Clinical Lead - Dr Roger Watson
Catchment criteria may apply for referrals for this service. Patient referrals from outside the Mater SEQ Catchment (which includes Metro South and West Moreton Hospital and Health Services) may not be accepted.
Exception: An agreement is in place between Mater and Wide Bay Hospital and Health Services. Referrals that form part of this agreement will be accepted.
This page contains information for general practitioners on how to refer patients aged 16 years and over to Urology services at Mater Hospital Brisbane.
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 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. They provide education, lifestyle and behavioural advice and treatment to this complex patient cohort.
Emergency care
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:
- 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
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.
Bulk Billed Clinics
Mater Health Services offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed specialist clinic, please provide a named referral to one of our specialists.
Current Waiting Time for Appointments
We provide up to date data on how long patients are waiting for their first appointment by specialty here.
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
Conditions in scope
Bladder Tumour
Essential information (referral will be declined without this)
- General Referral Information
- FBC, ELFT
- MSU for MCS
- Urine Cytology X3
- CT IVP
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
Bladder Tumour NOT confirmed as cancer
| No category 2 criteria | No category 3 criteria |
Haematuria
Essential information (referral will be declined without this)
- General referral information
- MSU M/C/S and urine cytology results
- ELFT FBC results
- USS urinary tract or CT IVP results
- Smoking history (even if negative)
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)
- Refer to HealthPathways or local guidelines
- 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:
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:
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)
- General referral information
- MSU M/C/S results
- USS urinary tract results
- ELFT results
Additional referral information (useful for processing the referral)
- Documented episodes of incontinence – bladder chart/diary, time and volume chart
Other useful information for management (not an exhaustive list)
- Refer to HealthPathways or local guidelines
- 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:
|
Lower Urinary Tract Symptoms (Female)
Essential information (referral will be declined without this)
- General referral information
- MSU M/C/S results
- USS urinary tract results
- Smoking history (even if negative)
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)
- Refer to HealthPathways or local guidelines
- 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)
- General referral information
- MSU M/C/S results
- USS urinary tract results
- Smoking history (even if negative)
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)
- Refer to HealthPathways or local guidelines
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:
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)
- General referral information
- MSU M/C/S results
- USS urinary tract results
- PSA history
- ELFT FBC results
Additional referral information (useful for processing the referral)
- Optional f:t PSA 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)
- Refer to HealthPathways or local guidelines
Medical Management
- Repeat PSA in 4-6 weeks if elevated
- ELFT FBC
- MSU
- Bladder chart and the international prostate symptom score
- USS urinary tract
Clinical resources
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)
- General referral information
- ELFT FBC results
- USS urinary tract or CT IVP results
Additional referral information (useful for processing the referral)
- Urine cytology
- Tc99m-MAG3 renography
Other useful information for management (not an exhaustive list)
- Refer to HealthPathways or local guidelines
- 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:
| Imaging showing any of the following:
| Imaging showing angiomyolipoma < 4cm |
Testicular, Epididymal, Scrotal, Penis or Foreskin Abnormalities
Essential information (referral will be declined without this)
- General referral information
- MSU M/C/S results*
- USS scrotum/testes results*
*Not necessary for penile cancer/tumour or phimosis conditions
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)
- Refer to HealthPathways or local guidelines
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
- Psychology
- External devices
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 |
| Intermittent testicular pain suggestive of intermittent testicular torsion and/or Haematospermia Foreskin phimosis Penile discharge or lesions or ballanitis (excluding genital warts) Painful swollen testis/epididymis provided testicular cancer has been excluded
|
Erectile dysfunction not responding to maximal medical management and/or Peyronie’s disease causing functional impairment or pain and/or Chronic testicular pain Foreskin phimosis, provided no obstructed vomiting Other foreskin abnormalities (frenum breve, scarring and tearing) |
Urinary Tract Calculi
Essential information (referral will be declined without this)
- General referral information
- MSU M/C/S results
- ELFT FBC results
- Non-contrast CT KUB results (preferred) or USS urinary tract results
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)
- Refer to HealthPathways or local guidelines
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:
| Proven calculi in kidney and any of the following:
All staghorn stones | No category 3 criteria |
Urinary Tract Infection (UTI) - Recurrent
Essential information (referral will be declined without this)
- General referral information
- MSU M/C/S results
- USS urinary tract results
Additional referral information (useful for processing the referral)
- ELFT results
- STI screen results
Other useful information for management (not an exhaustive list)
- Refer to HealthPathways or local guidelines
Medical Mangement
- 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:
| Recurrent UTI (women > 3 per year, men > 1 per year) |
Other Urological Condition
Essential information (referral will be declined without this)
- General referral information
- Relevant condition information
- Relevant pathology and imaging reports
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 |
Conditions not in scope
Non-routine 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.