Urinary Infection and Cystitis: Symptoms, the Urine Test and Treatment
Cystitis, inflammation of the bladder, is the most common urinary infection and it is considerably more frequent in women, because their urethra is shorter. It is recognized by burning on passing urine and an urge that will not stop, and in most people it settles quickly with the right treatment. The risk lies in an infection that climbs towards the kidneys and in infections that keep coming back because they are treated from memory. This article explains the symptoms, what leukocytes, nitrites and bacteria in a urine test mean, when a urine culture is needed, when an infection is an emergency and when you go to a urologist.
Symptoms of a urinary infection
- burning or pain on passing urine;
- passing small amounts frequently and a constant urge;
- pain or pressure above the pubic bone;
- cloudy urine or urine with an unpleasant smell;
- pink or reddish urine, that is, blood in the urine.
In older people an infection sometimes starts with nothing but confusion, weakness or a fall, with no burning on passing urine.
When an infection calls for an appointment straight away
- fever and shivering;
- pain in the flank, on one or both sides;
- nausea and vomiting;
- an infection in pregnancy;
- an infection in a man, which is always considered complicated;
- diabetes, a kidney stone or a catheter;
- symptoms that do not settle after two to three days of treatment.
Fever with flank pain can mean inflammation of the kidney (pyelonephritis) and calls for an appointment the same day.
How a urine test is read
| Item | What it means | Note |
|---|---|---|
| Leukocytes | White blood cells, a sign of inflammation | With symptoms they point to an infection. In women they can also come from vaginal discharge if the sample was not collected properly. |
| Nitrites | A product of some bacteria | A positive result strongly suggests infection, but a negative one does not rule it out. |
| Bacteria | Bacteria in the sample | Without leukocytes and without symptoms they are often the result of a contaminated sample. |
| Erythrocytes | Red blood cells | Common during an infection; if they persist after it has cleared, a check with a urologist is needed. |
| Urine culture | Which bacterium grows and which medicines it is sensitive to | The usual threshold is 100.000 bacteria per milliliter, but with clear symptoms a smaller number can be significant too. |
How to collect the sample properly
Use the first urine of the morning, after washing the external genitals with water, with no disinfectants. The first part of the stream goes into the toilet, and the middle part into a sterile container. The sample should reach the laboratory within one to two hours. For a urine culture the sample is taken before treatment begins, because even one dose of an antibiotic can give a falsely negative result. In women it is better not to collect a sample during a period.
Treating cystitis
Uncomplicated cystitis in a woman is most often treated by a doctor with a short course of antibiotics, and the choice of medicine depends on earlier infections and on which bacteria are common. In complicated and recurrent infections the treatment is chosen according to the urine culture. Do not take leftover antibiotics from the medicine cabinet: incomplete treatment and the wrong medicine encourage bacterial resistance and the return of the infection. Alongside treatment, drinking enough fluid and emptying the bladder regularly help. Cranberry preparations can modestly reduce how often infections occur in some women, but they do not treat an infection that is already there.
When infections keep coming back
We speak of recurrent infections at two infections in six months or three in a year. The cause is then looked for: an ultrasound of the kidneys and bladder with a measurement of residual urine, a stone, the prostate in men, post-menopausal changes in women and diabetes. A urology appointment with an ultrasound is a sensible first step. Blood in the urine that persists after the infection has cleared is always checked by a urologist, especially in smokers and after the age of 40.
What an appointment at Miren Medic looks like
At the Miren Medic clinic the urology appointment is carried out by Dr Aleksandar Lazić, specialist in urology, and it can be booked together with a urological ultrasound. Urine tests are run in the clinic laboratory. For a first, mild infection the first appointment can also be with a general practitioner, and in women with recurring symptoms a gynecological examination is part of the assessment. All of it without a referral.
Prices
| Service | Price |
|---|---|
| Urology appointment (Dr Aleksandar Lazić) | 6.000 RSD |
| Urological ultrasound | 6.000 RSD |
| Urology appointment + ultrasound | 10.000 RSD |
| General practitioner appointment | 4.000 RSD |
| Gynecological appointment | 12.000 RSD |
Frequently asked questions
What are the symptoms of a urinary infection?
Burning on passing urine, passing small amounts frequently, a constant urge, pain above the pubic bone and cloudy urine, sometimes with blood. Fever and flank pain mean the infection may have spread to the kidney.
What do leukocytes and nitrites in urine mean?
Leukocytes are a sign of inflammation, and nitrites are made by some bacteria. When both are positive and symptoms are present, an infection is very likely. Negative nitrites do not rule an infection out, and leukocytes can also come from an improperly collected sample.
Does a urinary infection clear up on its own?
In some healthy women mild cystitis settles without treatment, but there is no way to know in advance who that will be. The decision about treatment is therefore made with a doctor, and fever, flank pain, blood in the urine, pregnancy and an infection in a man all call for an appointment without waiting.
When is a urine culture needed?
In men, in pregnant women, in recurrent and complicated infections, when symptoms do not clear despite treatment and when a kidney infection is suspected. The sample is taken before treatment begins.
How long does treating cystitis take?
With uncomplicated cystitis the symptoms usually settle two to three days after treatment starts, and the length of the course is set by the doctor. The course is finished even when the symptoms stop earlier.
Which doctor do you see for a urinary infection?
For a first, mild infection a general practitioner. For recurrent infections, an infection in a man and blood in the urine, a urologist, and in pregnancy a gynecologist.
Book an appointment
If your urinary infections keep coming back or you have blood in your urine, book a urology appointment at the Miren Medic clinic. The examination, the ultrasound and the urine tests come from one place, without a referral.
