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Haematuria Referral Access Criteria

Haematuria Referral Access Criteria

Referrers should use this page when referring patients to public adult urology outpatient services for haematuria.
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Severe urinary tract bleeding resulting in clot retention and/or symptomatic anaemia
  • Visible haematuria following trauma
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate urology assessment (seen within 7 days):
  • Nil
To contact the relevant service, see Clinician Assist WA: Acute Urology Assessment (external site)
Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Visible (macroscopic) haematuria
  • Non-visible (microscopic) haematuria in the absence of a UTI confirmed through successive midstream specimens of urine collected at least a week apart
Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
History
  • Relevant history, onset, duration and severity of symptoms
  • Current medication list including anticoagulant/antiplatelet use
  • Any known allergies
Examination
  • Nil
Investigations
  • MSU (or CSU) MCS
  • For visible (macroscopic) haematuria: CT intravenous pyelography (IVP) or, if contraindicated, renal ultrasound (US)
  • For non-visible (microscopic) haematuria: renal ultrasound (US)          
Highly desirable
History
  • Nil            
Examination
  • Nil
Investigations
  • FBC
  • U&E
  • PSA (males)
  • Urine albumin/creatinine ratio (ACR)
Indicative clinical urgency category

Category 1

Appointment within 30 days

  • Visible macroscopic haematuria
  • Non-visible (microscopic) haematuria with upper tract or bladder lesion on imaging
  • Non-visible (microscopic) haematuria with hydronephrosis        

Category 2

Appointment within 90 days

  • Non-visible (microscopic) haematuria with no define lesion on imaging           

Category 3

Appointment within 365 days

  • No defined category 3 criteria 
Exclusions
  • Nil
Useful information
  • Contraindications for CT IVP include:
    • eGFR <30ml/min
    • Pregnancy
    • Known or suspected contrast allergy
  • Please note that the patient may be triaged directly to a flexible cystoscopy from this referral
  • Non-visible (microscopic) haematuria is defined as erythrocytes seen in the urine MCS rather than just blood positive on urinalysis
  • Glomerulonephritis is a cause of haematuria and if there is significant proteinuria consider a referral to renal medicine instead of urology

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Last reviewed: 29-04-2025
wa.gov.au