Recurrent UTIs

Who to refer

Recurrent UTI’s and Red Flags:

• Visible haematuria follow  Urology/HaematuriaVISIBLE

• Persistent pelvic pain or continuous UTI symptoms despite antibiotic treatment:
• Aged less than 60 – refer to Urology as Urgent
• Aged 60 and over – refer to Urology as Urgent Suspicion of Cancer

• History of pelvic cancer – refer to Urology as Urgent
• History of pelvic radiotherapy – refer to Urology as Urgent
• History of Urogynae procedures with mesh – refer to Urology as Routine
• History of complex pelvic surgery – refer to Urology as Routine
• ≥2 episodes of pyelonephritis– refer to Urology as Routine

Recurrent UTI’s and no Red Flags:

Men

• Refer to Radiology for urinary tract USS (not renal USS) to include post void residual volume AND refer to Urology as Urgent

Women

• Refer to Radiology for urinary tract USS (not renal USS) to include post void residual volume. If residual >150mls Refer to Urology as Routine.
• If infections persist despite trying all measures outlined above:
  • If aged 60 and over – Refer to Urology as Urgent
  • If aged less than 60 years – Refer to Urology as Routine

Who not to refer

• No red flags, residual volume on scan <150ml and symptoms settle with measures outlined above.

How to refer

Urology

Via SCI Gateway          Western General Hospital>Urology>LI Basic Sign Referral

Radiology

Via SCI Gateway          Clinical Radiology>LI Radiology Ultrasound>Ultrasound Urinary tract  – request to include post void residual volume

https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Recurrent%20cystitis.pdf