You may have a urinary tract infection (UTI) if you feel a burn while urinating or have frequent and intense urges to urinate. Discover more UTI symptoms and how to treat the infection.
Urinary Tract Infection
Image by CDC
Urinary Tract Infections
Depiction of a person with Urinary Tract Infection (UTI)
Image by https://www.myupchar.com
Depiction of a person with Urinary Tract Infection (UTI)
Depiction of a lady who has a Urinary Tract Infection (UTI). The typical symptoms of UTI have been shown.
Image by https://www.myupchar.com
Urinary Tract Infections
The urinary system is the body's drainage system for removing wastes and extra water. It includes two kidneys, two ureters, a bladder, and a urethra. Urinary tract infections (UTIs) are the second most common type of infection in the body.
You may have a UTI if you notice
Pain or burning when you urinate
Fever, tiredness, or shakiness
An urge to urinate often
Pressure in your lower belly
Urine that smells bad or looks cloudy or reddish
Pain in your back or side below the ribs
People of any age or sex can get UTIs. But about four times as many women get UTIs as men. You're also at higher risk if you have diabetes, need a tube to drain your bladder, or have a spinal cord injury.
If you think you have a UTI it is important to see your doctor. Your doctor can tell if you have a UTI with a urine test. Treatment is with antibiotics.
Source: NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Additional Materials (43)
What is a urinary tract infection (UTI) and what causes it?
Urinary Tract Infection : Our kidneys are remarkable filters. Each day, they filter about 200 quarts of blood to extract about 2 quarts of wastes, which is then eliminated as urine (2 ureters connect the kidneys to the bladder, which stores urine, until it is passed through the urethra). Urine does not normally contain bacteria, but infections can occur, particularly if there are obstructions of the urethra; according to the American Urological Association foundation, urinary tract infections result in more than 7 million visits to doctor's offices each year (about 5% of all visits to primary care physicians).
Image by TheVisualMD
How to Prevent Urinary Tract Infections
Video by Howcast/YouTube
Urinary Tract Infection
Video by DrER.tv/YouTube
Urinary Tract Infection In Women | Causes & Treatment
Video by Glamrs/YouTube
Antibiotic Awareness: Urinary Tract Infection (UTI), Cystitis or Bladder Infection
Video by Washington State Department of Health/YouTube
Urinary Tract Infection Animation
Video by Blausen Medical Corporate/YouTube
Pathology of Urinary Tract Infection
Video by AllHealthGo/YouTube
Chronic pyelonephritis (urinary tract infection) - an Osmosis preview
Video by Osmosis/YouTube
Baby Urinary Tract Infections (Baby Health Guru)
Video by Healthguru/YouTube
Urinary Tract Infections (UTIs) - Symptoms & Treatment - Dr. Robert Matthews
Urinary Tract Infection - Overview (signs and symptoms, pathophysiology, causes and treatment)
Armando Hasudungan/YouTube
1:47
Preventing Urinary Tract Infections in Babies and Kids
NationwideChildrens/YouTube
0:58
Mayo Clinic Minute: Treating Urinary Tract Infections
Mayo Clinic/YouTube
1:34
Treating Recurrent Urinary Tract Infections - Dr. Mark Ellerkmann - Mercy
Mercy Medical Center - Baltimore/YouTube
0:45
Lower urinary tract infection (cystitis) - an Osmosis preview
Osmosis/YouTube
0:49
What is a urinary tract infection (UTI)?
MassGeneralHospital/YouTube
2:47
Bladder infection - Causes and treatment
Healthchanneltv / cherishyourhealthtv/YouTube
10:12
UTIs in pregnancy | Reproductive system physiology | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
3:28
What is Cystitis?
Animation Point/YouTube
3:16
Can Cranberries Actually Treat UTIs?
Seeker/YouTube
22:03
Do Cranberries Prevent UTIs? - ICAAC 2012
American Society for Microbiology/YouTube
0:29
Bladder Animation
Blausen Medical Corporate/YouTube
1:02
UTIs in Children | Merck Manual Consumer Version
Merck Manuals/YouTube
9:33
Urination | Renal system physiology | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
3:35
How Does Circumcision Affect Your Penis?
Seeker/YouTube
0:34
Chlamydia Animation
Blausen Medical Corporate/YouTube
0:48
Posterior urethral valve (PUV) - an Osmosis preview
Osmosis/YouTube
0:52
Hydronephrosis - an Osmosis preview
Osmosis/YouTube
1:46
Five Signs That Could be Symptoms of Diabetes
Lee Health/YouTube
1:36
A UTI Making You Sick?
Lee Health/YouTube
20:19
Renal Infections and UTI - CRASH! Medical Review Series
Paul Bolin, M.D./YouTube
5:01
The Truth About Cranberry and UTIs
SciShow/YouTube
1:26
Facts About Cranberry Juice to Treat UTI
UMMCVideos/YouTube
Bladder Infection
What is a bladder infection?
Image by BruceBlaus
What is a bladder infection?
Bladder Infection
Image by BruceBlaus
Definition & Facts for Bladder Infection (Urinary Tract Infection—UTI) in Adults
What is a bladder infection?
A bladder infection is an illness caused by bacteria. Bladder infections are the most common type of urinary tract infection (UTI). A UTI can develop in any part of your urinary tract, including your urethra, bladder, ureters, or kidneys.
Your body has ways to defend against infection in the urinary tract. For example, urine normally flows from your kidneys, through the ureters to your bladder. Bacteria that enter your urinary tract are flushed out when you urinate. This one-way flow of urine helps to keep bacteria from infecting your urinary tract.
