MetroVan Urology

What We Offer

1. General Urology and Subspecialized Surgical expertise
2. Rapid communication - turnaround time from time of consultation to fax-receipt of report is usually by the end of the day
3. For all major cases, 2 urologists are present to optimize outcomes
4. Full complement of urological services using the most advanced equipment

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Referring Patients

• Referrals can be made by telephone or fax (see contact information).

  Fax: 604-273-7599

• Wait times to see patients varies from 2-6 weeks. If you have an urgent consultation, we can typically see your patient within a few days, often the same day. Please speak to us directly.

• We will contact your patient to schedule a convenient time and let you know by fax that your patient has been booked.

  Richmond Urological Care Centre (RUCC) referrals can be made by completeing this form and faxing to 604-244-5281

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Rapid Consultation

For New Patients

For urgent consults, we can usually see patients within 48 hours, often on the same day. We would ask that a physician to physician discussion take place. Please contact us so that we may discuss the case with you.

For Established Patients

Please contact the office directly. If the attending Urologist is unavailable, we can schedule your patient to be seen by one of the other Urologists currently in clinic.

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Gynecology Requests for Ureteral Stenting

If you feel that the placement of a ureteral stent would be beneficial in avoiding a urological complication during your surgery, you may make a request for a urologist to place a stent pre-operatively. Please complete the downloadable form and fax to our office to determine if we can accomodate your request.

Read the instructions carefully.

• Submission of this form does not guarantee that a urologist can attend.
• Written confirmation will be sent to your office.
• Please notify our office in writing of any changes in the surgery (start time, cancellations, etc.)

Guidelines for Referral

There are several things you can do to expedite the care of your patients. This includes ordering appropriate laboratory and imaging investigations prior to making the referral. The following should be used as guidelines only. Please tailor investigations as you see fit to your own assessment of the patient.

Hematuria

Blood in the urine can be a sign of serious underlying disease. Except instances where microscopic hematuria is detected in completely asymptomatic young patients (less than 40 years of age) with known stone disease or recent urinary tract infection, virtually all other patient should be evaluated. If in doubt, err on the side of caution and refer the patient for review.

1. Urinalysis x3 to confirm the presence of microscopic hematuria
2. Urine culture
3. Urine cytology
4. Creatinine
5. Imaging: Ultrasound for microscopic hematuria, CT IVP for gross hematuria
6. PSA if appropriate

Infertile Males

Males who have been unable to conceive after one year of conservative effort should be referred for evaluation. Their partner should also be evaluated, regardless of what the semen analysis result shows. There are some circumstances where earlier referral may be indicated such as males for whom there is a strong likelihood of having a fertility issue such as prior chemotherapy, radiation, pelvic surgery, erectile dysfunction, et cetera. In addition, advanced female reproductive age (older than the mid 30s) may prompt an earlier referral.

1. Semen analysis x 2. Refer patients to our website for instructions.
2. Total testosterone, follicle stimulating hormone and prolactin drawn before 9:30 AM (or within about 3 hours of waking).
3. If the patient has less than 5 MILLION SPERM PER ML - please order a (1) Karyotype and (2) Y-chromosome microdeletion (may be ordererd on a regular requisition, no preparation; direct to 'Cytogenetics lab Vancouver Hospital)
4. Only order a Cystic Fibrosis test if (1) there is azospermia (no sperm) and (2) the vas deferens is not palpable

Prostate Cancer Risk Assessment

A frequent reason for referral is concern regarding the presence of prostate cancer. This is often prompted by measurement of a high PSA or abnormal prostate exam. are evaluation is contextual and therefore having idea of what prior PSA values and the patient's general medical status is our critical in determining if the biopsy is indicated.

1. Repeat the PSA if there is only a single value is available which you consider to be abnormal.
2. Please send copies of all prior PSA values. While the rate of change over time is not significant, prior values will help us determine the reliability of the current PSA value of concern.
3. You may find our section on prostate cancer diagnosis and screening informative. Several tools to help you assess risk in your patients are available.

Urinary Tract Infection

Recurrent urinary tract infections are common in women, though rare in males. Men should have a urological evaluation if they have any infection. Use your discretion for females. Please do your best to document that an infection has infact occurred. The absence of a positive urine culture associated (i.e. culture-negative urinary symptoms) should be a flag to look for other causes - especially carcinoma in situ of the bladder.

1. The most recent copies of Urine analyses and Cultures are ABSOLUTELY REQUIRED
2. Urine cytology if the urine cultures are negative
3. List the antibiotics you have tried in the past - including duration
4. Any imaging reports you may have - e.g. renal US
5. For males, a PSA where appropriateUrologist Resources