Mater Specialist Quick Find

Urology – public patients 

Purpose

This page contains information for general practitioners on how to refer patients aged 16 years and over to Urology services at Mater Hospital Brisbane

Service

The Urology Service accepts referrals for patients residing within the Brisbane region and for patients in regional and rural areas via the Urology Outreach service. The Urology Service integrates with other specialties including Medical and Radiation Oncology, Radiology and Pathology at weekly multidisciplinary meetings where individualised plans of care are developed for complex patients. As part of the comprehensive service offered, Urodynamic studies can be performed at Mater Hospital Brisbane following Urology Consultant review.

The Urology Outreach Service is staffed by highly trained clinical nurses, Nurse Practitioners and Medical staff. Patients are assessed via comprehensive phone assessments, their cases presented to Mater Urologists and treatment plans are developed which are then communicated back to the patient and referring practitioner. Only if clinically required does that patient have to attend the Mater Hospital Brisbane for face to face assessment and surgical intervention.

The Urology service also has a dedicated Prostate Cancer Specialist Nurse and a Bladder Cancer Clinical Nurse consultant. These dedicated roles provide education, assessment, telephone follow up, discharge planning and linkage to supports to patients and their families affected by Prostate and Bladder Cancers

The Urology service team also comprises of two Nurse Practitioners who offer specific specialisation The rapid access and treatment Stones Service Nurse Practitioner assesses, arranges emergency transfer (as required), educates and provides follow up.  The Lower Urinary Tract Symptom (LUTS) Nurse Practitioner specialises in LUTS. The NP provides education, lifestyle and behavioural advice and treatment to this complex patient cohort.

How to Refer

If referral for care is indicated please list all of the General Referral Information and reason for request, and essential information as indicated below.

To refer, please fill in the Mater Adult Referral Form, available to download and embed into most major Practice Management software applications.

Referrals can be sent by:

Secure messaging  Medical Objects:   HM4101000R8
  HealthLink EDI:    materref   
Fax    07 3163 8548

 

 

 

 

Emergency  

If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergency medical advice if in a remote region:

 

View list of conditions:

  • Acute/severe renal or ureteric colic
  • Acute renal or ureteric colic with obstruction and/or infection
  • Acute urinary retention
  • Urinary tract and genital trauma
  • Urinary tract sepsis or severe infection
  • Severe urinary tract bleeding
  • Autonomic dysreflexia
  • Foreign bodies
  • Priapism
  • Acute scrotal pain/ torsion of the testes
  • Severe genital infection e.g. Fournier’s gangrene/epididymo-orchitis
  • Paraphimosis – unable to reduce

 

Scope of Service

Conditions out of scope

The following conditions are not routinely provided at Mater Hospital Brisbane:

View list of conditions:

  • Circumcision for cosmetic reasons
  • Aesthetic surgery
  • Sexually transmitted infections– refer sexual health clinic
  • Genital ulcers and warts – refer sexual health clinic provided verrucous carcinoma is excluded
  • Vasectomy and vasectomy reversal
  • Ejaculatory disorders
  • Catheter change/maintenance
  • Proteinuria – refer nephrology
  • Small epididymal cysts
  • Asymptomatic simple renal cyst

This service is unable to accept referrals for vasectomies and provides a limited service only for erectile dysfunction and fertility referrals. Patients should be advised of alternative options for these services.

 

Conditions in scope

Bladder Tumour

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • No additional information

Other useful information for management (not an exhaustive list)

  • No additional information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Urgent Phone Assessment

  • Confirmed Bladder Cancer diagnosis

Bladder Tumour NOT confirmed as cancer

 

No category 2 criteria

No category 3 criteria

 

Haematuria

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Triple phase CT abdomen/pelvis and CXR in patients with a proven renal mass

Other useful information for management (not an exhaustive list)

  • MSU
  • Urine cytology x 3
  • ELFT FBC
  • USS urinary tracts or CT IVP scan
  • Triple phase CT abdomen/pelvis and CXR if renal mass confirmed on imaging

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Any haematuria in an individual aged >40 years.

Haematuria in an individual aged < 40 years with abnormal cytology or urinary tract ultrasound that suggests malignancy:

  • renal parenchymal mass  >4cm
  • 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

 

Haematuria in an individual <40 years with:

  • renal parenchyma mass <4cm
  • persistent ( > 6 weeks) unexplained microscopic haematuria

If decline in GFR or proteinuria, refer to Nephrologist

No category 3 criteria

 

Incontinence / Bladder Dysfunction (Female)

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Documented episodes of incontinence – bladder chart/diary, time and volume chart
  • ELFT results

Other useful information for management (not an exhaustive list)

