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.

  • severe genital infection e.g. Fournier’s gangrene/epididymo-orchitis
  • severe haematuria
  • urinary tract sepsis/severe infection with urinary obstruction

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.

National Continence Helpline

Central Adelaide Local Health Network

Northern Adelaide Local Health Network 

Southern Adelaide Local Health Network

Exclusions

  • recurrent/persistent urinary tract infections (UTIs) less than 3 presentations per year in women

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • abnormal urinary tract imaging (and /or ultrasound or computed tomography scan) confirming anatomical or pathological process e.g.
    • hydronephrosis
    • significantly elevated post-void residual (PVR) volumes
    • stones
    • soft tissue lesion (concern for malignancy)

Category 2 (appointment clinically indicated within 90 days)

  • any confirmed UTI in men
  • greater than 3 UTIs in women in a 12 month period
  • severe urinary tract sepsis with recent history of hospital admission in less than 3 months
  • suspected genitourinary fistula

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
  • identify within your referral 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
  • contrast computed tomography (CT) urogram (pre and post intravenous contrast + delayed pyelograms) unless contraindicated

Pathology

  • complete blood examination (CBE)
  • electrolytes, urea and creatinine (EUC)
  • liver function test (LFT)
  • fasting glucose (fasting BSL)
  • thyroid function tests (TFTs)
  • estimated glomerular filtration rate (eGFR)
  • coagulation studies (Coags)
  • prostate-specific antigen (PSA)
  • urine culture (MCS)
  • sexually active people need 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

  • urine cytology, may help to prioritise referral

Clinical management advice

Cranberry juice has demonstrated effectiveness in decreasing the incidence of urinary tract infections (UTIs) among females, and should be considered as part of preventive care.

When managing benign prostatism in males, anti-cholinergic and beta3-adrenergic agonist therapy should be considered with the following symptoms:

  • difficulty voiding
  • nocturnal incontinence
  • overactive bladder
  • significant post-residual volumes

Clinical resources

Consumer resources