When should men see a urologist? Prostate, PSA and urinary symptoms explained

See your GP if changes in how you pass urine are bothering you, getting worse, or waking you twice or more a night. See them promptly if you notice blood in your urine. Your GP will review you and refer you to a urologist if you need one.

Getting up twice a night is easy to put down to getting older. Sometimes that’s all it is. It’s also one of the more treatable things that happens to men in their fifties and sixties, and a short GP appointment is usually enough to work out what’s going on.

Urinary symptoms worth raising with your GP

Any of these is a fair reason to book in:

getting up to pass urine twice or more a night
a slow or stop-start stream, or having to strain
trouble getting started, or dribbling afterwards
feeling your bladder hasn’t emptied
sudden urges that are hard to hold, or leaking

A common cause is an enlarged prostate. Doctors call it benign prostatic hyperplasia, or BPH. Benign means it’s not cancer. The prostate sits just below the bladder and tends to grow with age, which can squeeze the tube urine passes through.1

It isn’t the only cause. Evening drinks, caffeine, some medicines, diabetes and poor sleep can all play a part, which is why a chat with your GP is the right first stop.

A useful test: is it changing what you do? If you’re choosing the aisle seat, skipping the second cup of tea or planning drives around toilets, that’s worth a conversation.

Symptoms that shouldn’t wait

Blood in your urine, even once and even without pain. See your GP within days.
You can’t pass urine at all. This needs urgent care. Call Triple Zero (000) or go to your nearest emergency department.
Burning or pain with a fever.
A lump or change in a testicle.

Most of the time the cause turns out to be manageable. These are simply the ones to have checked sooner.

PSA testing: what the 2026 guidelines say

PSA (prostate specific antigen) is a protein made by the prostate and is measured by a simple blood test. Australia’s national guidelines for PSA testing recommend:

Aged 45 to 49: routine testing isn’t recommended unless you’re at higher risk, though your GP may offer a first test if you ask.
Aged 50 to 69: a PSA test every two years, after a discussion with your GP about whether testing is right for you.
Aged 70 and over: it depends on your general health and what matters to you.
Higher risk: testing every two years from 45. This includes men with a brother who has had prostate cancer, a father diagnosed before 65, a BRCA2 gene change, or Black sub-Saharan ancestry.

Having a PSA test is your choice, and there are two sides to weigh. Testing can find a cancer early, when there are more options. It can also flag a rise that turns out to be nothing or find a slow-growing cancer that may never have caused harm.

One raised result doesn’t mean cancer, because PSA can go up for other reasons. The guidelines recommend repeating the test in one to three months. If it’s still raised, your GP will talk with you about a referral, and an MRI scan is recommended before any biopsy.2

Urinary symptoms and PSA are best treated as two separate conversations. You can have one without the other.

What a urologist does

A urologist is a surgeon who specialises in the urinary tract (kidneys, bladder, prostate and the tubes between them) in men and women, and in the male reproductive organs.

Seeing a surgeon doesn’t mean you’re having surgery. A first appointment is mostly talking: your symptoms, your history, your medicines. You might be asked to do a urine test, pass urine into a machine that measures your flow, or have a quick ultrasound to see how well your bladder empties. Plenty of men leave with a plan built on small changes, medicine, or simply keeping an eye on things.

Finding a urologist in Melbourne: how the referral works

Start with your GP. They’ll examine you, order first tests and decide whether a specialist is needed.
Your GP writes a referral to a urologist. You need it to claim a Medicare rebate on the consultation.
You can ask for a particular specialist. If you’d like any procedure done at a certain hospital, ask your GP to refer you to a urologist who operates there.
You see the urologist in their consulting rooms. Ask what the consultation costs when you book.
If you need a procedure, the urologist’s rooms book it at a hospital where they operate. This is the moment to say which hospital you’d prefer.

The urologists accredited at Adeney are listed on our urology page.

Cystoscopy and other common procedures

A cystoscopy lets a urologist look inside your bladder using a thin tube with a camera, passed through the urethra. It’s often recommended after blood in the urine. A flexible cystoscopy is usually done as a day procedure with sedation. A rigid cystoscopy is done in hospital as a day procedure, under a general or spinal anaesthetic. It can be uncomfortable, and serious complications are rare.3

Cystoscopy is one of the urology day procedures performed at Adeney Private Hospital in Kew, in Melbourne’s inner east. Our urologists also treat kidney stones, prostate enlargement, and prostate, bladder and kidney cancers.

What urology costs at Adeney

Every urology procedure at Adeney Private is covered by our zero out-of-pocket arrangement, often called no gap, for Medibank and Bupa members with eligible hospital cover. That means no additional charge for your surgeon, surgical assistant, anaesthetist, and inpatient radiology, pathology and pharmacy.

Three things sit outside it:

your first consultation with the urologist in their rooms
any tests you have before you’re admitted, such as blood tests and scans
any excess or co-payment on your policy, which your fund sets

Some exceptions can apply, and waiting periods must be served. You’ll get the details in writing before you agree to anything. If you’re with another fund or paying your own way, you’re welcome here too, and we’ll give you a written estimate before admission.

If you’re reading this for someone else

You’ve probably noticed before he has. It can help to say what you’ve seen without diagnosing it: “You’re up a few times most nights. Would you mention it to the GP?” Offering to book the appointment, or to come along, makes it easier to say yes. The question sheet below gives you both something practical to take.

Questions to take to your GP

We’ve put together a one-page list of questions about urinary symptoms, PSA testing and referrals, with space for notes.

Download: Questions to take to your GP (PDF)

Frequently asked questions

When should I see a urologist?

When your GP refers you. That usually happens if urinary symptoms haven’t improved with first steps, if you’ve had blood in your urine, or if a PSA result is still raised on a repeat test.

Is getting up at night to pass urine normal as men get older?

It’s common, and it becomes more common with age. If it’s happening twice or more a night, or it bothers you, mention it to your GP. There’s often a treatable cause.

Do I need a referral to see a urologist in Melbourne?

You need a referral from your GP to claim a Medicare rebate on the consultation. Your GP can also help work out whether you need a specialist at all.

What age should men start PSA testing?

Under Australia’s 2026 guidelines, testing every two years is recommended from 50 to 69, after a discussion with your GP. Men at higher risk are recommended to start at 45.

Does a high PSA mean I have prostate cancer?

No. PSA can rise for other reasons. The guidelines recommend a repeat test in one to three months before any referral.

Does a cystoscopy hurt?

It can be uncomfortable, but it’s usually not painful. Either sedation or or a general anaesthetic is given depending on the complexity and type of cystoscopy. Your urologist will discuss this with you.

Is urology covered by zero out-of-pocket at Adeney?

Yes, for Medibank and Bupa members with eligible hospital cover, all urology procedures at Adeney are included. Your first specialist consultation, tests before admission and any policy excess are not. Some exceptions may apply.

This article is general information and doesn’t replace advice from your own doctor.

Footnotes

1. Healthdirect Australia. Benign prostate hypertrophy. https://www.healthdirect.gov.au/benign-prostate-hypertrophy

2. Prostate Cancer Foundation of Australia. 2026 Guidelines for the Early Detection of Prostate Cancer in Australia. Approved by the National Health and Medical Research Council, 18 May 2026. https://www.pcfa.org.au/awareness/new-guidelines-for-the-early-detection-of-prostate-cancer/

3. Healthdirect Australia. Cystoscopy. https://www.healthdirect.gov.au/cystoscopy

4. Adeney Private Hospital. Zero out-of-pocket, explained. https://adeneyprivate.com.au/adeney-insights-hub/zero-out-of-pocket-explained/