Sometimes your body’s defenses fail and the bacteria may cause a bladder infection. If you have bladder infection symptoms, see a health care professional.
Most of the time, getting treatment right away for an infection in your urethra or bladder can prevent a kidney infection. A kidney infection can develop from a UTI that moves upstream to one or both of your kidneys. Kidney infections are often very painful and can cause serious health problems, so it’s best to get early treatment for a UTI.
When a bladder infection or other UTI is diagnosed and treated properly, most people won't have complications.
Most UTIs occur in the bladder. In a few cases, an infection can spread to one or both kidneys.
Is there another name for a bladder infection?
Bladder infections are also called cystitis. Sometimes people use the more general term, urinary tract infection (UTI), to mean a bladder infection, although UTIs can occur in other parts of the urinary system. UTIs that occur in the urethra only are called urethritis. A kidney infection is called pyelonephritis.
How common are bladder infections?
Bladder infections are common, especially among women. Research suggests that at least 40 to 60 percent of women develop a UTI during their lifetime, and most of these infections are bladder infections. One in 4 women is likely to have a repeat infection.
Who is more likely to develop a bladder infection?
People of any age or sex can develop bladder infections, but women are at higher risk than men. Some people are more prone to getting these infections than others, especially those who have certain medical conditions or lifestyle factors.
You are more likely to develop a bladder infection if you
are sexually active
are a woman who has gone through menopause
are a woman who uses certain types of birth control, such as diaphragms or spermicide
have trouble emptying your bladder completely, like people with a spinal cord injury or nerve damage around the bladder
have a problem in your urinary tract that blocks, or obstructs, the normal flow of urine, such as a kidney stone or enlarged prostate
have an abnormality of the urinary tract, such as vesicoureteral reflux (VUR)
have diabetes or problems with your body’s immune, or natural defense, system
recently used a urinary catheter
had a UTI in the past
Women are more likely to develop a bladder infection than men, mainly due to differences in anatomy:
Women have a shorter urethra than men, which means bacteria have a shorter distance to travel to reach and infect a woman’s bladder.
In women, the opening to the urethra is closer to the rectum, where the bacteria that cause bladder infections live.
What are the complications of bladder infections?
If infections in the lower urinary tract, such as bladder infections, are not treated, they can lead to kidney infections. If you have a kidney infection, a health care professional will provide treatment to relieve your symptoms and help prevent complications.
Health care professionals routinely test pregnant women for bacteria in the urine because a bladder infection during pregnancy is more likely to become a kidney infection.
Complications from bladder infections are rare when you work with your health care provider to find the best treatment and complete it. If your infection is treated with antibiotics, it’s important to follow directions carefully and finish all the medicine, even after you start to feel better. If you stop taking antibiotics too soon, you may get another infection that is harder to treat.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (1)
Urinary Tract Infection - CDC
Urinary tract infections happen when bacteria, often from the skin or rectum, travel up the urethra and into the bladder.
Image by CDC
Urinary Tract Infection - CDC
CDC
Symptoms
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Dysuria
Image by TheVisualMD
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Dysuria
Dysuria
Image by TheVisualMD
Symptoms of Bladder Infection (Urinary Tract Infection—UTI) in Adults
What are the symptoms of a bladder infection?
Symptoms of a bladder infection may include
a burning feeling when you urinate
frequent or intense urges to urinate, even when you have little urine to pass
Kidney infections are often very painful and can cause serious health problems, so it’s best to get early treatment.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Causes
Bladder infections - Symptoms & Causes
Image by National Cancer Institute
Bladder infections - Symptoms & Causes
E. coli bladder infection - Here you see the bladder (blue) of a laboratory mouse that was re-infected 24 hours earlier with the bacterium Escherichia coli (pink), a common cause of UTIs. White blood cells (yellow) reach out with what appear to be stringy extracellular traps to immobilize and kill the bacteria.
Image by National Cancer Institute
What Causes a Bladder Infection?
Most of the time a bladder infection is caused by bacteria that are normally found in your bowel. The bladder has several systems to prevent infection. For example, urination most often flushes out bacteria before it reaches the bladder. Sometimes your body can’t fight the bacteria and the bacteria cause an infection.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (4)
Urinary Tract Infection Causes
Video by Lee Health/YouTube
What is a bladder infection?
Bladder Infection
Image by BruceBlaus
Urine cultured on Oxoid Brilliance UTI Agar plate. 1uL of urine spread onto agar surface. Top sample is from patient with clinical urinary tract infection (UTI). Bottom sample is a mixed culture.
Urine cultured on Oxoid Brilliance UTI Agar plate. 1uL of urine spread onto agar surface. Top sample is from patient with clinical urinary tract infection (UTI). Bottom sample is a mixed culture.
Image by Nathan Reading from Halesowen, UK
Bacteriuria
Bacteriuria and pyuria demonstrated at urinary microscopy. Multiple rod-shaped bacteria shown between the larger white blood cells at urinary microscopy from a patient with urinary tract infection.
Image by Steven Fruitsmaak
1:43
Urinary Tract Infection Causes
Lee Health/YouTube
What is a bladder infection?
BruceBlaus
Urine cultured on Oxoid Brilliance UTI Agar plate. 1uL of urine spread onto agar surface. Top sample is from patient with clinical urinary tract infection (UTI). Bottom sample is a mixed culture.
Nathan Reading from Halesowen, UK
Bacteriuria
Steven Fruitsmaak
Diagnosis
X-ray of urinary bladder filled with contrast media.
Image by Lucien Monfils
X-ray of urinary bladder filled with contrast media.
