Diagnosis
To diagnose UTI, a series of test may be needed. Your family doctor or urologist will take review your medical history and perform a physical examination, which may include an examination of the genitalia regions. If required, other tests will be performed.
Medical history
The doctor will collect a detailed medical history , asking questions about the symptoms. Questions may include:
Physical examination
The urologist will conduct a general physical examination on:
Urine test
You will be required to provide a urine sample for testing to exclude any current urinary tract infection and traces of blood in the urine.
Uroflowmetry
This simple test electronically records the rate of urine flow as you urinate into a container known as a uroflowmeter. It assists your doctor in assessing whether there is any obstruction to the urine flow.
Imaging of the bladder/kidneys
You may undergo an ultrasound of the bladder and kidneys, using high-frequency sounds to create images. Additionally, an X-ray/CT scan at the Diagnostic Imaging Centre may be needed to exclude any causes for persistent/recurrent infections (e.g., stones in the urinary tract).
Cystoscopy
In cases of blood in the urine or abnormal ultrasound/X-ray/CT, a flexible cystoscopy may be recommended. This day procedure enables the urologist to examine the bladder for any other conditions. Please refer to the flexible cystoscopy pamphlet for more information.
How to do a clean-catch specimen for females
Obtaining an uncontaminated specimen for female patients is often challenging but crucial for diagnosing UTI and blood in the urine. Please seek help from your doctor or nurse if you need advice on obtaining a clean-catch specimen. In some cases, a catheter (a thin tube inserted into the bladder via the urethra) may be used to ensure accurate results.
Recurrent UTIs in males
Male UTIs are considered complicated.
Investigation by a urologist is recommended as there may be an obstruction to urination or an underlying bladder condition.
Assessment for common conditions such stones, benign prostatic enlargement and prostatitis (inflammation of prostate) is necessary.
Symptoms may include lower urinary tract symptoms (e.g., pain during urination at the tip of the penis), pain in the abdomen, blood in the urine, inability to urinate, kidney infection and testicular infection.
Medications may be required if self-management or lifestyle changes are inadequate. Common medications include antibiotics, probiotics, cranberry extracts, topical oestrogen cream/pessary for postmenopausal females.
Antibiotic strategies:
Your Urologist will advise you on the suitability of the strategies, providing information on their benefits and risks.
Probiotics and cranberry extracts
These health supplements that may beneficial in preventing UTIs in otherwise healthy individuals.
Topical oestrogen cream
For postmenopausal females, topical oestrogen cream/pessary may be recommended to address dry or thin genitals. This therapy improves tissue quality of the genitalia region, preventing UTIs and alleviating some symptoms such as pain during urination.
Intravesical therapy
For patients with severe, recurrent infections with previous failed treatments, intravesical therapy with hyaluronic acid may be suggested. Multiple sessions, usually performed weekly, may be required to experience the benefits.
Living with recurrent UTIs
Although UTIs are usually not life-threatening for healthy individuals, they can negatively impact on the quality of life. For older or immunocompromised patients, severe UTI can pose life-threatening risks. Quality of life involves both physical and psychological health. Seeking help and treatment is important to gaining control over the condition and relieving associated symptoms.
