Urology consult communication
How to Consult Urology
What to include when calling Urology about obstructing infected stones, urinary retention, torsion, priapism, Fournier concern, hematuria, Foley difficulty, retention, or device problems.
Lead With the Decision
What urologic emergency, procedure, decompression question, device issue, or disposition decision do you need Urology to help with?
Not sure whether the consult is appropriate? Start with the Should I Consult Urology? triage page, then return here before calling.
Difficult Foley or retention
Frame the Consult Around the Job You Need Done
- Why is a catheter needed? Retention volume, strict I/O need, obstruction concern, perioperative need, clot retention, or local protocol indication.
- What makes this difficult? Resistance location, bleeding, pain, suspected false passage, phimosis, stricture, enlarged prostate, prior urologic surgery, radiation, urethral trauma, or device anatomy.
- What has already been tried? Catheter type and size, coude attempt, lubrication or anesthetic gel, patient positioning, irrigation, bladder scan, and who attempted placement.
- What objective data changes urgency? Vitals, sepsis concern, creatinine, anticoagulation, UA/culture if relevant, urine appearance, clot burden, hydronephrosis, and imaging or ultrasound findings.
- What are you asking Urology to decide? Bedside catheter attempt, cystoscopic placement, suprapubic access, OR, IR involvement, admission/transfer pathway, or outpatient follow-up timing.
Before the call
Have These Details Ready
- Problem type: obstructing stone, retention, scrotal pain, priapism, hematuria, catheter issue, Fournier concern, trauma, postoperative complication, or device problem.
- Vitals, sepsis concern, pain severity, renal function, UA/culture status, lactate if relevant, anticoagulation, and immune status.
- Imaging result with obstruction, stone size/location, hydronephrosis, abscess, gas, torsion concern, bladder volume, or trauma findings.
- Interventions already attempted: Foley size/type, coude attempt, irrigation, analgesia, antibiotics, detorsion attempt per local protocol, or decompression discussion.
- Specific request: bedside procedure, OR, IR decompression, transfer, admission service, outpatient timing, or troubleshooting advice.
Exam focus
Document the Specialty-Relevant Exam
- Abdominal, CVA, genital, perineal, scrotal, penile, catheter, and wound findings as relevant.
- Bladder scan, urine appearance, retention volume, catheter output, clots, and ability to irrigate.
- Cremasteric reflex, lie, tenderness, swelling, duration of scrotal pain, and Doppler timing when torsion is in the differential.
Phone or secure-chat script
A Cleaner Urology Consult Message
I am calling about a [age]-year-old with [urologic problem]. The decision I need help with is [bedside procedure/decompression/OR/transfer/admission/outpatient timing/device troubleshooting]. Key findings are [vitals/sepsis/renal function/UA/imaging/exam]. For catheter/retention cases: indication is [why catheter is needed], difficulty is [resistance/anatomy/bleeding/trauma concern], and attempts so far are [catheter type/size/coude/irrigation/local protocol steps].
Common pitfalls
Avoid Low-Signal Consults
- Calling for Foley difficulty without explaining why the catheter is needed, what catheter types/sizes were attempted, where resistance occurred, and what happened next.
- Buried sepsis or obstruction details in an infected stone case.
- Calling scrotal pain without onset time and exam details.
- Asking for "Urology consult" without naming the decision: bedside attempt, cystoscopy, suprapubic access, decompression, OR, transfer, admission owner, or follow-up timing.
Reference links
Useful Background
Educational tools only. SIC provides clinician-facing educational consult-triage references. SIC does not diagnose, treat, prevent, cure, or mitigate disease and is not a substitute for clinical judgment, local guidelines, institutional referral pathways, or recommendations from the relevant specialty department. See disclaimer and how SIC works.