Image by Lucien Monfils
Diagnosis of Bladder Infection (Urinary Tract Infection—UTI) in Adults
How do health care professionals diagnose a bladder infection?
Health care professionals use your medical history, a physical exam, and tests to diagnose a bladder infection.
A health care professional will ask if you have a history of health conditions that make you more likely to develop any type of UTI. During a physical exam, the health care professional will ask you about your symptoms.
Which tests do health care professionals use to diagnose a bladder infection?
Health care professionals typically test a sample of your urine to diagnose a bladder infection. In rare cases, a health care professional may also order another test to look at your urinary tract.
Lab tests
Urinalysis. You will collect a urine sample in a special container at a doctor’s office or at a lab. A health care professional will test the sample for bacteria and white blood cells, which the body produces to fight infection. Bacteria also can be found in the urine of healthy people, so a bladder infection is diagnosed based both on your symptoms and lab tests.
Urine culture. In some cases, a health care professional may culture your urine to find out what type of bacteria is causing the infection. Urine culture is not required in every case, but is important in certain circumstances, such as having repeated UTIs or certain medical conditions. The results of a urine culture take about 2 days to return and will help your health care professional determine the best treatment for you.
Imaging and other tests
If you have repeated bladder infections or have a complicated infection, a doctor may order imaging tests to look at your urinary tract. A complicated UTI is an infection linked to certain other conditions, such as a kidney stone, or a structural problem in your urinary tract.
Doctors may use cystoscopy to look inside the urethra and bladder. Doctors use a cystoscope, a tube-like instrument, during cystoscopy to look for swelling, redness, and other signs of infection in addition to structural problems that may be causing the infection.
Doctors may also use urodynamic testing, which is any procedure that shows how well your bladder, sphincters, and urethra are storing and releasing urine.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (9)
A UTI Making You Sick?
Video by Lee Health/YouTube
Cystoscopy-im-20050425
Images from a cystoscopy. The top two images show the interior of a bladder. The top left image shows the bladder wall, the top right shows the cystoscope passing into the bladder from the urethra. The bottom two images show an inflammed urethra. Cystoscopy carried out on Michael Reeve (29 year old male), at the North London Nuffield Hospital].
Image by Michael Reeve/Wikimedia
Cystoscopy
A diagram of the catheters used in cytometry
Image by The National Institute of Diabetes and Digestive and Kidney Diseases,
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Cystoscopy - Uretereal Cancer
This is an image of the ureteral cancer that I had. FOr scale, the cancer was about 35mm long.
Image by Old wombat/Wikimedia
Drawing of a cystoscope with labels pointing to two prisms, rod lens, telescope lenses, and a light pillar
Cytoscope
Image by NIDDK Image Library
Cystoscope
A cystoscope in an operating theatre, prior to a cystoscopy, in the North London Nuffield Hospital.
Image by Michael Reeve/Wikimedia
Drawing of inside of the urethra, as seen through a cystoscope. The sides of the urethra are pushed together, leaving little space for urine flow
Cystoscopic view of enlarged prostate from inside the urethra.
Image by NIDDK Image Library
How is a Urinary Tract Infection (UTI) Diagnosed?
Diagram showing a cystoscopy for a man and a woman.
Image by Cancer Research UK / Wikimedia Commons
Rigid cystoscope (left) and semirigid ureteroscope (right)
Drawing of two cystoscopes. The rigid cystoscope has a straight stem. The semirigid cystoscope is drawn with a u-shaped bend.
Image by NIDDK Image Library
1:36
A UTI Making You Sick?
Lee Health/YouTube
Cystoscopy-im-20050425
Michael Reeve/Wikimedia
Cystoscopy
The National Institute of Diabetes and Digestive and Kidney Diseases,
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Cystoscopy - Uretereal Cancer
Old wombat/Wikimedia
Drawing of a cystoscope with labels pointing to two prisms, rod lens, telescope lenses, and a light pillar
NIDDK Image Library
Cystoscope
Michael Reeve/Wikimedia
Drawing of inside of the urethra, as seen through a cystoscope. The sides of the urethra are pushed together, leaving little space for urine flow
NIDDK Image Library
How is a Urinary Tract Infection (UTI) Diagnosed?
Cancer Research UK / Wikimedia Commons
Rigid cystoscope (left) and semirigid ureteroscope (right)
NIDDK Image Library
Urinalysis Test
Urinalysis Test
Also called: Urine Test
A urine test is used to help diagnose a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. It evaluates many characteristics, macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye). It is a routine exam for your health check-up, before surgery, or when pregnant.
Urinalysis Test
Also called: Urine Test
A urine test is used to help diagnose a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. It evaluates many characteristics, macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye). It is a routine exam for your health check-up, before surgery, or when pregnant.
A urinalysis test consists in the evaluation of the macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye, can be seen through a microscope) characteristics of a urine sample to detect and measure various substances and compounds that the body filter through the kidneys.
Usually, these characteristics are done as a single panel and are not done separately as it had been before. This test can be used to make an overall health evaluation of the urinary tract, but it also helps diagnose and monitor many other conditions.
The structure of the test includes:
Macroscopic aspects:
Color
Appearance
Odor
Chemical examination:
pH
Density
Proteins
Glucose
Urobilinogen
Bilirubin
Leucocytes
Nitrites
Blood
Ketones
Microscopic aspects include:
Blood cells (white and red cells)
Epithelial cells
Bacteria
Crystals or casts
The most common uses of the urine test are:
Overall check up
To monitor pregnant women
If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
To monitor a medical condition, such as diabetes or kidney disease
Drug screening
You will need to give a clean catch urine sample.
