Urinary tract infections

If you suspect that you have a UTI based on your symptoms, contact your doctor. Your doctor will review your symptoms and perform a physical examination. To confirm a diagnosis of a UTI, your doctor will need to test your urine for microbes.

The urine sample needs to be a “clean-catch” sample. This means the urine sample is collected at the middle of your urinary stream, rather than at the beginning. This helps to avoid collecting bacteria or yeast from your skin, which can contaminate the sample. Your doctor will explain to you how to get a clean catch.

When testing the sample, your doctor will look for a higher number of white blood cells in your urine. This can indicate an infection.

Your doctor will also do a urine culture to test for bacteria or fungi. The culture can help identify the cause of the infection. It can also help your doctor choose a treatment.

If your doctor suspects the UTI is viral, special testing may need to be performed. Viruses are rare causes of UTIs but can be seen in people who’ve had organ transplants or who have other conditions that weaken their immune system.

Upper tract UTIs

If your doctor suspects that you have an upper tract UTI, they may also need to do a complete blood count (CBC) and blood cultures, in addition to the urine test.

A blood culture can confirm that your infection hasn’t spread to your bloodstream.

Chronic UTIs

Most UTIs go away after treatment. But some people develop chronic UTIs. Chronic UTIs either don’t go away after treatment or keep recurring. Recurrent UTIs are common among women.

If you have chronic UTIs, your doctor may want to check for any abnormalities or obstructions in your urinary tract. Here are some common tests:

An ultrasound is where a device called a transducer is passed over your abdomen. The transducer uses ultrasound waves to create an image of your urinary tract organs that are displayed on a monitor.

An intravenous pyelogram (IVP) involves injecting a dye into your body that travels through your urinary tract. Then, an X-ray of your abdomen is taken. The dye highlights your urinary tract on the X-ray image.

A cystoscopy uses a small camera that’s inserted through your urethra and up into your bladder to see inside your bladder. During a cystoscopy, your doctor may remove a small piece of bladder tissue and test it to rule out bladder inflammation or cancer as a cause of your symptoms.

A computerized tomography (CT) scan gets more detailed images of your urinary system.

UTIs during pregnancy

If you’re pregnant and have symptoms of a UTI, see your doctor right away.

UTIs during pregnancy can cause high blood pressure and premature delivery. UTIs during pregnancy are also more likely to spread to the kidneys.

Treatment of a UTI depends on whether it’s:

bacterial (most common)

viral

fungal

Your doctor will be able to determine which it is by looking at your test results.

Bacterial UTIs are treated with antibiotics. Viral UTIs are treated with medications called antivirals. Often, the antiviral cidofovir is the choice to treat viral UTIs. Fungal UTIs are treated with medications called antifungals.

Antibiotics for a UTI

The form of antibiotic used to treat a bacterial UTI usually depends on which part of the tract is involved.

Lower tract UTIs can usually be treated with oral antibiotics. Upper tract UTIs require intravenous antibiotics. These antibiotics are put directly into your veins.

Sometimes, bacteria develop resistance to antibiotics. To reduce your risk of antibiotic resistance, your doctor will likely put you on the shortest treatment course possible. Treatment typically lasts no more than 1 week.

Results from your urine culture can help your doctor select an antibiotic treatment that will work best against the type of bacteria that’s causing your infection.

Treatments other than antibiotics for bacterial UTIs are being examined. At some point, UTI treatment without antibiotics may be an option for bacterial UTIs by using cell chemistry to change the interaction between the body and the bacteria.