referral criteria from primary care - UTI in a man

Last reviewed 01/2018

Further investigation/referral depends on various factors (1,2)

  • referral for assessment is not routinely indicated
    • however, referral for assessment should be considered for men who have:
      • symptoms of upper urinary tract infection (pyelonephritis) (1)
      • failure to respond to appropriate antibiotic therapy (1)
      • frequent episodes of urinary tract infection (UTI) - this is stated as two or more episodes in a 3-month period (1)
      • features of urinary obstruction (e.g. in older men, enlarged prostate)
      • history of pyelonephritis, calculi, or previous genitourinary tract surgery
    • urgent referral is indicated for men with suspected cancer
      • any age with painless macroscopic haematuria:
        • if haematuria is associated with symptoms of UTI
          • culture the urine before referring
          • if UTI is not confirmed by urine culture, or if haematuria does not resolve with treatment of the UTI
            • refer urgently
      • recurrent or persistent UTI associated with haematuria, in a male aged 40 years or older
      • unexplained microscopic haematuria, in a male aged 50 years or older
      • with an abdominal mass identified clinically or on imaging that is thought to arise from the urinary tract

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