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 Decline referral Failed conservative treatment Urodynamics aligned to secondary care appointment Secondary Care Consultants agree pathway from this point with primary care Haematuria Pathway