This requires following these simple steps;
Clean your genitals
Start to urinate in the toilet
Stop halfway through
Collect about two ounces of midstream urine in the container
Stop again and close the container
Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
No preparation is required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
Macroscopic findings
Appearance (Clarity): normal urine is typically clear. If the urine seems to be cloudy or with floating particles, it may be indicative of urinary tract infection.
Color: most often shades of yellow. Unusual colors might be because of certain foods, medications or a specific condition.
Odor: normally it is relatively mild and not too noticeable.
Chemical examination
pH: this measures the acidity. Under normal conditions, the urine is acidic with pH levels that range from 4.5 to 8.0
Density (specific gravity): this measures how diluted or concentrated is your urine. Normal urine density is usually from 1.003 to 1.035.
Proteins: urine can have small amounts of proteins; however, finding high protein levels may indicate kidney disease or diabetes mellitus.
Glucose: no glucose should be found in the urine of a healthy individual.
Urobilinogen: normal results range from 0.1 to 1.0 mg/dL.
Bilirubin: no bilirubin should be found in the urine of a healthy individual. Positive findings may suggest liver disease.
Nitrite: no nitrites should be found in the urine of a healthy individual. When positive is highly indicative of urinary tract infection.
Ketones: normally is not found. However, it can be positive if you have been fasting for long periods of time, or if you have diabetes mellitus.
Microscopic aspects
Red blood cells (RBC’s): is not unusual to find RBCs in a urine sample; however, 3 or more red blood cells are regarded as a sign of hematuria (blood loss through urine).
White blood cells (WBC’s): under normal conditions, this parameter should be negative. A positive result is suggestive of urinary tract infection.
Epithelial cells: from 1 to 5 squamous/hpf is considered to be normal. Higher results may indicate contamination of the urine sample by improper collection methods.
Bacteria: it is normal to find up to 1+ bacteria; more than this is abnormal and should be analyzed to discern whether is caused by an infection or by improper sample storage.
Crystals or casts: no crystals or casts should be found in the urine of healthy individuals. When present, it may be indicative of kidney disease or kidney stones.
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, and the time elapsed between the urine collection and its evaluation in the laboratory.
Mayo Clinic: Urinalysis [accessed on Aug 19, 2018]
Urinalysis: A Comprehensive Review; Am Fam Physician. 2005 Mar 15;71(6):1153-1162. [accessed on Aug 19, 2018]
University of Utah: Urinalysis [accessed on Aug 19, 2018]
Additional Materials (22)
Urine Hydration chart
Image by Aishik Rehman/Wikimedia
Test Tube Containing Urine
Visualization of a test tube containing urine. Urine comprises mainly of water - 96% and the remaining 4% is urea and sodium.
Image by TheVisualMD
Urine in Vial
Urine is tested for a variety of reasons and can reveal a wealth of information about the source individual. More than 100 different tests can be done on urine. In addition to visual characteristics, for example color and clarity, urine may be examined for the presence of glucose, nitrites, or ketones. Microscopic examination may reveal the presence of red or white blood cells, or bacteria, yeast cells, or parasites. Urine samples may contain tumor markers, which can suggest cancer.
Image by TheVisualMD
White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)
White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)
Image by Bobjgalindo
Abundant uric acid crystals in a human urine sample
Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.
Image by Doruk Salancı
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.
Image by Doruk Salancı
Struvite crystals (urine)
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.
Image by Doruk Salancı
Uric acid crystals (urine)
Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.
Image by Doruk Salancı
Urine samples
Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Urine samples are evaluated visually, for color, clarity and concentration; chemically, for various substances, such as glucose and proteins, in solution; and microscopically, for signs of bacteria, crystals and other contaminants.
Image by TheVisualMD
Male Figure with Urinary System
Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.
Image by TheVisualMD
Urine collection container
Image by frolicsomepl/Pixabay
Cancer screening
Screening for Cancer: Urine Tests : Urine samples may contain tumor markers, which can suggest cancer. Urinalysis is commonly a part of routine health screening. It is simply an analysis of the urine that can be performed in many healthcare settings including doctors' offices, urgent care facilities, laboratories, and hospitals. Urinalysis can disclose evidence of diseases, even some that have not caused significant signs or symptoms.
Image by TheVisualMD
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Male Urinary System
Image of a male showing his urinary system. The urinary system, also known as the excretory system, produces, stores, and eliminates urine. It also helps to maintain the fluid balance in humans. The male urinary system consists of two kidneys, ureters, a urinary bladder, prostate, and urethra.
Image by TheVisualMD
Nephron of Kidney
The nephron is composed of looping and folding tubules that at first glance look like an impossibly tangled knot of highways, side roads and interchanges. But in fact, the nephron directs the traffic flow effortlessly. When stretched out, a nephron would be almost a couple of feet in length and there are about a million nephrons in each kidney. A nephron is composed of two basic parts: the glomerulus and the tubule. The glomerulus, part of the vascular system, is a tuft of capillaries that filters the wastes and fluid from the blood. The tubules then catch, concentrate and excrete the waste into the urine. The walls of the tubules are made of specialized cells, which serve as \"check points\" for the waste flowing by them. Hormonal sensors in these cells determine which substances should be excreted as waste and which substances will be reabsorbed into the blood to nourish the body's cells. The specific materials the cells are assigned to reabsorb or secrete include water and essential nutrients, salts and minerals, depending on where in the tubules the cells are located. From the glomerulus until the collecting duct, intricate and minute calculations are at constant play within the nephron. The production of urine does not just result in a waste product but also protects the fine balance of substances required to keep the body healthy.
