2ww Urology

Prostate feels malignant on digital rectal examination (Prostate cancer)
PSA levels are above the age‑specific reference range (Prostate cancer)

≥45y + unexplained visible haematuria without urinary tract infection (Bladder cancer, Renal cancer)
≥45y + visible haematuria that persists/recurs after treatment of UTI (Bladder cancer, Renal cancer)
≥60y + unexplained non‑visible haematuria + dysuria or raised WBC on full blood count (Bladder cancer)

Non‑painful enlargement or change in shape or texture of the testis (Testicular cancer)

Penile mass or ulcerated lesion, where a STI has been excluded (Penile cancer)
Persistent penile lesion after treatment for a STI (Penile cancer)
Unexplained or persistent symptoms affecting the foreskin or glans (Penile cancer)

Non-urgent Urology referral

≥60y + recurrent or persistent unexplained urinary tract infection (Bladder cancer)

Primary care investigations: prostate‑specific antigen (PSA) test and digital rectal examination (DRE)

• Any lower urinary tract symptom: nocturia, urinary frequency, hesitancy, urgency or retention

• Erectile dysfunction

• Visible haematuria

Direct access primary care investigation: testicular ultrasound

Unexplained or persistent testicular symptoms (testicular cancer)