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. While symptoms alone can give good clinical clues about an infection, a UTI test can definitively figure out if your urine is infected.  

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 pelvic area

• Waking at night to urinate (nocturia)

• 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 provider can diagnose a UTI based on your symptoms. If you’re young and healthy and have typical UTI symptoms, 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 3 or more UTIs in 12 months, or 2 or more in 6 months. Many people with recurrent UTIs can accurately tell 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 problems, or you’re at higher risk for serious infections.

Even though a test may not be needed to diagnose a UTI, it’s still helpful to tell your healthcare provider 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

A 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 first step when testing a urine sample is usually to dip a dipstick — a thin, plastic stick with chemicals on it — 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.   

Urinalysis

If you have an abnormal dipstick test, the next step is usually to send the urine for 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, your healthcare provider may also order a urine culture. This is a test that can figure out exactly what type of bacteria or microbe is causing your infection. 

Urine cultures can take longer than other tests — usually between 1 to 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 your infection. Although in many cases, your provider will still start you on treatment before the results are back.

It’s common to need a urine culture if a treated UTI isn’t getting better or if you have recurrent UTIs. The test results can be used to help find a different treatment. Providers also order urine cultures if they suspect you have a more severe type of UTI that has reached your kidneys (pyelonephritis). 

What other tests may be needed to diagnose a UTI?

If you have a recurrent UTI or a “complicated” UTI, you may need additional tests. A complicated UTI can happen to someone with an abnormal urinary tract or kidney stone, for example. In these cases, you may need the following tests:

• Blood tests: Your healthcare provider may order blood tests to look for signs of a severe infection or to check how well your kidneys are working. This typically includes a blood count and electrolyte panel.

• Cystoscopy: A cystoscopy is a test that looks inside the urethra and bladder. A provider 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 is working. It can also look for things like kidney stones that are blocking the urinary tract. 

How do at-home UTI tests work?

There are a few at-home UTI test kits you can get at the pharmacy or online (like AZO and Utiva test strips). These strips are similar to the dipsticks used in a provider’s 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.

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 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 your healthcare provider. 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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