Image by TheVisualMD
Fluid Filtration
Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of waste, which is then eliminated as urine. The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli. The kidneys also play a key role in maintaining the body's fluid balance within a very narrow range. Even a 1% increase in blood sodium, for example, will make a person thirsty enough to take a drink in order to return the fluid balance to normal.
Image by TheVisualMD
Ammonia, Urine
Ammonia is a waste product generated by intestinal bacteria during the digestion of protein. From the intestine, ammonia is transported to the liver, where it is converted into urea, which is then excreted in the urine by the kidneys. The conversion and elimination of ammonia can be impaired by liver disease or kidney damage, which can result in a dangerous build up of ammonia.
Image by TheVisualMD
Pyuria
Urine may contain pus (a condition known as pyuria) as seen from a person with sepsis due to a urinary tract infection.
Image by James Heilman, MD
Urine
Sample of human urine
Image by Markhamilton
Interpretation of the Urinalysis (Part 1) - Introduction and Inspection
Video by Strong Medicine/YouTube
Interpretation of the Urinalysis (Part 2) - The Dipstick
Video by Strong Medicine/YouTube
How to collect a mid-stream urine sample for a urinary tract infection test
Video by Pathology Tests Explained/YouTube
How to collect a first-void or first-pass urine sample
Video by Pathology Tests Explained/YouTube
Urine Hydration chart
Aishik Rehman/Wikimedia
Test Tube Containing Urine
TheVisualMD
Urine in Vial
TheVisualMD
White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)
Bobjgalindo
Abundant uric acid crystals in a human urine sample
Doruk Salancı
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample
Doruk Salancı
Struvite crystals (urine)
Doruk Salancı
Uric acid crystals (urine)
Doruk Salancı
Urine samples
TheVisualMD
Male Figure with Urinary System
TheVisualMD
Urine collection container
frolicsomepl/Pixabay
Cancer screening
TheVisualMD
Sensitive content
This media may include sensitive content
Male Urinary System
TheVisualMD
Nephron of Kidney
TheVisualMD
Fluid Filtration
TheVisualMD
Ammonia, Urine
TheVisualMD
Pyuria
James Heilman, MD
Urine
Markhamilton
6:10
Interpretation of the Urinalysis (Part 1) - Introduction and Inspection
Strong Medicine/YouTube
16:36
Interpretation of the Urinalysis (Part 2) - The Dipstick
Strong Medicine/YouTube
1:03
How to collect a mid-stream urine sample for a urinary tract infection test
Pathology Tests Explained/YouTube
1:06
How to collect a first-void or first-pass urine sample
A glucose in urine test measures the amount of glucose (sugar) in your urine. The test is used to monitor both type 1 and type 2 diabetes.
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Use the slider below to see how your results affect your
health.
mg/dL
15
Your result is Negative.
Glucose is not usually found in urine. If it is, further testing is needed.
Related conditions
A glucose in urine test measures the amount of glucose in your urine. Glucose is a type of sugar. It is your body's main source of energy. A hormone called insulin helps move glucose from your bloodstream into your cells. If too much glucose gets into the blood, the extra glucose will be eliminated through your urine. A urine glucose test can be used to help determine if blood glucose levels are too high, which may be a sign of diabetes.
A glucose in urine test may be part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. Urinalysis is often included as part of a routine exam. A glucose in urine test may also be used to screen for diabetes. However, a urine glucose test is not as accurate as a blood glucose test. It may be ordered if blood glucose testing is difficult or not possible. Some people can't get blood drawn because their veins are too small or too scarred from repeated punctures. Other people avoid blood tests due to extreme anxiety or fear of needles.
You may get a glucose in urine test as part of your regular checkup or if you have symptoms of diabetes and cannot take a blood glucose test. Symptoms of diabetes include:
Increased thirst
More frequent urination
Blurred vision
Fatigue
You may also need a urinalysis, which includes a glucose in urine test, if you are pregnant. If high levels of glucose in urine are found, it may indicate gestational diabetes. Gestational diabetes is form of diabetes that happens only during pregnancy. Blood glucose testing can be used to confirm a diagnosis of gestational diabetes. Most pregnant women are tested for gestational diabetes with a blood glucose test, between their 24th and 28th weeks of pregnancy.
If your urine glucose test is part of a urinalysis, you will need to provide a sample of your urine. During your office visit, you will receive a container in which to collect the urine and special instructions to ensure the sample is sterile. These instructions are often referred to as the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
Your health care provider may ask you to monitor your urine glucose at home with a test kit. He or she will provide you with either a kit or a recommendation of which kit to buy. Your urine glucose test kit will include instructions on how to perform the test and a package of strips for testing. Be sure to follow the kit instructions carefully, and talk to your health care provider if you have any questions.
You don't need any special preparations for this test.
There is no known risk to having a glucose in urine test.
Glucose is not normally found in urine. If results show glucose, it may be a sign of:
Diabetes
Pregnancy. As many half of all pregnant women have some glucose in their urine during pregnancy. Too much glucose may indicate gestational diabetes.
A kidney disorder
A urine glucose test is only a screening test. If glucose is found in your urine, your provider will order a blood glucose test to help make a diagnosis.
https://medlineplus.gov/lab-tests/glucose-in-urine-test/ [accessed on Sep 15, 2019]
https://medlineplus.gov/ency/article/003581.htm [accessed on Sep 15, 2019]
https://www.labcorp.com/test-menu/26061/glucose-quantitative-urine [accessed on Sep 15, 2019]
https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=glucose_urine [accessed on Sep 15, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (6)
Abdomen Revealing Pancreas and Kidney
Sugar is one of the nutrients your body uses for energy. It is the product of the body's breakdown of complex carbohydrates and is circulated in the blood to all your cells. Although blood sugar levels change depending on whether you just ate or exercised, in general, your body keeps the sugar levels within a narrow range. Not enough sugar - hypoglycemia - and you can get hungry, shaky, sweaty, tired, and even faint. Too much sugar - hyperglycemia - is a cardiovascular risk factor leading to arteriosclerosis (hardening of the arteries). To control blood sugar levels, your body depends on a hormone called insulin.