  • Bladder chart/diary – time and volume chart
  • MSU
  • USS urinary tract and post-void residual
  • Physiotherapy and/or continence nurse management e.g. pelvic floor muscle exercises and bladder training
  • Consider anticholinergics if low residuals on bladder scan, no suspicion of a sinister cause, not hypersensitive to the drug, and no history of acute angle glaucoma

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Suspected malignant mass

Bladder outlet obstruction

Haematuria or sterile pyuria

Elevated post-void residuals (> 300mls) and hydronephrosis on USS and/or altered renal function

Known or suspected neurogenic bladder

Suspected urogenital fistulae

 

Incontinence requiring multiple (> 2) pad changes per day

Nocturnal incontinence

Post-void residual > 100ml

Associated faecal incontinence

Moderate to severe pelvic organ prolapse

Incontinence requiring 1-2 pad changes per day and any of the following:

  • recurrent (> 3 per year) or persistent UTI and/or
  • persisting bladder or urethral or perineal pain and/or
  • socially limiting (severe) and/or
  • failed physiotherapy/continence nurse management and/or
  • failed anti-cholinergic and beta3 adrenergic agonist therapy

 

Lower Urinary Tract Symptoms (Female)

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • History of previous incontinence/prolapse/pelvic surgery and/or pelvic radiation/ malignancy
  • Bladder diary – time and volume chart
  • ELFT results

Other useful information for management (not an exhaustive list)

  • Bladder chart/diary – time and volume chart
  • MSU
  • Physiotherapy and/or continence nurse management e.g. pelvic floor muscle exercises and bladder training
  • Consider USS urinary tract and post-void residual measurement
  • Consider anticholinergics: if low residuals on bladder scan, no suspicion of a sinister cause, not hypersensitive to the drug, and no history of acute angle glaucoma

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Abnormal USS suggestive of urinary tract tumour or suspicion of malignancy

Elevated post-void residuals (> 300mls) and hydronephrosis on USS and/or altered renal function

Severe irritative symptoms

Haematuria and/or sterile pyuria

Acute urinary retention post IDC insertion

Known or suspected neurogenic bladder and/or neurological symptoms

Suspected urogenital fistulae

 

 

USS suggestive of bladder outlet obstruction

Bladder stones

Elevated post-void residuals > 100ml

Nocturnal incontinence

Suspected or proven urethral stricture and/or urethral diverticulum

Acute change in long-term catheter

Persistent or progressive symptoms despite maximal medical management

Moderate to severe pelvic organ prolapse

Previous incontinence/prolapse/pelvic surgery and/or pelvic radiation/ malignancy

Recurrent UTI (> 3 per year)

Persisting bladder or urethral or perineal pain

Socially limiting (severe)

Failed physiotherapy/continence nurse management

Failed anti-cholinergic and beta3 adrenergic agonist therapy

 

 

 

 

Lower Urinary Tract Symptoms (Male)

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • PSA history
  • Family history of prostate cancer
  • ELFT results
  • Bladder chart and the international prostate symptom score sheet

Other useful information for management (not an exhaustive list)

Medical Management

  • MSU
  • ELFT
  • PSA if >40 years old
  • USS urinary tract
  • Trial of alpha blockers if appropriate
  • Bladder chart and the international prostate symptom score sheet

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Abnormal USS suggestive of urinary tract tumour

Elevated post-void residuals and hydronephrosis on USS and/or altered renal function

Severe irritative symptoms and any of the following:

  • haematuria
  • suspicion of malignancy
  • Acute urinary retention post IDC insertion
  • New elevated PSA> 10ng/ml

 

USS suggestive of bladder outlet obstruction

Bladder stones

Recurrent UTI (> 1 per year)

Elevated post-void residuals > 200ml

Suspected or proven urethral stricture

Acute change in long-term catheter

Persistent or progressive symptoms despite maximal medical management

Incontinence

Elevated PSA < 10ng/ml

Suspected or symptomatic benign prostatic hypertrophy or prostatomegaly

No category 3 criteria

 

Prostate - Suspected Cancer / Elevated PSA

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Optional f:t PSA ratio history (if available)
  • Family history of prostate cancer
  • Bladder chart and the international prostate symptom score sheet

Other useful information for management (not an exhaustive list)

  • Repeat PSA in 4-6 weeks if elevated
  • ELFT FBC
  • MSU
  • Bladder chart and the international prostate symptom score
  • USS urinary tract

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

PSA > 10ng/ml

Radiological imaging indicative of ureteric obstruction

Palpable or suspicious nodule

Increasing/elevated age-related PSA on 2 or more interval specimens or >0.7ng/ml/year in men aged <75 years

 

No category 3 criteria

 

Renal Mass (Tumours / Cysts)

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Urine cytology
  • Tc99m-MAG3 renography

Other useful information for management (not an exhaustive list)

