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 urinary retention
  • severe/uncontrolled haematuria i.e. persistent haematuria or haematuria with clots
  • urinary tract sepsis/systemic infection
  • suspected renal trauma
  • passing clots

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

Exclusions

  • clinical suspicion of post-streptococcal glomerulonephritis – refer to nephrology or emergency department if indicated
  • concerns of ‘childhood non-accidental injury’ – refer to Child Protection Services for further information. If requiring clinical care please, refer to both urology and Child Protection Services.
  • microscopic haematuria - refer to nephrology
  • sexually transmitted infections – refer to Adelaide Sexual Health Centre

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • macroscopic haematuria

Category 2 (appointment clinically indicated within 90 days)

  • nil

Category 3 (appointment clinically indicated within 365 days)

  • nil

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 history
  • family history of haematuria, renal disease/stones
  • current medications, allergies e.g. non-steroidal anti-inflammatory drugs (NSAIDs), rifampicin, metronidazole, nitrofurantoin, or cyclophosphamide
  • allergies and sensitivities
  • presenting symptoms history, including:
    • onset/duration
    • previous episodes of haematuria
    • symptoms of urinary infection e.g., dysuria, frequency, pain, fever
    • systemic symptoms e.g., fatigue, oedema, rash, arthralgia, or coryza
    • recent surgery or trauma including non-accidental injury
    • history of underlying bleeding disorder or immunodeficiency
    • food intake as beetroot and berries can colour urine to pink or red
    • exercise
  • height/weight
  • body mass index (BMI)
  • growth chart trends
  • blood pressure (trends)
  • physical examination findings e.g., review eyes, skin, genitalia, joint tenderness or swelling, and signs of oedema or organomegaly
  • pathology
    • mid-stream urine (MSU) microscopy, culture and sensitivity (M/C/S)
    • 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
  • medical imaging
    • kidneys, ureters and bladder (KUB) ultrasound (US)
    • relevant diagnostic/imaging reports, including location of company and accession number

Additional information to assist triage categorisation

  • pathology:
    • complete blood examination (CBE)
    • electrolytes, urea & creatinine (EUC)
    • liver function test (LFT)
    • coagulation studies (coags)
    • urine culture, protein, creatinine ratio