Guidelines
These guidelines are intended as a source of information for referring GPs to help determine whether referral is necessary & to aid management if referral is not appropriate.
Androgen deficiency
Summary: Urological referral inappropriate; refer to Endocrinologists
Balanitis
Summary: Urological referral not normally indicated
Catheter problems
Summary: Urological referral rarely required
Cystitis (acute)
Summary: Urological referral not normally indicated for acute cystitis but may be necessary for unresolving pyelonephritis
Cystitis (chronic)
Summary: Urological referral may be necessary
Ejaculatory disorders
Summary: Urological referral not indicated for most patients
Enuresis
Summary: Urological referral not normally indicated for primary enuresis but should be considered in adults and in patients with secondary enuresis
Epididymal cysts
Summary: Urological referral not normally indicated
Epididymitis
Summary: Urological referral usually indicated
Erectile deformity
Summary: Urological referral not indicated for most patients
Erectile dysfunction (impotence)
Summary: Urological referral rarely indicated
Foreign bodies
Summary: Immediate referral indicated
Genital ulcers
Summary: Urological referral not indicated
Haematospermia (blood in the semen)
Summary: Urological referral rarely indicated
Haematuria (blood in the urine)
Summary: Fast-Track referral usually indicated to Haematuria Clinic
Hydrocele
Summary: Urological referral not normally indicated
Hypospadias
Summary: Paediatric urological referral indicated
Incontinence
Summary: Urological referral for nurse/physiotherapist-led incontinence assessment in women
Infertility
Summary: Urological referral not normally appropriate
Inguinal hernia
Summary: Urological referral inappropriate
Loin pain
Summary: Urological referral only indicated for a demonstrable urological abnormality
Lower urinary tract symptoms (LUTS)
Summary: Manage in primary care & refer only if symptoms are not improved by oral therapy
Neurogenic bladder
Summary: Immediate urological referral essential
Peyronie's disease
Summary: Urological referral not normally indicated
Phimosis & paraphimosis
Summary: Usually requires urological referral
Pneumaturia & faecuria
Summary: Urological referral not appropriate
Priapism
Summary: Immediate urological referral indicated
Prostatitis
Summary: Referral only needed for symptoms unresponsive to treatment
Proteinuria
Summary: Urological referral not appropriate
PSA measurements
Summary: If in doubt about the normality of a PSA level or whether one should be measured, obtain advice from a Consultant Urologist
Renal calculi
Summary: Urological referral not normally indicated for asymptomatic stones or for stones found incidentally. Symptomatic stones should be referred for an urological opinion
Renal failure
Summary: Urological referral only indicated in chronic renal failure secondary to obstructive uropathy
Retention of urine
Summary: Immediate urological referral usually necessary
Sterile pyuria
Summary: Urological referral not usually indicated
Torsion
Summary: Immediate urological referral indicated
Trauma to the urinary tract
Summary: Immediate urological referral indicated
Undescended testis
Summary: Paediatric urological referral indicated
Ureteric calculi
Summary: Referral indicated for all ureteric calculi >5mm diameter and, as an emergency, for uncontrolled symptoms
Urethral bleeding
Summary: Usually due to prostatic disease but requires referral to exclude an intra-vesical problem
Urethral discharge
Summary: Urological referral not indicated
Vaginal prolapse
Summary: Urological referral not appropriate
Varicocele
Summary: Urological referral rarely indicated
Vasectomy
Summary: Referral to Addenbrooke's or Hinchingbrooke not appropriate; not available on the NHS
Vasectomy reversal
Summary: Referral to Addenbrooke's or Hinchingbrooke not appropriate; not available on the NHS
Venereal warts
Summary: Urological referral not appropriate
