Staying with UTIs

Urine testing in UTIs

– urine cultures are not mandatory in nonpregnant women with suspected uncomplicated cystitis

However they are mandatory for:
– cystitis in pregnant women
– cystitis in men
– recurrent UTIs / recent antibiotic use / suspected treatment failure
– acute pyelonephritis

Repeat urine culture is advised at least 48 hours after completion of treatment to confirm clearance of infection.

Cystitis / UTI in men is unusual. There is commonly an underlying urinary tract abnormality and UTIs are often associated infection of the posterior urethra, prostate or epididymis.
All males with UTIs should be examined for prostatitis. If they are sexually active, consider investigating for STDs (in particular chlamydia and gonorrhoea).

Who needs imaging?
– recurrent pyelonephritis
– pyelonephritis in men
– known renal/ureteric stones
– previous renal / ureteric / bladder procedures / procedures that increase the risk of ureteric injury (pelvic surgery / radiotherapy for colorectal adenocarcinoma etc.)