Image by TheVisualMD
Diabetes Symptoms
(left to right) Fatigue: dehydration, lack of ability to utilize glucose for energy and other factors cause fatigue; weight loss: because it can't use glucose for energy, the body breaks down muscle instead; constant hunger: diabetes prevents glucose from entering cells, leading to constant hunger due to cell starvation; increased thirst: too much urination leaves tissues dehydrated and causes increased thirst; frequent urination: fluids are drawn from tissues and the kidneys constantly filter out glucose, leading to frequent urination.
Image by TheVisualMD
Male Figure with Urinary System
Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.
Image by TheVisualMD
Kidney Glomeruli, Compromised Filtration
Our kidneys are remarkable filters. Each day, they filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Proteins are also normally filtered out of the blood and recycled in the body by the kidneys. When kidneys are diseased or damaged, however, their ability to filter out proteins is compromised, which allows protein to then leak into urine.
Image by TheVisualMD
Diseased and Aging Kidney Tissue Comparisons
As a person ages, the number of nephrons, the kidneys' vital filters, decreases, as does the overall amount of tissue in the kidneys. A healthy aging kidney will not function like a 20-year-old kidney, but it can still do its job. The difference between an aging kidney in a healthy body and a kidney damaged by hypertension or diabetes can be as stark as the difference between someone who is a picture of health and someone who is debilitated by illness.
Image by TheVisualMD
Glomerulonephritis
Our kidneys filter about 200 quarts of blood each day to extract about 2 quarts of waste, which is then eliminated as urine. The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli. Glomerulonephritis is the inflammation of these tiny filters and can be caused by diabetes and chronic high blood pressure or, in acute cases, infection. When kidney function declines, waste products normally filtered out and excreted into the urine begin instead to accumulate in the blood.
Image by TheVisualMD
Abdomen Revealing Pancreas and Kidney
TheVisualMD
Diabetes Symptoms
TheVisualMD
Male Figure with Urinary System
TheVisualMD
Kidney Glomeruli, Compromised Filtration
TheVisualMD
Diseased and Aging Kidney Tissue Comparisons
TheVisualMD
Glomerulonephritis
TheVisualMD
Bilirubin in Urine Test
Bilirubin in Urine Test
Also called: Total Urine Bilirubin, Bilirubin
Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. When the liver is damaged, bilirubin can leak into your urine. A bilirubin in urine test can help detect liver disease.
Bilirubin in Urine Test
Also called: Total Urine Bilirubin, Bilirubin
Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. When the liver is damaged, bilirubin can leak into your urine. A bilirubin in urine test can help detect liver disease.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Bilirubin is not normally found in the urine.
Related conditions
A bilirubin in urine test measures the levels of bilirubin in your urine. Bilirubin is a yellowish substance made during the body's normal process of breaking down red blood cells. Bilirubin is found in bile, a fluid in your liver that helps you digest food. If your liver is healthy, it will remove most of the bilirubin from your body. If your liver is damaged, bilirubin can leak into the blood and urine. Bilirubin in urine may be a sign of liver disease.
A bilirubin in urine test is often part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. Urinalysis is often included as part of a routine exam. This test may also be used to check for liver problems.
Your health care provider may have ordered a bilirubin in urine test as part of your regular checkup, or if you have symptoms of liver disease. These symptoms include:
Jaundice, a condition that causes your skin and eyes to turn yellow
Dark-colored urine
Abdominal pain
Nausea and vomiting
Fatigue
Because bilirubin in urine can indicate liver damage before other symptoms appear, your health care provider may order a bilirubin in urine test if you are at a higher risk for liver damage. Risk factors for liver disease include:
Family history of liver disease
Heavy drinking
Exposure or possible exposure to hepatitis virus
Obesity
Diabetes
Taking certain medicines that can cause liver damage
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container to your health care provider.
You don't need any special preparations to test for bilirubin in urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having a urinalysis or a bilirubin in urine test.
If bilirubin is found in your urine, it may indicate:
A liver disease such as hepatitis
A blockage in the structures that carry bile from your liver
A problem with liver function
A bilirubin in urine test is only one measure of liver function. If your results are abnormal, your health care provider may order additional blood and urine tests, including a liver panel. A liver panel is a series of blood tests that measure various enzymes, proteins, and substances in the liver. It is often used to detect liver disease.
Bilirubin in Urine: MedlinePlus Lab Test Information [accessed on Aug 22, 2021]
https://medlineplus.gov/ency/article/003595.htm [accessed on Aug 22, 2021]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Ketones in Urine Test
Ketones in Urine Test
Also called: Urine Ketones, Ketone Bodies (Urine), Ketones Urine Test
Ketones in urine may indicate a problem with the body's ability to burn energy. Diabetics are at a higher risk for developing urine ketones. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.
Ketones in Urine Test
Also called: Urine Ketones, Ketone Bodies (Urine), Ketones Urine Test
Ketones in urine may indicate a problem with the body's ability to burn energy. Diabetics are at a higher risk for developing urine ketones. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.
