Diagnosis
The diagnosis of a urinary tract infection consists of several components. First of all, the medical history should be taken. The doctor will ask about the symptoms, how long they have existed, whether a urinary tract infection has occurred before, whether there are any previous illnesses and whether medication is taken regularly.
It is also important to know whether the urinary tract infection was acquired at home or in a care facility (hospital, nursing home). This is followed by a physical examination focusing on the lower abdomen and the kidney region. The doctor will, for example, tap both kidney areas with his fist to check if there is pain.
Depending on how old and morbid the patient is, a blood sample can also be taken. In young healthy women, the most common group of patients with simple urinary tract infections, no additional blood needs to be taken. For older, pre-diseased patients, a blood sample may be useful.
Blood is also usually taken from patients with renal storage knocking pain. The decisive criterion for deciding whether a bladder infection is present or not is a urine test, the so-called urine status. This is explained in more detail in the next section.
In addition to the diagnostic measures mentioned above, an ultrasound examination may also be used to assess the bladder and kidneys and to rule out urinary retention. With a quick and easy self-test at home you can determine a first suspicion of a bladder infection yourself. A urinary tract infection is usually treated by the family doctor.
He has a wide range of diseases that he can treat. In the hospital, in most cases the internists, i.e. the doctors for internal diseases, are responsible for the treatment of urinary tract infections. In hospitals where there is a urology department, this department can also take over the treatment of urinary tract infections.
The urine status is a laboratory examination to clarify various diseases. The urine to be examined should preferably be medium-flow urine. This means that when going to the toilet, some urine is urinated first, only the urine from the middle phase of urination is collected.
The urine is then either sent to the laboratory and examined there or a quick test is carried out with a test strip. The urine is tested for the presence of red blood cells (blood in the urine = haematuria), white blood cells (leukocyturia), nitrite, protein, sugar and other components. An elevated number of white blood cells in the urine is groundbreaking for the diagnosis of a urinary tract infection.
Nitrite is also often present as many bacteria as well as E. coli form nitrite. A missing detection of nitrite does not exclude the presence of a urinary tract infection. In addition to the diagnosis of urinary tract infections, the urine status is also used for the diagnosis of other kidney diseases as well as diabetes mellitus and, more rarely, pheochromocytoma and liver diseases.
Hospitals usually always have the option of having urine tests accurately evaluated by a laboratory. If no acute laboratory is available, as is the case in a doctor’s practice, for example, urine test strips are used as an alternative. This is a strip of plastic on which different colored zones can be seen.These zones test for the presence of certain substances in the urine.
A normal urine test strip tests for the presence of red blood cells (erythrocytes), white blood cells (leukocytes), nitrite, sugar (glucose), protein, ketones, pH and urobilinogen. Each zone contains an indicator that changes colour differently on contact with the substance to be tested. The more of the substance to be tested is present, the stronger the color change.
The urine test strip is held briefly in the container containing the medium-stream urine to be tested and can then be read immediately. A reference scale is included to help explain the different color changes. The urine test strip is a helpful tool for an initial diagnosis.
It provides a rough indication of the possible presence of certain diseases. However, the strip test cannot provide any precise information about the amount of substances contained in the test. The intensity of the color change merely indicates a rough estimate of the quantity.
To obtain more precise information, a more precise urine test in the laboratory is then necessary. Urine test strips are used in the practice (family doctors, gynaecologists, pediatricians) and can also be used by the patient as a self-test. They are a very helpful tool for primary diagnostics for the above mentioned measures and can be supplemented by further tests if necessary.
