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.
- nil
For clinical advice, please telephone the relevant specialty service.
Central Adelaide Local Health Network
- Royal Adelaide Hospital (08) 7074 0000
- The Queen Elizabeth Hospital (08) 8222 6000
Northern Adelaide Local Health Network
- Lyell McEwin Hospital (08) 8182 9000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
Women's and Children's Health Network
- Women’s and Children’s Hospital (08) 8161 7000
Category 1 (appointment clinically indicated within 30 days)
- trial of void
- intermittent self-catheterisation
- difficulty voiding with renal impairment
Category 2 (appointment clinically indicated within 90 days)
- difficulty voiding +/- significant residuals on bladder screening without renal impairment
Category 3 (appointment clinically indicated within 365 days)
- uncomplicated urinary incontinence
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
- height/weight
- BMI
- bladder diary including intake/output
- quality of life concerns including missed work/study/family
- pelvic examination findings
- kidneys, ureters and bladder ultrasound with post volume residuals included
- relevant diagnostic/imaging reports including location of company and accession number
Pathology
- mid-stream urine (MSU) microscopy, culture and sensitivity (M/C/S)
- urine cytology
Sexually active people
Complete a sexually transmitted infection screen, including:
- human immunodeficiency virus and syphilis serology
- chlamydia and gonorrhoea which requires:
- endocervical swab for culture and
- endocervical polymerase chain reaction swab or urine sample
Clinical management advice
Physiotherapy and/or continence nurse management referral should be considered as part of initial management for urinary incontinence e.g. pelvic floor muscle exercises and bladder training.
All patients require kidneys, ureters & bladder ultrasound which will also assess their post void residual volume.
Consider first line medication therapy if low residuals on bladder scan, no suspicion of a sinister cause. This would include vaginal oestrogen in post-menopausal women, anticholinergics or beta-3 agonists.
Clinical resources
- Australian Commission on Safety and Quality in Health Care - Care Pathway for the Management and Referral of Urinary Incontinence in Women
- Australian Indigenous Health Info Net - Central Australian Aboriginal Congress: Women's Business Manual for Remote and Rural Practice 7th Edition
- Australian Medical Association - New Stolen Generation resources for GPs
- Continence Foundation of Australia - Management of Urinary Incontinence
- Urogynaecological Society of Australasia (UGSA) – Over Active Bladder
- UGSA – Stress Urinary Incontinence
Consumer resources
Reason for request
- to establish a diagnosis
- for treatment or intervention
- for advice and management
- for specialist to take over management
- for a specified test/investigation the General Practitioner cannot order
- for other reason (e.g. rapidly accelerating disease progression)
- transfer of care from another tertiary service
- clinical judgement indicates a referral for specialist review is necessary.
Patient demographic details
- full name, including aliases
- date of birth
- residential and postal address
- telephone contact number/s – home, mobile and alternative
- Medicare number, where eligible
- name of the parent or caregiver, if appropriate
- preferred language and interpreter requirements
- identifies as Aboriginal and/or Torres Strait Islander
Clinical modifiers
- impact on employment
- impact on education
- impact on home
- impact on activities of daily living
- impact on ability to care for others
- impact on personal frailty or safety
- identifies as Aboriginal and/or Torres Strait Islander
Other relevant information
- Willingness to have surgery, where surgery is a likely intervention.
- Choice to be treated as a public or private patient.
- Compensable status, e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.
- Relevant social history, including identifying if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf.
- Triage of a specialist outpatient referral is based on clinical decision making to allocate an appropriate urgency categorisation.
- Where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
- A change in patient circumstance (such as condition deteriorating or pregnancy) may affect the urgency categorisation and should be communicated as soon as possible.
- All new referrals will be triaged by a consultant and appointment times scheduled according to clinical urgency.