  • USS and/or CT IVP
  • Consider Tc99m-MAG3 renography if PUJ obstruction suspected

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Imaging showing any of the following:

  • solid renal mass > 4 cm
  • mucosal/collecting system lesion

complex cystic lesion > 4cm in size

 

 

Imaging showing any of the following:

  • solid or complex cystic renal mass <4 cm without evidence of metastatic disease
  • angiomyolipoma > 4cm
  • angiomyolipoma < 4cm in a woman of child bearing age
  • PUJ obstruction

large symptomatic simple renal cyst

Imaging showing angiomyolipoma < 4cm

 

Testicular, Epididymal, Scrotal, Penis or Foreskin Abnormalities

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Urine PCR and/or swabs results
  • Urine cytology results

Other useful information for management (not an exhaustive list)

  • Medical management
  • Trial of steroid cream for phimosis
  • MSU
  • Urine PCR and/or swabs for chlamydia and gonorrhoea for suspected epididymo-orchitis
  • Urine cytology if indicated
  • USS scrotum/testes
  • If suspected or confirmed STI refer sexual health clinic
  • For erectile dysfunction:
  • Lifestyle changes
  • PDE5 inhibitors
  • Co morbidity management (e.g. diabetes, heart disease)
  • HRT

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Scrotal pain or swelling and any of the following:

  • painful swollen testis/epididymis and/or
  • painless, solid, testicular mass
  • swelling suspicious of testicular cancer

Suspected penile cancer or tumour

Metastatic germ cell tumors require both Urology and Oncology input. For optimum care, should be seen within 2 weeks

 

Scrotal pain or swelling and any of the following:

  • hydrocele/varicocele
  • painful or large epididymal cyst

Intermittent testicular pain suggestive of intermittent testicular torsion and/or

Haematospermia

Foreskin phimosis

Penile discharge or lesions or ballanitis (excluding genital warts)

Erectile dysfunction not responding to maximal medical management and/or

Peyronie’s disease causing functional impairment or pain and/or

Chronic testicular pain

 

Urinary Tract Calculi

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • If patient has passed previous stone and this has been examined, include details of calculi
  • XR KUB results
  • Serum calcium and urate results

Other useful information for management (not an exhaustive list)

  • Medical management
  • Analgesia:
  • NSAIDs
  • Consider an alpha blocker e.g.Tamsulosin 400 micrograms
  • MSU
  • ELFT FBC, serum calcium and urate
  • Non contrast CT KUB and XR KUB
  • Stone prevention advice

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Proven calculi in ureter and any of the following:

  • decreased renal function and/or increasing pain and/or
  • high-risk patients e.g. patients with single kidney/renal transplant

 

Proven calculi in kidney and any of the following:

  • resolved symptoms
  • recurrent symptoms

All staghorn stones

No category 3 criteria

 

Urinary Tract Infection (UTI) - Recurrent

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • ELFT results
  • STI screen results

Other useful information for management (not an exhaustive list)

  • MSU
  • STI screen if appropriate
  • Antibiotics
  • USS and post-void residual
  • Consider urinary alkalising agent ural/cranberry juice
  • Consider alpha blockers if high residual volume with benign prostatism in men

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Recurrent (women > 3 per year, men > 1 per year) or persistent UTI with abnormal urinary tract USS e.g. hydronephrosis, stones, scarring, soft tissue lesion

Recent history (3 months) of admission for severe urinary tract sepsis

Recurrent (women > 3 per year, men > 1 per year) or persistent UTI and any of the following:

increased residuals > 100ml and/or

upper urinary tract infections

Recurrent UTI (women > 3 per year, men > 1 per year)

 

Other Urological Condition

Essential information (Referral will be declined without this)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

 

 

Our Specialists 

Dr Roger Watson

Director  –  Department of Urology & Continence

Dr Adrian Clubb

Urologist

Dr Jodi Hirst

Urologist 

Dr Andrew Jennings

Urologist

Dr Stuart Philip

Urologist

Dr Peter Swindle

Urologist

Dr David Winkle

Urologist

Jude Logan

Urology Nurse Practitioner

Kylie Everett

Urology Stone Nurse Practitioner

Included in the team is a prostate cancer specialist nurse and specialist urology nurses

 

Bulk Billed Clinics 

Mater Health offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed clinic, please provide a named referral to one of the specialists listed above.

Contact Us 

If you would like to discuss a referral, including clinical criteria, or update the status of a current patient please contact our priority GP phone line on 07 3163 2200 .

Current Waiting Time for Appointments 

We provide up to date data on how long patients are waiting for their first appointment by specialty here.

Referral Guideline Development

These Mater Referral Guidelines align with standardised best practice tools for referral to publicly funded specialist outpatient services developed in Queensland through the Clinical Prioritisation Criteria project. 

 

Content last updated: 6 July 2018

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