I’m a GP – your UTI symptoms may not actually be a UTI

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At his famous tea party in Wonderland, the Mad Hatter asked a peculiar question of Alice – why was a raven like a writing desk? She struggled to work out why, but then it turned…

At his famous tea party in Wonderland, the Mad Hatter asked a peculiar question of Alice – why was a raven like a writing desk? She struggled to work out why, but then it turned out he hadn’t the slightest idea either.

That’s how I sometimes initially feel about patients experiencing urinary symptoms, and are concerned they may have a urinary tract infection – commonly known as a UTI. They’re such a common part of my working life as a GP that when a patient reports a burning or stinging sensation when passing urine, going to the loo more frequently, or lower abdominal pain, then it’s an almost knee-jerk reaction to suspect one.

It’s estimated that UTIs count for up to six per cent of GP consultations – a really quite staggering statistic. I’d be tempted to say it’s even more. I can’t actually recall a clinical day where I haven’t seen at least two or three.

That’s because every morning, at least eight or 10 urine samples are dropped off at the surgery by patients noting these sorts of symptoms. They then go to our practice nurse who performs a dipstick test – where a test strip is dipped into the urine to see what substances are present besides water and urea.

What we’re looking for to diagnose a UTI is either white blood cells (suggesting inflammation, and an immune response to an infection), or nitrites – these compounds, made by bacteria, are generally a better indicator. Sometimes infection causes irritation of the bladder or the urethra (the pipe carrying urine out of the body) so, on occasions, traces of blood can also be picked up.

We may send the urine sample off to the lab for further analysis. This will tell us if there are any bacteria in the urine, and if so, which antibiotics will work to clear them. We often start patients on antibiotics before these test results come back – especially if a UTI seems likely, the patient is uncomfortable, or at risk of developing complications.

Then we play the waiting game. It usually takes two to three days to get the…

The…

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