When to refer

Refer urgently to secondary care in the following circumstances:

• Microscopic haematuria if aged 50 years or older
• Macroscopic haematuria at any age
• Recurrent or persisting UTI associated with haematuria if aged 40 years or older
• Suspected mass arising from urinary tract

Consider referral in the following circumstances:

• Significant prolapse
• Persisting bladder or urethral pain
• Associated faecal incontinence
• Suspected neurological disease
• Symptoms of voiding difficulty
• Suspected urogenital fistula
• Previous continence surgery
• Previous pelvic cancer surgery or radiation therapy
• Failure to respond to conservative or pharmacological intervention