment options for abnormal uterine bleeding include non-surgical and surgical options. When surgical treatment is appropriate, minimally invasive surgery (including minimally invasive hysterectomy) is often possible.


Colposcopy: abnormal cervical screening tests and other cervical problems
The cervical screening program uses a combination of the new HPV test and the pap test (also called pap smear) to detect HPV infection and/or abnormal cells on the cervix that may lead to cervical cancer if untreated. We understand that an abnormal cervical screening result can be very stressful, however, it only rarely means that cervical cancer is already present.
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If your results require specialist assessment, your GP will refer you for a colposcopy, which can be performed in Dr Goulding’s consulting suites. This test uses a special microscope (called a colposcope) to examine the cervix and determine whether treatment is necessary. If treatment is required a simple procedure is all that is usually required to remove any abnormal cells. This is done with a thin wire loop (a LLETZ procedure).
Abnormal cysts or pelvic tumours
An abnormal cyst or tumour can commonly arise from the ovaries or uterus and may cause pelvic symptoms such as pain and discomfort. Your GP may initially investigate these symptoms by arranging for you to have a pelvic ultrasound and some specialised blood tests.
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An ovarian cyst may be a simple cyst (almost always benign or non cancerous), or a complex cyst (a cyst with more concerning features that may sometimes have borderline or cancerous changes). In many cases surgical removal of the cyst is the only way to determine whether a cyst is benign, borderline or cancerous.
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Fibroids, which are benign tumours in the uterus, are another common problem. When detected, they may not cause women any symptoms or may cause problems such as pelvic pain/discomfort, abnormal bowel or bladder function, pain during intercourse, or abnormal uterine bleeding. Treatment with medication is often effective for fibroids. In situations where medications don’t work, surgery (including hysterectomy i.e. removal of the uterus) may be considered. Minimally invasive options may be possible.
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Less frequently, a mass in the uterus can be caused by a cancer. If you have worrisome symptoms or high risk features, Dr Goulding will see you promptly for investigation and treatment.


Vulvovaginal Conditions
There are a number of conditions that can affect your vagina and vulva (the outside part of the female genitals). Some are uncomfortable, others can be painful and irritating. Most can be easily treated. Sometimes vaginal and vulval symptoms can be due to other more serious causes, and it is important you are assessed by a clinical skilled in the management and diagnosis of vulval conditions.
Dr Goulding has a special interest in vulval conditions, she is able to facilitate a timely diagnosis and treatment of both benign, pre-cancerous and cancerous conditions of the vulva.