Urology Referrals

If any of the following are present or suspected, phone 000 to arrange immediate transfer to the Emergency Department or seek emergent advice if in a remote area.

  • acute, painful urinary retention
  • acute paraphimosis (if unable to reduce in primary care)
  • acute renal or ureteric colic with obstruction and/or infection
  • acute scrotal pain only with suspicion of torsion
  • proven obstructing ureteric stone in patient with single kidney or kidney transplant
  • severe scrotal infection concerning for Fournier’s gangrene
  • severe urinary tract bleeding resulting in clot retention and/or symptomatic anaemia
  • torsion of the testes
  • unexplained acute onset urinary incontinence suspected as part of acute, or acute-on-chronic urinary retention (Patient in discomfort/pain and unable to void)
  • visible haematuria following trauma.

To arrange an urgent review or advice, please phone the RPH switchboard on 9224 2244 and ask to speak with the on-call registrar for the relevant speciality.

After verbal clinical handover and agreement with the registrar that the patient requires an appointment with RPH within 7 days please email the patient’s referral to RPH.OutpatientReferrals@health.wa.gov.au.

Ensure the referral is:

  • marked IMMEDIATE
  • the name of the registrar or consultant spoken with is written on the referral
  • all essential referral information, investigations, clinical photos are included.

IMMEDIATE (Appointment within 7 days):

  • Chronic urinary retention with deteriorating renal function or hydronephrosis.
  • Confirmed renal malignancy.
  • Suspected or confirmed testicular tumour.
  • Very high PSA and confirmed malignancy.

Urology manages the below listed conditions.

Referrals are triaged based on clinical priority following referral access criteria (RAC) (external link).

Specialist clinics/services include:

Referrals will be returned without this information.

Urology referrals must meet the referral access criteria (RAC) (external link).

Please include all investigations, bladder diary, relevant STI screening and previous conservative management information is included within your referral to ensure all criteria are met.

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the referral.

Minimum standard referral is included in the standard referral template (external link) and available on the Department of Health website (external link).

Please ensure patient email and mobile phone numbers are included to facilitate patient contact.

Patients can be flagged for video or telephone consultations at referral, triage or follow-up.

As per optional referral information on the Department of Health website (external link).

Please Note: Urology has an extensive outpatient waitlist for routine referrals. Consider alternate referral pathways such as:

Named referrals for Urology will be allocated a suitably qualified specialist to see the patient, noting these referrals are booked based on first on, first off principles from the outpatient waitlist.

The following are not routinely provided in a public Urology service:

  • Lower urinary tract symptoms.
  • Moderate to severe organ prolapse (female).
  • Penile discharge.
  • Renal mass less than 4cm
  • Scrotal abnormalities.
  • Urinary incontinence.

While the WA Health Excluded Procedures precludes procedures performed for cosmetic or other non-medical reasons, procedures which meet an identified clinical need to improve the health of the patient may be undertaken in public hospitals.

To avoid patients unnecessarily waiting for and attending appointments in cases where surgery cannot be offered at Royal Perth Hospital, referral criteria have been established for abdominal lipectomy, breast reduction, blepharoplasty, male circumcision, rhinoplasty and varicose veins.

Visit the referral criteria for each of the six WA Health excluded procedures page (external link) for more information.

The following are not routinely provided in a public Urology service:

  • Male circumcision excluding phimosis, paraphimosis, balanitis or when medically indicated.
  • Social / cultural circumcision.
  • Penile procedures for sex transformation.
  • Primary erectile dysfunction, excluding erectile dysfunction secondary to surgical intervention, trauma or radiation therapy.
  • Procedures for cosmetic reasons (i.e. in the absence of significant functional impairment) including penile enhancement and penile implants.
  • Reversal of sterilisation.
  • Infertility surgery.

EMHS is responsible for providing public health services to the people who reside within its boundaries.

The catchment map (PDF 400KB) outlines the suburb catchment areas for East Metropolitan Health Service (EMHS). The country areas that flow to EMHS are Kimberley, Pilbara and Wheatbelt.

Referral to a hospital for assessment and/or treatment is based around multiple criteria. These include:

  • Place of residence – most hospitals have catchments to help service people closer to home. For country patients, the residence of family with whom they will reside whilst attending appointments can be taken into consideration.
  • Age – RPH is an Adult Hospital, children are only treated by some hospitals.
  • Hospital location of specialty services – some conditions need designated specialist services that are not available at all hospitals.

Please use this information to guide referrals to the hospital servicing your patient's residence, and inform your patients of these criteria when you are referring them for public hospital services via the Central Referral Service (CRS).

Last Updated: 06/04/2023