A couple of days back a lady came to me saying she is getting UTI over and over again in the last year. She is taking medicines as prescribed, but has no relief, and never has had.

Another young woman of about 30 had come in a few months back, she had two children and had what she thought was UTI for three years, and now was fixated on the Uterus as the root of all her problems and wanted it out as she thought it would cure her.

There is also the case of a young, recently sexually active girl, who is not married, and just complains of burning while passing urine, and is empirically treated for UTI.

What is common in all these three cases?

They are not UTI.

First was a pelvic mass, pressing on the bladder and not allowing the lady to pass urine, presenting as frequency, the second was a case of Over Active Bladder, and the third was a case of sexually transmitted infection.i

You will be surprised that even in a country like UK, 37% cases diagnosed as UTI are not UTI, they are Sexually transmitted infections and make up 64% of total STI’s detected [#].

40-60% women will get UTI at least once in their lifetime.

If you want to stay healthy there are some things you can do to lessen the risk of UTI.

• Stay well hydrated whatever the weather. You need to pass urine once on two hours to flush your urinary tract, so the amount of fluids that help you in this is our adequate. Do not compare with others.
• You need to pass urine and wash thoroughly after each sexual activity.
• Menstrual pads have to be changed at least once in 13 hours if not six, even if there is no bleeding.

If in spite of these precautions, you do get burning, pain and frequency of urination, sometimes blood in urine, pain from loin to groin or lower abdominal pain with chills and fever, please do not delay or take self-medication.

As a lady with symptoms what can you do? Go to a Doctor.

You will have to give urine sample for testing. There is a correct way of giving urine sample. Your private parts have to be washed and a clean catch midstream sample has to be given for testing in the container provided.

The urine is tested, if infection is suspected, then a culture and sensitivity test is required. It is not wise to start antibiotics without giving urine for culture as there are many strains of resistant bacteria that would not respond to just any antibiotic. Sometimes even a combination of antibiotics may have to be given.

You need an internal pelvic exam to rule out STI or any mass in the pelvis.

If you have painless bleeding in urine, a cystoscopy to rule out Bladder Cancer will be needed.

You will also need a sonogram for evaluation of your pelvis and Kidney, Ureter and Bladder. This will tell about stones and any block in the pathway.

If a stone is seen, an IVP x-ray would be needed to assess renal function and site of block, size of stone etc.

Routine blood tests for infection, renal function, STI, Suger etc will also be needed.

Once diagnosed correctly, usually UTI is easy to treat. You need to follow instructions of your treating doctor, and go for follow up when called.

So it is very clear that if the cascade of investigations is followed, nothing that is not UTI will be able to masquerade as UTI. Diagnosis will be quicker and so treatment will be without delay for the existing condition.

If you have any questions, feel free to comment below. I can be reached via Contact Me page

[1]	Tomas, M. E., Getman, D., Donskey, C. J., & Hecker, M. T. (2015). Overdiagnosis of urinary tract infection and underdiagnosis of sexually transmitted infection in adult women presenting to an emergency department. Journal of clinical microbiology, 53(8), 2686-2692.