Urinary incontinence (female) Referral Access Criteria

Referrers should use this page when referring patients to public adult urology outpatient services for urinary incontinence (female).
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.
  • Unexplained acute onset urinary incontinence suspected as part of acute, or acute-on-chronic urinary retention (Patient in discomfort/pain and unable to void)
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).
  • Urge, stress or mixed or continued urinary incontinence and/or other Lower Urinary Tract Symptoms (LUTS)
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
  • Details of previous treatment and outcome (e.g. anticholinergics such as oxybutynin or solefenicin / beta-3 agonists such as mirabegron)
  • History or risk for bladder tumours and presence/absence of haematuria
  • Evidence of Pelvic Floor Training Exercises (PFTE) referral and results.            
Examination
  • Nil
Investigations
  • MSU M/C/S
  • Urinary tract USS including post-void residual         
Highly desirable
History
  • Bladder diary (time and volume)           
Examination
  • Nil
Investigations
  • STI screening
  • FBC including fasting BGL/HbA1c
Indicative triage category

Category 1

Appointment within 30 days

  • Suspected malignant mass
  • Urinary Retention Visible haematuria and/or sterile pyuria
  • Elevated post-void residuals and hydronephrosis on USS (obstructive uropathy)
  • Known or suspected neurogenic bladder
  • Suspected urogenital fistulae            

Category 2

Appointment within 90 days

  • Incontinence requiring multiple (>3) pad changes per day despite 3 months of pelvic floor training exercises (PFTE) and any of the following:
    • Nocturnal incontinence
    • Recurrent symptomatic (> 3 per year) or persistent microbiologically confirmed UTI (organisms cultured in urine despite 3 courses of oral antibiotics administered based on sensitivities)
    • Persisting bladder or urethral or perineal pain
    • Socially limiting
    • Inadequate response (persisting symptoms) to physiotherapy/continence nurse management
    • Inadequate response (persisting symptoms) to anti-cholinergic and beta3 adrenergic agonist therapy           

Category 3

Appointment within 365 days

  • Incontinence requiring 1-2 pad changes per day (despite 3 months of PFTE) and any of the following:
    • Nocturnal incontinence
    • Persisting (not responding to simple analgesia) bladder or urethral or perineal pain
    • Recurrent (> 3 per year) or persistent UTI (as defined above)
    • Socially limiting (severe)
    • Inadequate response to physiotherapy/continence nurse management
    • Inadequate response to anti-cholinergic and beta3 adrenergic agonist therapy             
Exclusions
  • Nil
Useful information
  • Nil

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Last reviewed: 05-01-2024