Haematuria/Bladder lesion Referral Access Criteria

Referrers should use this page when referring patients to public adult urology outpatient services for haematuria/bladder lesion.
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Severe urinary tract bleeding resulting in clot retention and/or symptomatic anaemia.
  • Visible haematuria following trauma
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate urology assessment (seen within 7 days):
  • Nil
To contact the relevant service, see HealthPathways: Acute Urology Assessment (external site)
Presenting issues
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Visible haematuria
  • Non-visible haematuria in the absence of a UTI confirmed through successive midstream specimens of urine collected at least a week apart
  • Imaging suggestive of bladder lesion
Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test due to financial reasons or geographical location).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.

History
  • Nil            
Examination
  • Nil
Investigations
  • MSU or CSU M/C/S (mandatory for Haematuria)
  • Urinary tract USS or CT Urogram / CT IVP (mandatory for bladder lesion)           
Highly desirable
History
  • Nil            
Examination
  • Nil
Investigations
  • U&Es
  • Urine cytology results
  • PSA (males)
  • Albumin/Creatinine Ratio
  • PCR Chlamydia/Gonococcus
Indicative triage category

Category 1

Appointment within 30 days

  • Visible or persistent (> 3 months) microscopic haematuria in the absence of a UTI in an individual aged >40 years.
  • Non-visible haematuria with risk factors (male, >50 years, smoking history, family or personal history of urothelial cancer):
    • Renal parenchymal mass ≥3cm
    • Bladder or collecting system mass
    • Unexplained isolated hydronephrosis
  • In the absence of urinary tract infection or other obvious benign cause, or persists despite maximum medical treatment i.e. antibiotics            

Category 2

Appointment within 90 days

  • Haematuria in an individual <40 years
  • Renal parenchyma mass <3cm
  • Persistent (> 6 weeks) unexplained microscopic haematuria
  • If decline in GFR or proteinuria also refer to Nephrology in addition to Urology           

Category 3

Appointment within 365 days

  • No defined category 3 criteria 
Exclusions
  • Nil
Useful information
  • Nil

Feedback

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Last reviewed: 09-06-2023