Urinary Tract Infection - Diagnosis

Symptomatic UTIs cause symptoms such as frequent urination, burning urination, sensation of incomplete bladder emptying, pain or pressure in the lower abdomen and signs such as foul smelling, cloudy, or bloody urine. If untreated, bladder infections can migrate to the kidneys and cause pyelonephritis, which is a more serious type of infection.

A sample of urine is sent to a laboratory and cultured to accurately identify the type of bacteria and to help determine which antibiotic will most effectively eradicate the infection. Occasionally it is necessary to collect a catheterized specimen, especially if the voided specimen is contaminated with skin cells. In the meantime, patients are often started on a trial of antibiotics, especially if they are experiencing symptoms, until the culture results are available, which are usually within 48 hours. Occasionally it is necessary to switch the antibiotics if the culture results show that the bacteria is resistant to the initial antibiotic.

If infections persist or fail to respond to normal measures, additional workup may be necessary. Tests that may be ordered include an ultrasound or x-ray of the kidneys and bladder and cystoscopy. Cystoscopy is a simple procedure that is performed in the office. Numbing jelly is first instilled into the urethra. Next a special instrument called a cystoscope is gently inserted into the urethra and into the bladder. Sterile fluid is used to fill the bladder and a small instrument with a light and special lens at the end is used to examine the bladder. Live pictures of the procedure are displayed on a television monitor.

Risk Factors:

Risk factors for developing recurrent urinary tract infections vary with age.3 Risk factors in premenopausal women include history of a UTI as a child, mother with a history of UTIs, and sexual activity. Women that are more active sexually active, especially if they have had more than one new partner within the past year, are more likely to develop a UTI. The type of birth control used is also relevant. The use of a diaphragm and condoms that contain spermicidal jelly increase the risk of developing recurrent UTIs.

Risk factors in postmenopausal women include lack of vaginal estrogen, history of UTI in premenopause, and non-secretor blood type (genetically inherited).

Risk factors in elderly women include catherization, urinary incontinence, cystocele (dropped bladder), retention of urine, injudicious use of antibiotics, and impaired function (e.g., stroke, Alzheimers).

[Top]

Need more information on health and wellness?
Click here for a link to health and wellness recommendations from the National Institute of Health.