Recurrent urinary tract infection (UTI) Referral Access Criteria

Referrers should use this page when referring patients to public adult urology outpatient services for recurrent urinary tract infection (UTI).

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.
Nil

Immediate referral
Immediately contact on-call registrar or service to arrange immediate urology assessment (seen within 7 days):
Nil To contact the relevant service, see Clinician Assist WA: Acute Urology Assessment (external site)

Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
Female with symptoms and 2 or more microbiologically confirmed UTIs in 6 months Male with symptoms and 1 or more microbiologically confirmed UTIs in a year

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 in regional or remote areas or due to financial reason). 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	Relevant history, onset, and severity of symptoms Details of previous treatment and outcome Current medication list Any known allergies
Examination	Nil
Investigations	MSU (or CSU) MCS and history of previous MSU (or CSU) MCS results Urinary tract ultrasound (US) U&E For males: PSA result (within 2 years)

Highly desirable
History	For females: Menopause status If peri-/post-menopausal female, details of any hormone replacement therapy (HRT) use or topical therapy and response.
Examination	Nil
Investigations	STI screening (Chlamydia and gonorrhoea) Any blood tests for diabetes (e.g. random glucose, fasting glucose, HbA1c)

Indicative clinical urgency category
Category 1 Appointment within 30 days	Recurrent symptomatic (female ≥ 3 per year, male ≥ 1 per year) or persistent UTI with abnormal urinary tract ultrasound (US) (e.g. hydronephrosis, stones, scarring, soft tissue lesion) Recent history of admission (within the last 3 months) for severe urinary tract sepsis
Category 2 Appointment within 90 days	Recurrent symptomatic (female ≥ 3 per year, male ≥ 1 per year) or persistent UTI and any of the following: increased residuals > 200ml upper urinary tract infections
Category 3 Appointment within 365 days	Recurrent symptomatic UTI (female ≥ 3 per year, male ≥ 1 per year)

Indicative clinical urgency category

Category 1

Appointment within 30 days

Recurrent symptomatic (female ≥ 3 per year, male ≥ 1 per year) or persistent UTI with abnormal urinary tract ultrasound (US) (e.g. hydronephrosis, stones, scarring, soft tissue lesion)
Recent history of admission (within the last 3 months) for severe urinary tract sepsis

Category 2

Appointment within 90 days

Recurrent symptomatic (female ≥ 3 per year, male ≥ 1 per year) or persistent UTI and any of the following:
- increased residuals > 200ml
- upper urinary tract infections

Category 3

Appointment within 365 days

Exclusions
A single episode of a UTI in females

Useful information
Suggest optimisation of diabetic control (if appropriate) and trial of medical therapy (e.g. regular hexamine hippurate and vitamin C) before specialist referral SGLT2 inhibitors (also called gliflozins or flozins e.g. empagliflozin, dapagliflozin) may be a contributing factor for recurrent UTIs and genital infections due to glucosuria.

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Last reviewed: 29-04-2025

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