Think You Have a UTI? Here’s What to Know about UTI Tests

If you think you might have a urinary tract infection (UTI), you may be wondering how to get a UTI test — or whether a test is even necessary. After all, the symptoms are often obvious. But even if you are pretty sure you have an infection, sometimes it’s still best to get a UTI test. And there are few different UTI tests available. So, which is best? When are they helpful? And how long does it take to get results? Let’s dig in.

What is a UTI?

A UTI is a common infection that affects the urinary tract. This is the body system where urine is collected and eliminated from the body. It includes the kidneys, ureters, bladder, and urethra. Most UTIs involve the lower tract of the urinary system (the urethra and bladder), but the upper tract (the kidneys and ureters) can also be involved.

The main cause of UTIs is a type of bacteria called Escherichia coli (E. coli). But other types of bacteria, and even some fungi and viruses, can cause them.

UTIs can affect anyone. But, if you have a vagina, you’re more likely to get a UTI. Typical UTI symptoms can include:

• Pain or burning during urination (dysuria)

• Frequent and urgent urination

• Pain in the lower abdominal or pelvic area

• Blood in the urine (hematuria)

How do you diagnose a UTI?

To diagnose a UTI, you don’t always need a test. Oftentimes, a healthcare professional can diagnose a UTI based on your symptoms. If you don’t have any other medical conditions and your symptoms are straightforward, they may be able to diagnose and treat a UTI without testing.

This may also be true for people who have recurrent UTIs. This is technically defined as three or more UTIs in 12 months, or two or more in 6 months. Many people with recurrent UTIs know when a UTI is starting, and then they can begin treatment on their own. 

But there are times when a UTI test is needed. This is especially true if:

• Your symptoms are more severe than a typical UTI.

• Something else could be causing your symptoms.

• You’re pregnant.

• You have other medical conditions, or you’re at higher risk for serious infections.

EXPERT PICKS: WHAT TO READ NEXT

• What does a UTI feel like? The symptoms of a urinary tract infection (UTI) can be different depending on the severity of the infection, your sex, and even your age. Learn more about the UTI symptom spectrum. 

• It’s complicated… Healthcare professionals classify UTIs as complicated or uncomplicated. We explain what this means, and how it impacts your treatment.

• How to get rid of a UTI — fast: If your UTI test is positive, we explain the quickest way to get treatment. And what else you can do to help your body get over it.

Even though a test may not be needed to diagnose a UTI, it’s still helpful to tell your healthcare team about your symptoms. This can help make sure there’s nothing else going on and that you get the right treatment.    

The 3 types of UTI tests

Any type of UTI test starts with a urine sample. This can then be tested in three ways: a urine dipstick, a urinalysis, and a urine culture.

Urine dipstick

The quickest and easiest UTI test is called a dipstick. A thin, plastic stick with chemicals on it is dipped into the urine. The dipstick will change colors if your urine has signs of infection, like blood, bacteria, or white blood cells.

A urine dipstick gets fast results. And it may be the only test healthy women with typical UTI symptoms need. But because it’s a relatively basic test, it’s not always the most accurate or detailed test.

Urinalysis

A more detailed UTI test is called a urinalysis. In this test, a specialist examines the urine under a microscope. This test can show signs of infection in more detail, like bacteria, white blood cells, or red blood cells. A microscopic urinalysis can also show signs of kidney disease that are not related to a UTI.

Urine culture

Depending on your symptoms, a healthcare professional may also order a urine culture. This is the best way to know for sure if you have an infection. And if you do have an infection, this test can also help figure out exactly what type of bacteria or microbe is causing your infection. 

Urine cultures can take longer than other tests — usually between 1 and 3 days. But they can give more detailed results about the type of urine infection you have. Importantly, a urine culture also helps your care team choose the best treatment for the infection. Although in many cases, your care team will still start you on treatment before the results are back.

A urine culture is also helpful if a treated UTI isn’t getting better or if you have recurrent UTIs. The test results can be used to help find a more effective treatment. 

What other tests may be needed to diagnose a UTI?

If you have a “complicated” UTI, you may need additional tests. A complicated UTI means there are some features that may make it harder to treat, or put you at increased risk of complications. The following circumstances or symptoms make a UTI complicated:

• Pregnancy

• Male sex

• Weakened immune system

• Indwelling catheters

• Fever

• Kidney involvement

• Sepsis

• Unusual bacteria

In these cases, someone may need the following tests:

• Blood tests: Tests like a blood count and electrolyte panel can look for signs of a serious infection or to check kidney function. And a blood culture can detect if an infection has spread to the blood.

• Cystoscopy: A cystoscopy is a test that looks inside the urethra and bladder. A trained professional inserts a thin, tube-like camera (a cystoscope) into the urethra. The camera sends pictures of the inside of the urinary tract to a computer screen.

• Imaging tests: Imaging tests, like an ultrasound or CT scan, are tests that take pictures to show what the urinary tract looks like and how it’s working. It can also look for things like kidney stones that are blocking the urinary tract. 

How do at-home UTI tests work?

You can find at-home UTI test kits at the pharmacy or online Examples include AZO and Utiva test strips, but there are many different products out there. These strips are similar to the dipsticks used in a medical office, and they look for white blood cells and signs of bacteria.

The tests are convenient and easy to use. Like a pregnancy test, you can just pass the strip into a stream of urine for a few seconds. Or you can collect urine in a cup and dip it in there. After 1 to 2 minutes, the colors on the strip will change depending on what’s in your urine.

Interpreting UTI test results

To interpret your UTI test results, it’s important to follow the directions on the individual product you have. Most at-home tests will test for two substances in the urine:

• Leokocytes

• Nitrites

The product will come with a diagram of the colors that correspond to a negative result, and the colors that correspond to a positive result for each substance. A positive result for either leukocytes or nitrites suggest you might have a UTI. 

Are at-home UTI tests accurate?

At-home UTI tests can be a useful tool to help figure out if you have a UTI or not. They’re meant to be used only if you already have symptoms. But it’s important to know that they aren’t 100% accurate. And certain medications and supplements (like tetracycline and vitamin C) can affect the results. 

While at-home tests may be helpful, they aren’t a substitute for advice or an evaluation from a healthcare professional. They also can’t tell you which antibiotic is the best treatment. A laboratory urine culture is needed for that. 

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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