In order to improve efficiency of the urology consultation service, we have compiled a list of common inpatient consult requests that are best suited for the outpatient setting. Inpatient evaluations and notes are notes necessary for patients with the following conditions:

1. Recurrent urinary tract infections

1. Obtain urine culture while in-house, prior to initiation of antibiotics
2. For pediatric population on daily prophylactic regimen, please continue regimen on discharge and schedule follow-up with patient’s pediatric urologist

2. Non-infected, non-obstructive kidney stones (clean UA or negative urine culture, no hydronephrosis or hydroureter

1. Obtain non-contrast CT abdomen/pelvis or X-Ray KUB if not recently performed
2. Schedule outpatient

3. Small renal mass, incidentally found (=<4 cm)

1. Obtain multiphase CT abdomen/pelvis, or CT “renal mass protocol”
2. Schedule outpatient appt

4. Testicular/scrotal pain with no suspicion for infection or torsion

1. Obtain scrotal US
2. Supportive therapy with ice/heat, tight-fitting underwear, NSAIDs

5. Foley catheter removal

1. Unless explicitly detailed in EMR or conversation, no catheter needs to be removed exclusively by urology service. This includes coude catheters

6. Urinary retention (eg: post-operative retention, no difficulty with catheter placement)

1. Check UA/Urine culture to r/o inf etiology
2. Initiate alpha-blocker when retention first observed (Tamsulosin 0.4 mg qday)
3. Add bowel regimen if constipated. Minimize narcotics, encourage ambulation.
4. Perform void trials prior to morning rounds. If patient continues to retain, he may be d/c with catheter
5. Schedule outpatient appt

7. Microscopic hematuria

1. Obtain CT Urogram, or MR Urogram if renal failure patient
2. Schedule outpatient appt for microscopic hematuria workup completion (cystoscopy)

8. Non-draining/Malpositioned nephrostomy tube:

1. If not draining, gently flush tube with 10cc normal saline
2. If the patient is known to urology dept, please contact consult service