{"label":"Ketones in Urine Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"N","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":20},"text":"A negative test result is normal.","conditions":[]},{"flag":"borderline","label":{"short":"S","long":"Small","orientation":"horizontal"},"values":{"min":20,"max":40},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]},{"flag":"abnormal","label":{"short":"M","long":"Moderate","orientation":"horizontal"},"values":{"min":40,"max":60},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]},{"flag":"abnormal","label":{"short":"L","long":"Large","orientation":"horizontal"},"values":{"min":60,"max":80},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]}],"value":10}[{"normal":0},{"borderline":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
A negative test result is normal.
Related conditions
The test measures ketone levels in your urine. Normally, your body burns glucose (sugar) for energy. If your cells don't get enough glucose, your body burns fat for energy instead. This produces a substance called ketones, which can show up in your blood and urine. High ketone levels in urine may indicate diabetic ketoacidosis (DKA), a complication of diabetes that can lead to a coma or even death. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.
The test is often used to help monitor people at a higher risk of developing ketones. These include people with type 1 or type 2 diabetes. If you have diabetes, ketones in urine can mean that you are not getting enough insulin. If you don't have diabetes, you may still be at risk for developing ketones if you:
Experience chronic vomiting and/or diarrhea
Have a digestive disorder
Participate in strenuous exercise
Are on a very low-carbohydrate diet
Have an eating disorder
Are pregnant
Your health care provider may order a ketones in urine test if you have diabetes or other risk factors for developing ketones. You may also need this test if you have symptoms of ketoacidosis. These include:
Nausea or vomiting
Abdominal pain
Confusion
Trouble breathing
Feeling extremely sleepy
People with type 1 diabetes are at a higher risk for ketoacidosis.
A ketones in urine test can be done in the home as well as in a lab. If in a lab, you will be given instructions to provide a "clean catch" sample. The clean catch method generally includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
If you do the test at home, follow the instructions that are in your test kit. Your kit will include a package of strips for testing. You will either be instructed to provide a clean catch sample in a container as described above or to put the test strip directly in the stream of your urine. Talk to your health care provider about specific instructions.
You may have to fast (not eat or drink) for a certain period of time before taking a ketones in urine test. Ask your health care provider if you need to fast or do any other type of preparation before your test.
There is no known risk to having a ketones in urine test.
Your test results may be a specific number or listed as a "small," "moderate," or "large" amount of ketones. Normal results can vary, depending on your on your diet, activity level, and other factors. Because high ketone levels can be dangerous, be sure to talk to your health care provider about what is normal for you and what your results mean.
Ketone test kits are available at most pharmacies without a prescription. If you are planning to test for ketones at home, ask your health care provider for recommendations on which kit would be best for you. At-home urine tests are easy to perform and can provide accurate results as long as you carefully follow all instructions.
Ketones in Urine: MedlinePlus Lab Test Information [accessed on Sep 15, 2019]
https://medlineplus.gov/ency/article/003585.htm [accessed on Sep 15, 2019]
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=ketone_bodies_urine [accessed on Sep 15, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
DKA - Diabetic Ketoacidosis
Video by DrER.tv/YouTube
Symptoms of Ketoacidosis
Video by Diabetes.co.uk/YouTube
Diabetes & Associated Complications
Video by Boehringer Ingelheim/YouTube
Acute complications of diabetes - Diabetic ketoacidosis | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
A medical illustration depicting a ketone urine test
A medical illustration depicting a ketone urine test
Image by BruceBlaus
5:46
DKA - Diabetic Ketoacidosis
DrER.tv/YouTube
1:00
Symptoms of Ketoacidosis
Diabetes.co.uk/YouTube
5:50
Diabetes & Associated Complications
Boehringer Ingelheim/YouTube
11:26
Acute complications of diabetes - Diabetic ketoacidosis | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
A medical illustration depicting a ketone urine test
BruceBlaus
Urine Specific Gravity Test
Urine Specific Gravity Test
Also called: Urine SG, Specific Gravity of Urine, Urine Density
A urine specific gravity test measures the concentration of solutes in your urine, which shows if your kidneys are properly diluting urine. This test is a partial analysis used in case of suspected kidney disorder.
Urine Specific Gravity Test
Also called: Urine SG, Specific Gravity of Urine, Urine Density
A urine specific gravity test measures the concentration of solutes in your urine, which shows if your kidneys are properly diluting urine. This test is a partial analysis used in case of suspected kidney disorder.
{"label":"Urine Specific Gravity Reference Range","scale":"lin","step":0.01,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0.8,"max":1.002},"text":"Your urine is too diluted.","conditions":["Diabetes","Kidney disorders","Glomerulonephritis","Pyelonephritis","Kidney failure","Overhydration"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":1.002,"max":1.03},"text":"Normal results can slightly vary from laboratory to laboratory.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":1.03,"max":1.2},"text":"Your urine is too concentrated. ","conditions":["Liver disease","Adrenal glands disorder","Heart disease","Dehydration","Shock"]}],"value":1.02}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
1.002
1.03
Your result is Normal.
Normal results can slightly vary from laboratory to laboratory.
Related conditions
In the kidneys, most of the water, ions, and nutrients are returned to the body while waste products and excess ions are excreted through the urine.
Normally, the color of urine is straw-yellow but it may be affected by several situations, including infections, intake of certain foods or medications, or insufficient or excessive fluid intake. Your urine color may reflect how concentrated or diluted is your urine.
A urine specific gravity (SG) test is used to compare the density of your urine to the normal density of water. The result gives an overview of the concentration of the solutes (particles) in your urine. In other words, it shows how well your kidneys are diluting urine.
A shift in the urine SG test result may give the first indication that your kidneys are not working properly. However, if a kidney disorder is suspected, further tests should be taken to confirm or exclude certain disease.
