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.

  • urosepsis
  • acute urinary retention
  • acute renal failure
  • acute trauma to urethra
  • suspected cauda equina syndrome
  • suspected spinal cord compression
  • systemic signs of infection
  • urinary outlet obstruction

Please contact the 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.

Southern Adelaide Local Health Network

Women's and Children's Health Network


  • Rconcerns of ‘childhood non-accidental injury’ – refer to Child Protection Services for further information
  • incontinence associated with developmental delays or behavioural diagnosis (e.g. attention-deficit/hyperactivity disorderor or autism spectrum disorder) - assessment by occupational therapy and paediatric medicine prior to urology
  • monosymptomatic nocturnal enuresis - consider referral to enuresis clinic
  • sexually transmitted infections – refer to Adelaide Sexual Health Centre
  • stress incontinence – consider allied health practitioner involvement for first-line treatment
  • uncomplicated lower urinary tract symptoms (LUTs) without first-line treatment

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • moderate to high post-volume residuals (PVRs) for age/bladder size with:
    • altered renal function and/or
    • hydronephrosis and/or
    • severe irritative symptoms (bladder pain or severe cystitis)

Category 2 (appointment clinically indicated within 90 days)

  • incontinence associated with a history of recurrent urinary tract infections (UTIs)
  • repeated episodes of urinary retention
  • elevated PVRs for age and bladder size
  • persistent or progressive symptoms despite first-line treatment
  • previous incontinence/pelvic surgery and/or pelvic radiation/malignancy
  • urethral stricture
  • meatal stenosis
  • neurogenic bladder and/or neurological symptoms, if neurogenic bladder and/or neurological symptoms unexplained, consider imaging and investigations
  • suspected/confirmed urogenital fistula
  • haematuria and/or sterile pyuria

Category 3 (appointment clinically indicated within 365 days)

  • child with greater than 6 months daytime urinary incontinence
  • secondary enuresis or new onset incontinence in a previously dry child

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

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 within your referral 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
  • interpreter required
  • age
  • past medical/surgical/psychosocial/family history
  • current and trialled medications, specifically alpha blockers, 5 alpha reductase inhibitors, anticholinergic agent, beta-3 adrenergic antagonists, phosphodiesterase type 5 inhibitor
  • previous management trialled and outcomes e.g. intermittent self-catheterisation, aperients
  • allergies and sensitivities
  • presenting symptoms history, including:
    • onset/duration
    • daytime accidents
    • frequency
    • urgency
    • straining
    • pain on urination
    • if periods of dryness ask about physical, emotional and social triggers
    • previous treatments
    • history of constipation
    • history of urinary tract infections (UTI’s)
  • associated co-morbidities e.g. neurological condition or spinal injury; pelvic surgery, malignancy, chemotherapy/radiotherapy, constipation, enuresis,
  • quality of life concerns including missed work/school/extracurricular activities
  • height/weight
  • body mass index (BMI)
  • growth chart trends
  • blood pressure trends
  • abdominal examination findings
  • neurological examination findings
  • bladder/stool chart, intake/output fluid chart
  • indwelling urinary catheter status, if relevant
  • urinalysis (dipstick) result
  • kidneys, ureters and bladder (KUB) ultrasound (US) with pre and post volumes
  • pathology:
    • mid-stream urine (MSU) microscopy, culture and sensitivity (M/C/S) (ideally first pass urine collection)
    • sexually active people complete a sexually transmitted infection (STI) screen, including chlamydia and gonorrhoea which requires:
      • endocervical/penile swab for culture and
      • endocervical/penile polymerase chain reaction (PCR) swab or urine sample

Additional information to assist triage categorisation

  • bladder diary
  • kidneys, ureters, bladder (KUB) ultrasound (US) including pre and post volumes
  • relevant diagnostic/imaging reports, including location of company and accession number
  • abdominal x-ray