Urinary Tract Infection - Diagnosis

Diagnosis

A doctor can confirm if you have a urinary tract infection by testing a sample of your urine. For some younger women who are at low risk of complications, the doctor may not order a urine test and may diagnose a urinary tract infection based on the description of symptoms.

Urine Tests

Urinalysis. A urinalysis is an evaluation of various components of a urine sample. It involves looking at the urine color and clarity, using a special dipstick to do different chemical testing, and possibly inspecting some of the urine underneath a microscope. A urinalysis usually provides enough information for a doctor or nurse to start treatment.

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Urine Culture. If necessary, the doctor may order a urine culture, which involves incubating and growing the bacteria contained in the urine. A urine culture can help identify the specific bacteria causing the infection, and determine which type of antibiotics to use for treatment. A urine culture may be ordered if the urinalysis does not show signs of infection but the doctor still suspects a UTI is causing the symptoms. It may also be ordered if the doctor suspects complications from the infection.

Clean-Catch Sample. To obtain an untainted urine sample, doctors usually request a so-called midstream, or clean-catch, urine sample. To provide this, the following steps are taken:

• Patients must first wash their hands thoroughly, then wash the penis or vulva and surrounding area four times, with front-to-back strokes, using a new soapy sponge each time.
• The patient then begins urinating into the toilet and stops after a few ounces.
• The patient positions the container to catch the middle portion of the stream. Ideally, this urine will contain only the bacteria and other evidence of the urinary tract infection.
• The patient then urinates the remainder into the toilet.
• The patient securely screws the container cap in place without touching the inside of the rim.

The sample is generally given to the doctor or sent to the laboratory for analysis.

Collection with a Catheter. Some patients (small children, elderly people, or hospitalized patients) cannot provide a urine sample. In such cases, a catheter may be inserted into the bladder to collect urine. This is the best method for providing a contaminant-free sample, but it carries a risk of introducing or spreading infection.