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Hernia, hydrocele and testicular conditions

Find assessment and management information at Brisbane South HealthPathways under:

Useful management information

  • Principles of reduction include
    • apply firm continuous pressure with one hand to the mass and with the other hand direct the hernia contents through the deep ring. Your second hand should be placed just lateral to the midpoint of the inguinal ligament and push posteriorly
  • An USS does not contribute to management
  • In the majority of cases it is thought inappropriate for children to wait more than 6 months for an outpatient initial appointment
  • Next of kin or person(s) who is legally responsible for patient consent, with the exception of children under guardianship orders with the Department of Communities, Child Safety and Disability services, should be present at the first outpatient appointment
  • Paediatric surgery registrars at Queensland Children's Hospital and GCUH can offer telephone advice to rural HHS. In some areas it would be more appropriate to seek initial advice from local general paediatric service or general surgery services
    • QCH: 07 3068 1111
    • GCUH: 1300 744 284

Minimum referral criteria (Does your patient meet the minimum criteria?)

Does your patient meet the minimum referral criteria?

Category 1
(appointment within 30 calendar days)

If you feel your patient meets Category 1 criteria, please mark “urgent” on your referral

  • Child ≤ 6 months with Indirect Inguinal Hernia or uncertain diagnosis
  • Epididymoorchitis
  • Scrotal tumour/mass
  • Intermittent scrotal pain
Category 2
(appointment within 90 calendar days)
  • Indirect inguinal hernia ≥ age of 6 months
  • Hydrocele if it persists > 2 years or causes symptoms or grows rapidly
  • Unilateral undescended testis ≥ age of 3 months
  • Transilluminable swelling
Category 3
(appointment within 365 calendar days)
  • Retractile testis – referral after the age of 2 years

If your patient does not meet the minimum referral criteria

  • Find assessment and management information at Brisbane South HealthPathways
  • If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
    • Please note that your referral may not be accepted or may be redirected to another service

Standard referral information (To be included in all referrals)

Reason for request

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • A comprehensive capture of information in relation to MSH Referral Criteria

Clinical modifiers

  • The presence of clinical modifiers may impact the categorisation of the patient.
  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)


Essential referral information for Hernia, hydrocele and testicular conditions referrals (Referral will be returned without this)

  • Onset and severity
  • Is the swelling reducible?
  • Trauma
  • Prior genitourinary surgeries / known urological abnormality (if applicable)
  • MCS and MSU results (epididymoorchitis only)

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referral.

Additional referral information for Hernia, hydrocele and testicular conditions referrals

  • Irreducible inguinal hernia
    • keep fasted and give paracetamol prior to transfer to emergency
  • Reassurance uncomplicated hydrocele is elective surgical condition

Emergency Immediate transfer to the Emergency Department

If any of the following are present or suspected, please refer the patient to emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region

Hernia, hydrocele and testicular conditions

  • Irreducible, incarcerated or strangulated inguinal hernia
  • Suspected testicular torsion
  • Inguinal hernia: If under <52 weeks post conceptual age, call nearest paediatric surgical unit for urgent review
  • Acute scrotal pain with or without swelling
  • Ambiguous genitalia and neonatal bilateral undescended testes are urgent referrals to service

Out of catchment

Metro South Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service.  If your patient lives outside the Metro South Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Last updated 1 May 2024