• Admit the man to hospital if symptoms are severe (for example severe nausea and vomiting, confusion, tachypnoea, tachycardia, or hypotension) — intravenous antibiotics may be required.
• Referral for urological assessment is not routinely required for men who have had a urinary tract infection (UTI).
• Refer for urological assessment men who:
• Have failed to respond to appropriate antibiotic treatment.
• May have an underlying cause for the UTI (such as urinary obstruction, which is more likely in older men, especially if they have hesitancy, straining, or weak urinary stream).
• Have frequent episodes of UTI (for example two or more episodes in a 3-month period).
• Have a history of pyelonephritis, calculi, or previous genitourinary tract surgery.
• Are younger than 50 years of age and have persistent microscopic haematuria with otherwise normal renal function tests (urinary protein and serum creatinine).
• Refer for renal assessment if the man has persistent microscopic haematuria with proteinuria or raised serum creatinine.
• Refer urgently if cancer is suspected. Refer the man to a team specializing in the management of urological cancer if:
• He is of any age, with macroscopic haematuria and urine culture fails to confirm a UTI or the haematuria does not resolve with treatment of the UTI. 
• He is 40 years of age or older, and presents with recurrent or persistent UTI associated with haematuria.
• He is 50 years of age or older, and is found to have unexplained microscopic haematuria.
• An abdominal mass is identified (clinically or on imaging) that is thought to arise from the urinary tract.

In depth