Haematuria

1
Women Over 16 Years at Presentation
Agreed 27.2.07

• Exclude and/or treat prior to referral into
  pathway
• Microscopic haematuria in women aged over 50 yrs.
• Visible haematuria.
• Recurrent or persisting UTI associated with
  haematuria in women aged 40 yrs or over.
• Suspected malignant pelvic mass.
• Considerations for additional referrals
• Persisting bladder or urethral pain.
• Clinically benign pelvic masses.
• Associated faecal incontinence.
• Suspected neurological disease.
• Symptoms of voiding difficulty.
• Suspected urogenital fistulae.
• Symptomatic prolapse visible at or below the
  vaginal introitus.
• Palpable bladder on bimanual or physical
  examination after voiding.

Time Line Aim for presentation to appointment 4
to 6 wks Aim for weekly triage
Presenting to Primary Care NP or GP
History
Examination vaginal abdominal
Very elderly/infirm/ residential care
DN Assessment
Treat
Infection excluded Dip test/8SG or MSU
Negative
Central Triage
Treated as per evidence base by nurse
specialist/urotherapist prescribe/make
recommendations
Any other pathology refer as appropriate
Better - Back to Primary Care
Failed conservative treatment Urodynamics aligned
to secondary care appointment
Decline referral
Secondary Care
Consultants agree pathway from this point with
primary care
Haematuria Pathway