How do healthcare providers diagnose UTIs & UI in women?

UTIs in Women

To diagnose UTI, a healthcare provider will start by asking about symptoms and taking the patient's medical history. Sometimes, a woman may feel like she has a UTI, but may instead be experiencing irritation from some other cause, such as a soap or medication.

A healthcare provider may take one or more of the following steps to help confirm the presence of a UTI:¹

• Test the urine for the presence of bacteria and white blood cells, which fight infection. The patient may need to provide a "clean catch" urine sample. To do this, patients wash their genital areas to prevent bacteria from getting into the sample and then catch the urine midstream in a sterile cup.
• Culture the urine sample, especially if the patient has recurring infections or is a hospital patient. Culturing makes bacteria easier to identify by combining the urine with a substance that encourages bacteria to grow.
• Order a sensitivity test on any bacteria detected, which can help decide which antibiotic will be most effective for treating the infection.

For recurring UTIs, healthcare providers may order one or more of the following tests to find out if the urinary tract is normal:¹

• Kidney and bladder ultrasound. This test bounces sound waves off the pelvic organs to create an image of their structure and reveal abnormalities.
• Voiding cystourethrogram. The test creates an X-ray image of the bladder and urethra while the bladder is full and during urination. It can show abnormalities inside the organs and whether urine flow is normal.
• Computerized tomography (CT) scan. X-rays and computers are used in this test to create clear, detailed three-dimensional images.
• Magnetic resonance imaging (MRI). This test uses radio waves and magnets rather than X-rays to produce clear, detailed images of the body's organs and soft tissues.
• Radionuclide scan. During this test, special cameras and computers are used to create images as a small amount of a radioactive chemical passes through the kidneys.
• Urodynamics. This test determines how well the bladder, sphincter muscles, and urethra are storing and releasing urine.
• Cystoscopy. During this test, the healthcare provider inserts a tube-like instrument inside the urethra and bladder to look for a cause of infection, such as a structural anomaly.

For information about UTIs in children, visit https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-tract-infections-in-children.

UI in Women

To diagnose UI, healthcare providers begin by taking a medical history and asking about symptoms. They often ask patients to keep a bladder diary to track patterns of voiding (urinating) and leaking episodes. The diary can help a healthcare provider understand the cause of the problem and how best to treat it.

Information collected in a bladder diary typically includes times and amounts a patient urinates, straining or discomfort, fluid intake, and when and about how much urine leaks. Healthcare providers may give patients a special pan that fits over the toilet rim to measure how much they urinate. If the diary, symptoms, and medical history are not enough to diagnose UI, healthcare providers may recommend other tests. In addition to urodynamics and cystoscopy tests and an ultrasound of the urinary tract, the tests may include:²

• A bladder stress test. This test requires a patient to cough vigorously while the healthcare provider watches for leakage from the urethra opening.
• Urinalysis and urine culture. A laboratory test of urine is conducted to detect infection, urinary stones, and other possible UI causes.

For information about UI in men, visit https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems.

For information about UI in children, visit https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-bedwetting-children.