How UTIs Are Diagnosed

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The diagnosis of urinary tract infections (UTIs) typically involves analysis of a urine sample, and in some cases, imaging tests may be used.

Every year, UTIs account for as many as 8.1 million visits to healthcare providers. These infections can cause a great deal of pain and discomfort, and seeking a diagnosis is the first step in finding relief and preventing potentially serious complications, such as permanent kidney damage.

UTI diagnosis
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At-Home Testing

A number of over-the-counter products may help you test for a UTI on your own, usually by holding a dipstick in your urine stream and then checking the testing strip for certain changes.

While these home test kits are popular among people with recurring UTIs, they’re not nearly as reliable as the diagnostic tools used by medical professionals.

Therefore, it’s important to see your healthcare provider right away if you’re experiencing UTI symptoms—such as pain or burning when you urinate, fever, and an urge to urinate frequently.

Labs and Tests

If you’re seeing your healthcare provider for symptoms of a UTI, you’ll most likely have to provide a urine sample.

To make sure the sample is sterile, urine is often collected according to a process called “the clean catch method.”

  • You’ll be given an antiseptic cleansing pad to clean your genital area before providing the urine sample.
  • You will start your urine stream in the toilet and then urinate in the collection container, finishing your stream in the toilet.

Your collection container may have markings to indicate the amount of urine required for analysis.

Unlike many other diagnostic tests (such as blood tests), there’s usually no need to fast or follow other special instructions in preparation for a urine sample test.

Urine samples are used to perform the following types of diagnostic tests.

Urinalysis

Defined as the physical, chemical, and microscopic examination of urine, urinalysis entails testing the urine for infection-causing bacteria and other substances. These substances may include nitrites, which can signal the presence of a UTI.

Urinalysis testing also measures the white blood cell count in your urine. A high white blood cell count in urine is often an indication of infection.

Urine Culture

Also known as a “bacteria culture test,” a urine culture is frequently used as a follow-up to urinalysis. This test can identify the specific bacteria causing your UTI, which helps in the selection of the most effective antibiotic to use in treatment.

A urine culture involves taking part of your urine sample and placing it in a special environment in the lab to promote cell growth. If bacteria are present, they will soon begin to multiply. There are also special new technology-based urine cultures that are available for certain circumstances.

Urine culture results are usually available within a few days, but certain slow-growing bacteria may take several days or longer to analyze.

Imaging

If your UTI symptoms are severe or don't improve with treatment, further testing can determine if you have other problems in your urinary tract. This can include imaging techniques, which provide pictures of your urinary tract.

Imaging tests used to diagnose urinary tract issues include ultrasounds, computerized tomography (CT) scans, and magnetic resonance imaging (MRI). These tests may also be used to identify urinary tract abnormalities that could be causing recurrent UTIs.

During the evaluation of recurrent urinary tract infections (or underlying medical problems in people with UTIs), doctors sometimes perform an imaging test known as ​a cystoscopy. The cystoscopy is not done during active UTI, but only when there is no UTI to diagnose a reason for recurrent UTIs.

Cystoscopy

Performed by urologists (medical specialists who focus on the urinary tract), cystoscopy uses a long, thin instrument to look inside your urethra and bladder. This instrument is called a cystoscope and features an eyepiece (typically attached to a camera which projects to an LCD/video screen) at one end, a tube in the middle, and a tiny lens and light at the opposite end of the tube.

The cystoscope provides detailed images of the lining of the urethra and bladder.

Preparing for the Procedure

Before your cystoscopy, your healthcare provider may ask you to drink plenty of liquid prior to the test. In some cases, you may need to temporarily discontinue certain medications (such as blood thinners).

What Will Happen

When used for evaluation of the urinary tract (including for workup of recurrent UTIs and or blood in urine), cystoscopy takes about five to 30 minutes. The test is typically done during an office visit or in an outpatient center or hospital. To prevent discomfort, your urologist will apply an anesthetic gel around the urethral opening (or inject a local anesthetic into the urethra).

  • For females, cystoscopy is performed with the patient lying on their back with their knees up and spread apart.
  • Male patients generally lie on their back.

Once the anesthetic has taken effect, your urologist will gently insert the tip of the cystoscope into your urethra, then slowly glide it through the urethra and into the bladder.

In order to obtain a clear view of the bladder wall, saline is used to fill and stretch the bladder. (It should be noted that this part of the procedure may cause some discomfort or the urge to urinate.)

When your urologist has finished examining your urethra and bladder, they may remove the saline from your bladder or ask you to empty your bladder by urinating.

After Care

After undergoing a cystoscopy, you may experience a mild burning feeling or discomfort in your bladder area or kidney area when urinating. Some patients also see small amounts of blood in their urine or feel the need to urinate more frequently or urgently. If these problems persist for more than 24 hours or a fever greater than 100.4F develops, make sure to consult your doctor.

You should also seek medical attention if you are unable to urinate despite the feeling of a full bladder, have bright red urine or blood clots in your urine, experience severe discomfort, or have a fever.

Taking a warm bath or using over-the-counter pain relievers may help alleviate post-cystoscopy discomfort.

Differential Diagnosis

UTIs can trigger signs and symptoms similar to those associated with other issues affecting the urinary tract. The following conditions are commonly considered when you are being evaluated for a possible UTI:

Your healthcare provider will be able to differentiate between these conditions based on your symptoms, physical examination, and diagnostic tests.

Frequently Asked Questions

  • Can I diagnose a UTI myself?

    If you've already had one UTI and are familiar with the symptoms, most likely yes. However, in all cases, a urine culture should be done before a doctor prescribes an antibiotic.

  • What should I do after being diagnosed with a UTI?

    You'll need an antibiotic to cure the infection. Take it exactly as your healthcare provider prescribes and don't stop taking it sooner than they tell you to—even if you start feeling better.

    Meanwhile, you can ease your symptoms and help your recovery along by:

    • Drinking plenty of water
    • Urinating often
    • Easing pain with a heating pad on your lower belly or back
    • Cutting back on caffeine and alcohol
  • What is the difference between cystitis and a UTI?

    Clinically speaking, there is no difference: Cystitis means "inflammation of the bladder," which often can be caused by a bacterial infection of the urinary tract. Some healthcare providers use the term "acute uncomplicated cystitis" to refer to UTIs.

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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