If you are a woman and you have the typical symptoms of a lower UTI, further testing is not usually required to confirm the diagnosis. This is because a lower UTI causes a distinctive pattern of symptoms, so a reasonably confident diagnosis can be made simply by asking you about your symptoms.
When testing is required
There are a number of circumstances where testing is usually recommended. These are:
- In all cases of UTI in men. UTIs are uncommon in men, so it is important to rule out other possible causes of the symptoms.
- In cases of a suspected upper UTI. These infections have a higher risk of complications, so a careful assessment of the state of the urinary tract needs to be made.
- UTIs that occur in pregnant women. Pregnant women have a slightly higher risk of developing complications.
- In cases where a person has blood in their urine. Although unlikely, this could be a symptom of bladder cancer, so it is important to rule out or confirm the diagnosis.
- In cases where a person has a risk factor that makes them more vulnerable to developing serious complications, such as having a weakened immune system.
Initial testing involves taking a urine sample and testing it for the presence of bacteria. This can confirm the diagnosis and it is useful for deciding what the most effective antibiotic is to use for your treatment.
Further testing
Further testing for a UTI is only required if your symptoms fail to improve, or you experience repeated UTIs that could be caused by abnormalities in your urinary tract, such as a bladder stone.
Further testing may also be required to rule out a diagnosis of bladder cancer in cases where you have noticed blood in your urine.
Intravenous urogram (IVU)
One test that is used to assess the state of the urinary tract is called an intravenous urogram (IVU).
Before the IVU takes place, you will be injected with a special dye that shows up on an X-ray. The radiologist (a specialist in using medical imaging technology, such as X-rays) will study how the dye moves through your urinary system in order to see whether there are any problems.
You may experience a metallic taste in your mouth and flushed, itchy skin when the dye is injected. However, this is normal and these symptoms should pass after a few minutes.
Cystoscopy
Another test that is sometimes used is known as a cystoscopy. A cystoscopy is a procedure that uses a special instrument, called a cystoscope, to examine the inside of your bladder. A cystoscope is a thin, flexible telescope that is passed into your body so that the urologist (a specialist in treating conditions that affect the urinary tract) can look inside your bladder.
During a cystoscopy, a jelly-like substance that contains a local anaesthetic is squirted into the opening of your urethra (the tube that runs from the bladder to the penis, or vagina, through which urine passes). As well as working as a painkiller, the jelly helps the cystoscope to pass into the urethra more easily.
A cystoscopy usually takes between five and ten minutes to perform. The urologist will study the lining of your bladder and urethra in order to identify any abnormal areas that could be the result of bladder cancer.