Urology Consult 💧
Guide for urology consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.
📋 Key Info to Have Ready
- Patient identifiers: full name, date of birth, location, MRN
- Admission reason: note that admission may not be for urology
- Reason for consult and timeline (e.g. acute urinary retention, haematuria, catheter issues)
- Relevant medical history: BPH, prostate cancer, urological surgeries, UTIs, stone disease
- Medications: especially anticoagulants, alpha-blockers, anticholinergics, diuretics
- Observations: vitals, urine output (amount, clarity, hematuria), bladder scan result
- Recent interventions: catheterisation attempts (type, size, difficulty), irrigation, flushing
- Bloods: U&E (particularly creatinine), FBC, coag profile if bleeding
- Imaging: renal tract ultrasound or CT KUB if available
- What you're seeking: advice on catheterisation, need for irrigation, consideration for flexible cystoscopy or further intervention
🔎 Investigations to Know
- Bladder scan – volume pre/post void if relevant
- U&E – assess renal function and need for decompression
- FBC – look for signs of infection or hematuria
- Coagulation – especially if bleeding or anticoagulated
- Urine dip +/- culture – if signs of infection or unclear diagnosis
- Imaging – CT KUB or renal ultrasound in case of suspected obstruction
📞 Example Script
- Hi, this is [Your Name], the intern from the [Team Name]. I'm calling to request a urology consult for a [Age] year-old [M/F] patient with [e.g. urinary retention / haematuria / catheter issues].
- They were admitted for [reason for admission], but now have a urology concern of [e.g. acute urinary retention, catheter blockage].
- The patient has a background of [e.g. BPH, prostate cancer], and currently has [description of the problem – e.g. ongoing hematuria despite irrigation].
- We've attempted [e.g. catheterisation with 16Fr Foley, flushed with saline], with [result].
- U&E shows [creatinine, K+], FBC is [value], bladder scan shows [volume].
- We're seeking your advice on [e.g. further catheter management, need for cystoscopy, plan for irrigation or admission].
📝 Tips
- Document catheter type, size, insertion technique and drainage result
- Mention if patient is on anticoagulation or antiplatelet therapy
- Clarify if issue is urgent (e.g. obstructive uropathy, clot retention)
- Know whether they've had similar issues or interventions before
- Have any imaging or bladder scan available at time of call