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Urinary tract calculi

Urinary tract calculi – Adult

Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice if in a remote region:

  • Proven (obstructing) ureteric stone in patient with single kidney or kidney transplant
  • Acute renal or ureteric colic with obstruction and infection

Immediately contact on-call registrar or service to arrange an immediate urology assessment (seen within 7 days) for:

  • Nil

To contact the relevant service, please see HealthPathways: Acute Urology Assessment

Presenting issues
  • Painful or difficulty urinating
  • Lower abdominal pain / flank pain
Mandatory referral information (referral will be returned if this information is not included)

Investigations

  • MSU M/C/S results
  • FBC
  • U&Es
  • Non-contrast CT KUB results or urinary tract USS

If unable to attach reports please include relevant information/findings in the body of the referral.

Referral to state reason if not able to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)
Highly desirable referral information
  • If patient has passed previous stone and this has been examined, include details of calculi
  • XR KUB results
  • Serum calcium and urate
Indicative triage category
Indicative triage category
Category 1
Appointment within 30 days
  • Proven calculi in ureter and any of the following:
    • Decreased renal function and/or increasing pain
    • High-risk patients e.g. patients with single kidney/renal transplant 

**Small stones under 5mm that have a good chance of passage may be observed in the community with analgesia and a follow up scan in 4 weeks with guidance to collect stone.
Category 2
Appointment within 90 days
  • Proven calculi in kidney (non-obstructive) that the patient may wish to have treated operatively
  • All staghorn stones
Category 3
Appointment within 365 days
  •  No defined category 3 criteria
Last reviewed: 05-01-2024
wa.gov.au