Urology Austin

UTI diagnosis and treatment should be done without delay.

For patients who feel that they are experiencing a urinary tract infection, it’s important to undergo UTI diagnosis and treatment as soon as possible. In reality, if a UTI to goes untreated, it can spread and lead to more complex health problems.

UTI diagnosis and treatment

For patients experiencing a UTI, it’s important to conduct a thorough evaluation as soon as possible. When visiting Urology Austin, the provider will start by reviewing the patient’s complete medical history. They will also perform a physical examination and a urinalysis.  The physical examination will include a  pelvic examination. This exam will help the provider determine if the bladder and urethra are normal. For women, the urologist will also want to evaluate whether the vaginal tissue is healthy.

The doctor will also want to know if the patient has a history of UTIs. It is very important for them to review previous culture results. This helps to determine whether true bladder infections have been present or whether these are re-infections or persistent UTIs.

In-office diagnostic tools

Urinalysis or urine culture: A clean catch or catheterized urine sample will be collected and analyzed to determine if the patient has a urinary tract infection, blood in their urine, or any other abnormality in their urine. If infection is suspected, the urine sample will be sent for a urine culture.

Post void residual: This test is performed to see if urine remains in the bladder after ‘complete’ voiding. These measurements may be made by catheterization or ultrasound. A normal post-void residual is less than 100 cc of urine remaining in the bladder.

Further evaluation

Voiding diary: A voiding diary is an essential part of a patient’s evaluation. It allows the physician to further review bladder function based on fluid intake, urine output, and the frequency of urination during the day and night.

Cystoscopy: Cystoscopy is a test that allows the doctor to look at the interior lining of the bladder and urethra – areas which usually do not show up well on x-rays. A cystoscope is a thin scope that is inserted through the urethra into the bladder. The doctor can examine the inside of the bladder for stones, tumors, pockets that don’t empty, and foreign bodies.

Imaging of the kidneys and ureters: A CT scan or ultrasound of the upper part of the urinary tract may be appropriate, especially if the infections have been difficult to treat or have been associated with fevers, elevated blood counts, or nausea and vomiting. This indicates potential involvement of the upper tracts. Additionally, breakthrough infections or persistent UTIs may indicate the need for further upper tract evaluation. Kidney stones or urethral obstruction are infrequently found.

Treatment options for recurrent uncomplicated UTIs

There are several treatment options available including medications, supplements and behavioral modifications.

Medications

  • Antibiotics – A course of antibiotics can be prescribed based on the infection.
  • Treat by Culture – This course of therapy is appropriate if patients are getting 3-4 UTIs or less per year and the patient has had a negative work-up in the past.
  • Postcoital Prophylaxis – This type of therapy is appropriate for patients with UTIs that are always associated with intercourse.
  • Continuous Prophylaxis – With this type of therapy, a small dose of antibiotics is taken on a daily basis to prevent recurrence of UTIs.

Behavior therapy to reduce UTIs

  • Drink additional fluids – particularly water
  • Void before and after sexual intercourse
  • Double void – this helps to further empty the bladder
  • Wipe from front to back
  • Avoid using products in the genital area that contain perfume
  • Practice good personal hygiene
  • Maintain bowel regularity
  • Practice good diabetic control
  • Take showers instead of baths
  • Wash foreskin regularly if uncircumcised
  • Vaginal hormone replacement

Alternative treatment options

  • Cranberry Supplementation – Do not use if you have a history of overactive bladder. Do not drink cranberry juice that is loaded with sugar.
  • Vitamin C supplementation – Do not use if you have a history of overactive bladder.
  • D-mannose
  • Probiotics