How do I determine if a patient with urinary incontinence requires referral to a specialist?

Refer to a specialist in women with urinary incontinence if there is persisting bladder or urethral pain, a palpable bladder after voiding, clinically benign pelvic masses, associated faecal incontinence, suspected neurological disease, symptoms of voiding difficulty, suspected urogenital fistulae, previous continence surgery, previous pelvic cancer surgery, or pelvic radiation therapy ¹.

Additionally, consider referral if there is suspicion of bladder cancer, such as unexplained or recurrent haematuria, especially in women aged 45 years and over, or if there is persistent bladder or urethral pain, voiding difficulty, or a history of chronic urinary retention ²,³.

Recurrent or persistent unexplained UTIs in women aged 60 years and over may also warrant referral for bladder cancer assessment ²,³.