Diagnosis of Urinary Tract Infection in Women

Urinary tract infection (UTI) in most women can be diagnosed clinically based on signs and symptoms. Tests are done to confirm the diagnosis. Some tests and procedures that are done to diagnose urinary tract infections include:

• urine sample analysis
• urine culture
• imaging studies
• cystoscopy

Urine sample analysis: A sample of urine is taken for testing. The urine sample is examined microscopically to see if there are any pus cells, red blood cells or bacteria. Contrary to belief, first sample of morning urine is not needed for accurate testing. A clean catch sample of urine at any time of the day is adequate. To avoid contamination of the sample, clean the genital area with an antiseptic pad or soap and water before collecting urine and it is preferable to collect the urine midstream.

Urine culture: In this test, sample from urine is used to grow bacteria in a lab. Sample from the urine is put in a special culture plate and it is incubated for a few days. If there are bacteria in the urine, growth can be seen on the culture plate in 24-48 hours. The doctor can determine from this test the bacteria that are causing your infection and the medications that are effective to treat the infection.

Imaging studies: If you have severe or recurrent infection, the doctor may recommend imaging studies to determine if there is any abnormality in your urinary tract that is causing frequent infections. Ultrasound or computerised tomography (CT) scan are most commonly done imaging studies in a patient with UTI.

• Ultrasound: It is a painless test that can help to identify problems in the urinary tract, such as kidney stones, any abnormality in the urinary tract, etc. This test is often performed first as it is a safe test, has no hazard of radiation exposure and is widely available.
• CT scan: It is a painless test, which produces a series of images of the part of the body that is being examined; in this case, the kidney and other structures in your abdomen. It is useful to detect small stones in the kidney and other abnormalities that may not be seen on conventional X-rays or ultrasound.
• Intravenous urinary pyelogram: In this, a dye is injected intravenously (into vein) i.e. usually in a vein in your arm. After this, a series of X-rays of the urinary tract are taken as the dye passes through the kidneys, ureters and bladder. This test helps to show the structure of your urinary tract and any abnormality.

Cystoscopy: In this test, a special instrument called a cystoscope (a thin, flexible telescope) is inserted through the urethra to see the inside of your urethra and bladder.