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 renal failure
  • ureteric or bladder outflow obstruction
  • urinary retention
  • infective symptoms (e.g. if obstruction is due to stone)

Please contact the urology registrar on call 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


  • previously fully investigated hydronephrosis without obstruction or sinister pathologies detected without clinical and radiological progression

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • hydronephrosis with concerning features including
    • suspicion of malignancy
    • urinary retention not meeting threshold for emergency presentation
    • obstructing stones not meeting threshold for emergency presentation
    • deteriorating renal function

Category 2 (appointment clinically indicated within 90 days)

  • hydronephrosis without concerning features

Category 3 (appointment clinically indicated within 365 days)

  • nil

For information on referral forms and how to import them, please view general referral information.

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
  • relevant past medical/surgical history
  • current medications, allergies
  • history of presenting complaint including
    • onset
    • duration
    • concerning features
  • physical examination findings
    • abdominal e.g. palpable bladder
    • digital rectal examination (DRE) (men)/pelvic examination (women)
  • pathology
    • complete blood examination (CBE)
    • electrolytes, urea and creatinine (EUC)
    • liver function test (LFT)
    • estimated glomerular filtration rate (eGFR)
    • prostate-specific antigen (PSA)
    • mid-stream urine (MSU)
  • computed tomography (CT) urogram (pre and post intravenous contrast + delayed pyelograms) unless contraindicated
  • relevant diagnostic/imaging reports including location of company and accession number

Additional information to assist triage categorisation

  • consider mercaptoacetyltriglycine (Tc99m-MAG3) renography if pelvic-ureteric-junction (PUJ) obstruction suspected