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Lower urinary tract symptoms (female)

Lower urinary tract symptoms – Adult (female)

Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice if in a remote region:

  • Acute, painful urinary retention

Immediately contact on-call registrar or service to arrange an immediate urology assessment (seen within 7 days) for:

  • Chronic urinary retention with deteriorating renal function or hydronephrosis
  • Confirmed renal malignancy

To contact the relevant service, please see HealthPathways: Acute Urology Assessment

Presenting issues
  • Severe lower urinary tract symptoms
  • Urge, stress or mixed or continue urinary incontinence (where medical therapies have tried and failed)
  • Mild to moderate symptoms that have not responded to medical management (oral medication)  
Mandatory referral information (referral will be returned if this information is not included)

History

  • Details of previous treatment and outcome

Investigations

  • MSU or CSU M/C/S
  • U&Es
  • Urinary tract USS including post-void residual or CT IVP (if there is a history of visible haematuria)

If unable to attach reports, please include relevant information/findings in the body of the referral

Referrer to state reason if unable to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)
Highly desirable referral information
  • Bladder diary
Indicative triage category
Indicative triage category
Category 1
Appointment within 30 days
  • Suspected malignant mass
  • Bladder outlet obstruction
  • Visible haematuria or sterile pyuria in absence of UTI
  • Elevated post-void residuals AND hydronephrosis on USS and/or altered renal function
  • Suspected acute neurogenic bladder
  • Suspected urogenital fistulae
Category 2
Appointment within 90 days
  • Incontinence requiring multiple (> 2) pad changes per day
  • Nocturnal incontinence
Category 3
Appointment within 365 days
  • Incontinence requiring 1-2 pad changes per day and any of the following:
    • Recurrent (> 3 per year) or persistent UTI
    • Persisting bladder or urethral or perineal pain
    • Socially limiting (severe)
    • Inadequate response (persisting symptoms) to physiotherapy/continence nurse management
    • Inadequate response (persisting symptoms) failed anti-cholinergic and beta3 adrenergic agonist therapy
Excluded urology services

Referral to public adult urology outpatient services is not routinely accepted for the following conditions:

Condition Details (where applicable)
Moderate to severe organ prolapse
  • Refer to gynaecology
Last reviewed: 05-01-2024
wa.gov.au