Urology (adult) Referral Access Criteria

Patient requires immediate (within 7 days) attention
Immediate referrals (patient to be seen within 7 days) should be sent directly to the relevant hospital. Do not send immediate referrals via Central Referral Service (CRS).
Contact the on-call registrar or service to arrange an immediate urology assessment for:
  • Chronic urinary retention with deteriorating renal function or hydronephrosis.
  • Confirmed renal malignancy
  • Suspected or confirmed testicular tumour
  • Very high PSA and confirmed malignancy
To contact the relevant service, please see HealthPathways: Acute Urology Assessment (external site)             
Urology (adult) conditions with Referral Access Criteria

These conditions are routinely seen by urology (adult) outpatient services. This is not an exhaustive list of all conditions seen by the outpatient service. Consideration for referral will not be excluded unless the condition is listed on the exclusion list. If the condition you are referring for is not listed, or is unknown, please include details in the body of the referral.

Referrals missing 'mandatory information' with no explanation provided may not be accepted.

Excluded conditions and services

Exclusions

Referrals to public urology (adult) outpatient services are not routinely accepted for the following conditions:

Condition Details (where applicable)
Lower urinary tract symptoms

Excluded condition for the following:

  • Mild to moderate lower urinary tract symptoms i.e. International Prostate Symptom Score (I-PSS) score of 0-19 that have not been treated
  • Symptoms that have adequately responded to medical management (e.g. 5α-reductase inhibitors such as Dutasteride or α 1a-adrenoreceptor antagonist such as Prazosin/Tamsulosin/Silodosin)
  • See HealthPathways: Urology (external site)
Male infertility
Moderate to severe organ prolapse (female)
Penile discharge
Primary erectile dysfunction

Excluded condition unless the following features apply:

  • Erectile dysfunction secondary to surgical intervention
Renal mass

Excluded condition for the following:

Scrotal abnormalities

Excluded condition for the following:

  • Minimally symptomatic (i.e. not impairing quality of life)/asymptomatic epididymal cyst, hydrocele or varicocele identified through ultrasound
  • See HealthPathways: Urology (external site)
Urinary incontinence

Excluded condition for the following:

  • Patients who have not yet tried and failed conservative treatments. These may include tamsulosin/Duodart/anticholinergics, physiotherapy for Pelvic Floor Training Exercises (PFTE) 
  • See HealthPathways: Adult Urinary Incontinence (external site)

Excluded elective procedures

All elective procedures must meet an identified clinical need to improve the health of the patient. Procedures are not to be performed for cosmetic or other non-medical reasons. Excluded procedures will not be performed unless under exceptional circumstances and where a clear clinical need has been identified. For excluded procedures, the referral must clearly state:

  • that the request is for an excluded procedure
  • the clinical exception reason as to why it should be considered.

Access the WA Elective Surgery Access and Waiting List Management Policy at WA Health Policy Frameworks.

Excluded procedure Exceptional circumstance includes
Gender reassignment procedures  
Insertion/revision of artificial erection device
  • Patients using uridomes
  • Spinal patients with neurological erectile dysfunction
Lengthening of penis (phalloplasty)  
Male circumcision
  • Phimosis
  • Paraphimosis
  • Balanitis
Penile procedures for sex transformation  
Procedures for cosmetic reasons
  • Significant functional impairment
Reversal of sterilisation
Vaginoplasty   
Vulvoplasty/Labiaplasty 
  • Functional labial hypertrophy causing persistent infections
Last reviewed: 05-01-2024