Do I Need A Urine Test (Urinalysis) Before Getting Treated For a UTI Through Telemedicine?

Written by Dr. Ryner Lai

October 15, 2020

What Is a Urinalysis? 

Urinalysis (UA) is also known as a urine test. It is a simple test in which the patient provides a urine sample in a specimen cup, which is then sent to a lab for analysis. This test is usually ordered by a medical provider if they suspect that you might have a urinary tract infection (or kidney disease). Usually, if the results of the urinalysis suggest that you have a urinary tract infection, your doctor will start you on a course of antibiotics treatment. 

 

Is Urinalysis Always Necessary?

Urinalysis is not always necessary. This is because the test might not have any impact on the clinical decision on whether or not to start a patient on treatment. For example, if a patient has no symptoms for a urinary tract infection but the urinalysis shows the presence of bacteria in the urine, there is usually no reason to commence treatment. 

Conversely, if a patient has symptoms of a urinary tract infection, such as having a burning sensation when peeing and the urine being smelly or cloudy, then treatment is usually started, regardless of the result of the urinalysis. 

In the second case, a urine culture may be helpful. The way a urine culture works is that a sample of urine is incubated in the lab to allow any bacteria that might be present to grow. If there are bacteria that grow out a certain number of colonies, the culture is considered positive. The cultured bacteria are then identified under the microscope and tested for susceptibility. This will tell the doctor which antibiotics will be effective and which antibiotics that they might be resistant to. However, the results of a urine culture might take days to return, which would render it less useful because your doctor will usually want to start treatment right away. 

In other words, the decision of a doctor to start treatment on a possible urinary tract infection is primarily based on the clinical history provided by the patient. Urinalysis should only be used as an adjunct in the diagnosis and treatment of UTIs. However, many practitioners order urinalysis tests routinely–in the absence of symptoms–which has led to the negative effects of increased healthcare costs and over-treatment in asymptomatic patients (which in turn may lead to greater antibiotic resistance). 

 

Should I Get a Urine Test Ordered? 

The answer depends on the individual circumstance: most of the time, you will be treated for urinary tract infection if the doctor suspects the diagnosis based on your symptoms, regardless of your urinalysis results. If you have typical symptoms of a urinary tract infection, urinalysis will not change anything. Moreover, a urinalysis should not be ordered routinely or as a screening test. It might lead to many false positive results (the test suggesting you have a urinary tract infection when in fact you don’t) resulting in the unnecessary treatment of patients and the development of antibiotic resistance. 

Urinalysis is more useful in less clear-cut cases, such as if the patient has atypical symptoms or if the patient continues to have urinary tract infection symptoms even after undergoing treatment. A urinalysis can also be helpful if ordered alongside a urine culture or an STD test. Ultimately, consult your doctor and follow his or her advice on whether to order a urinalysis. 

 

Written by Dr. Ryner Lai

October 15, 2020

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