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Urinary tract infection (UTI)-Diagnosis

This post is also available in: हिन्दी (Hindi)

How the UTI is diagnosed?

Lab tests

1. Urine analysis (midstream sample): the test can reveal abnormal pus cells, RBC’s or bacteria in the urine which in presence of symptoms suggest a diagnosis of UTI. Quite often the bacterias present near the urethra can contaminate the urine sample giving a false positive result of UTI. This is avoided by using a special antiseptic pad to clean the genitals and by taking a mid stream sample of urine.

urine-in-container-for-the-test

 

2. Urine culture: the collected sample of urine is taken and kept in a special dish which allows the bacteria to grow. This tests helps in identifying the bacteria that is causing the UTI and in knowing what antibiotic would be effective on it.

microbial-culture

Indication: typically indicated in all men and women with:

Recurrent or untreated UTI

Suspected kidney infection (pyelonephritis)

Pregnancy

Atypical symptoms

Positive result: considered diagnostic if results show greater than 100,000 colonies/mL of urine culture.

Imaging studies:

A doctor would ask you to get an imaging test in following cases:

• If u have recurrent UTI

• If you are not responding to treatment

• If u have fever

• If u are a male

• If u have diabetes

• If he thinks you might be suffering from infection which is associated with some other underlying condition such as kidney stone or abnormal structure of urinary tract.

1. Ultrasound KUB: is the first imaging test done for UTI. It can show following risk factors that can predispose you to develop urine infection:

• Kidney stones

• Urine obstruction (hydronephrosis)

• Urine retention

It can also show evidence of urine infection by suggesting presence of thickened urinary bladder walls or presence of abscess in kidneys.

Preparation for the test:

• This test needs you to keep your bladder full so that any abnormality of the urinary tract can be better visualized.

• Sometimes, after completing your test the doctor may ask you to empty your bladder and come back immediately. He would again do an ultrasound to check for the retention of urine.

2. CT abdomen or KUB: CT is considered better than ultrasound for complicated cases of UTI. The doctor would advice you for CT if your fever doesn’t settle even after 3 days of treatment. He may also order if he wants to evaluate hematuria, suspected kidney infection, kidney stones or cause of obstruction

Advantage:

Better visualization of underlying conditions such as kidney stones, obstruction or any abnormality in the structure of the urinary tract.

• Better chances of diagnosing kidney infections and its complications such as abscesses in and around kidney.

Disadvantage:

• Costlier

• Uses radiation

• Not available everywhere

• Very rarely can induce reaction due to the use of contrast

3. Cystoscopy: if you have a recurrent UTI the doctor may perform cystoscopy. In this test, the doctor would pass a cystoscope which has a thin long tube attached with a camera. This test helps him to check for signs of infection such as swelling, redness, etc and to rule out any structural abnormality. It can also help to rule out other conditions that may present as a bladder infection.

4. Urodynamic test: a doctor may perform a test called uroflowmetry to check your urine flow and to look for any retention of urine.

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