Referral to emergency

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

  • acute urinary retention
  • acute paraphimosis (acute swelling of partially retracted foreskin)
  • severe acute balanitis
  • priapism
  • foreign bodies
  • bladder exstrophy

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Southern Adelaide Local Health Network

Women's and Children's Health Network

Exclusions

  • circumcision requested for cultural/religious reasons
  • common foreskin related conditions – refer to paediatric surgery
    • balanitis
    • foreskin adhesions
    • paraphimosis
    • phimosis
    • recurrent balanitis/posthitis
  • common foreskin related conditions – do not require outpatients department assessment
    • redundant foreskin
    • smegma cysts of foreskin/penis
  • concerns of ‘childhood non-accidental injury’ – refer to Child Protection Services for further information

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • ambiguous genitalia

Category 2 (appointment clinically indicated within 90 days)

  • hypospadias
  • epispadias

Category 3 (appointment clinically indicated within 365 days)

  • isolated chordee
  • any other concerns regarding penile anomalies

For information on referral forms and how to import them, please view general referral information.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander  
  • relevant social history, including identifying within your referral if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf
  • interpreter required
  • age
  • past medical/surgical/psychosocial/family history
  • current medications
  • allergies and sensitivities
  • presenting symptoms history, including:
    • onset/severity
    • duration
    • trauma, if relevant
    • concerning features e.g. urinary stream/retention, preputial ballooning, pain
    • previous management trialled and outcomes e.g., topical steroids for hypospadias
  • quality of life concerns including missed work/school/extracurricular activities
  • height/weight
  • body mass index (BMI)
  • growth chart/pubertal staging trends
  • blood pressure trends
  • abdominal examination findings
  • penile examination findings e.g., discolouration, swelling, resting position
  • relevant diagnostic/imaging reports, including location of company and accession number

Sexually active people

  • Complete a sexually transmitted infection (STI) screen, including chlamydia and gonorrhoea which requires:
    • endocervical/penile swab for culture and
    • endocervical/penile polymerase chain reaction (PCR) swab or urine sample