Urinary Tract Infections (UTIs)

Most urinary tract infections are easy to recognize and diagnose because of their distinct symptoms. Diagnosing a UTI is most times done right in the doctor’s office. A urinary tract infection will usually show up in a urine test. However, the doctor might send the urine to a laboratory for further inspection and to discern which type of antibiotic would work best.

Further tests are generally done to determine the correct treatment in cases of more serious urinary tract infections. Common tests used to detect a UTI include:

• Urinalysis – Urinalysis examines urine for abnormal substances such as blood, protein, sugar (glucose), or other foreign substances. A urinalysis will detect the type of bacteria or germs causing the infection.
• Urine culture – A urine culture is sent to a laboratory for further examination for bacteria, yeast, or other microorganisms that could be growing in the urinary tract. The results are used to determine the course of treatment.
• Ultrasound – For people who experience frequent urinary tract infections, ultrasound, which uses sound waves to create images, may be used to view the kidneys and bladder for structural abnormalities.
• Cystoscopy –A cystoscopy is sometimes performed on people who get frequent UTIs. This procedure is done in the doctor’s office with a local anesthetic. The doctor carefully guides a thin, flexible scope through the urethra into the bladder. A sterile solution is injected into the bladder. This test allows doctors to view the inside of the bladder. The cystoscopy can visualize infections, the presence of stones, or other signs of urinary diseases.
• CT scan – CT scans generate clear, three-dimensional images of the urinary system that can be viewed from a computer monitor. They are beneficial in finding infections, cysts, stones, and tumors.

Diagnosing urinary tract infections in elderly patients can be difficult since they do not experience the same symptoms as younger people. Elderly patients do not feel the usual pain accompanying a UTI; their behavior changes. They become confused and disoriented. As these behaviors are associated with dementia, symptoms of a UTI could be overlooked. However, it is important to treat a urinary tract infection in an older person quickly since, if left untreated, it could result in sepsis.

How can a primary doctor help?

Primary care physicians are experienced in handling urinary tract infections. These physicians are knowledgeable and aware of the symptoms that could indicate a UTI. A primary care doctor can diagnose a UTI in their office by using a dipstick urinalysis to detect bacterial infections. If none is present, this would indicate a person does not have a UTI and should seek additional medical attention.

If a primary care doctor believes further care is needed, they will refer the patient to a specialist called a urologist; these specialists handle the diagnosis and treatment of conditions affecting the urinary system. If a problem with the kidneys is suspected, your doctor may suggest a nephrologist who handles diseases of the kidneys.