A urine specific gravity test is mainly used as a partial analysis to assess the kidney’s ability to concentrate and dilute urine. Thus, it can be used to help detect certain disorders or diseases of the urinary tract.
Your doctor may order a urine specific gravity test as part of your routine health checkup, or to help diagnose or monitor the following conditions:
Urinary tract infection
Dehydration or overhydration
Kidney infection (pyelonephritis)
Kidney failure
Shifts in sodium levels (hypernatremia or hyponatremia)
Diabetes
Shock
Heart failure
Testing for urine specific gravity starts with mid-stream urine sample collection. It is recommended that the sample is collected in the morning when the urine concentration is the highest.
To collect the urine sample, you need to clean your genitals and then discard the first stream of urine into the toilet (this is done to “clean” your urethra), proceeding then to collect about two ounces of midstream urine in the container. You need to be careful not to touch your genitals with the container to avoid possible contamination with external germs. Once you have collected enough urine, put the container cap on and then you can finish emptying your bladder into the toilet.
After the collection, the sample is transported to the laboratory.
Your doctor may ask you to stop taking certain medications and foods before the test.
There are no risks related to a urine gravity test.
The normal value for urine specific gravity is 1.002-1.030.
Lower-than-normal values of urine gravity may indicate:
Higher-than-normal urine gravity test results may refer to an increased level of some substances in your urine, such as proteins, bacteria, glucose, urine crystals, red and white blood cells. These findings may occur in cases of:
Liver disease
Adrenal glands disorder
Heart disease
Dehydration (not consuming enough water, or losing too much fluid through sweating, vomiting, or diarrhea)
Shock
Certain foods may affect the color of your urine; therefore, it's advised not to eat foods such as beet, rhubarb, blackberries, carrots or lava beans before giving a urine sample.
Sometimes doctors may choose a urine osmolality test instead of a urine specific gravity test. The urine osmolarity test is more specific and could help your doctor to diagnose certain disorders more accurately.
https://medlineplus.gov/ency/article/003587.htm [accessed on Oct 09, 2021]
Urine Specific Gravity Test: Overview, Tests, and Procedure [accessed on Oct 29, 2018]
Urine specific gravity test: Procedure and results [accessed on Oct 29, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (20)
Hematuria
Hematuria Trauma : Gross hematuria due to kidney trauma.
Image by James Heilman, MD
Hematuria by anatomic location
Source of Hematuria by anatomic location
Image by Copene
Phenazopyridine
Pyridiumurine : The characteristic color of urine after taking pyridium.
Image by James Heilman, MD
Drawing of a kidney with an inset of a nephron
The glomeruli are sets of looping blood vessels in nephrons--the tiny working units of the kidneys that filter wastes and remove extra fluid from the blood.
Image by NIDDK Image Library
Urine samples
Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Urine samples are evaluated visually, for color, clarity and concentration; chemically, for various substances, such as glucose and proteins, in solution; and microscopically, for signs of bacteria, crystals and other contaminants.
Image by TheVisualMD
Urine in Vial
Urine is tested for a variety of reasons and can reveal a wealth of information about the source individual. More than 100 different tests can be done on urine. In addition to visual characteristics, for example color and clarity, urine may be examined for the presence of glucose, nitrites, or ketones. Microscopic examination may reveal the presence of red or white blood cells, or bacteria, yeast cells, or parasites. Urine samples may contain tumor markers, which can suggest cancer.
Image by TheVisualMD
Ureteropelvic junction obstruction
Drawing of a swollen kidney that results from ureteropelvic junction obstruction. The point of blockage is labeled UPJ obstruction. UPJ obstruction occurs when urine is blocked where the ureter joins the kidney.
Image by NIDDK Image Library
Bilirubin, Jaundice Urine
When damaged or dying red blood cells are broken down, bilirubin, a yellow pigment and component of hemoglobin, is released into the bloodstream. Bilirubin is usually eliminated from the body by the liver as a component of bile, which is released into the small intestine to aid digestion. Under normal circumstances, very little, if any, bilirubin is excreted in the urine, but in cases of liver damage or a blockage of the bile ducts, some bilirubin can leak out and appear in the urine, turning it a darker color.
Image by TheVisualMD
Urine Color Chart
Urine Color Chart - Hydration
Image by OpenStax College
Healthy vs Damaged Kidney
A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.
Urine Test for Albumin
If you are at risk for kidney disease, your provider may check your urine for albumin.
Albumin is a protein found in your blood. A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. The less albumin in your urine, the better. Having albumin in the urine is called albuminuria.
A diagram showing a healthy kidney with albumin only found in blood, and a damaged kidney that has albumin in both blood and urine.
A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.
A health care provider can check for albumin in your urine in two ways:
Dipstick test for albumin. A provider uses a urine sample to look for albumin in your urine. You collect the urine sample in a container in a health care provider’s office or lab. For the test, a provider places a strip of chemically treated paper, called a dipstick, into the urine. The dipstick changes color if albumin is present in the urine.
Urine albumin-to-creatinine ratio (UACR). This test measures and compares the amount of albumin with the amount of creatinine in your urine sample. Providers use your UACR to estimate how much albumin would pass into your urine over 24 hours. A urine albumin result of
30 mg/g or less is normal
more than 30 mg/g may be a sign of kidney disease
If you have albumin in your urine, your provider may want you to repeat the urine test one or two more times to confirm the results. Talk with your provider about what your specific numbers mean for you.
If you have kidney disease, measuring the albumin in your urine helps your provider know which treatment is best for you. A urine albumin level that stays the same or goes down may mean that treatments are working.
Image by The National Institute of Diabetes and Digestive and Kidney Diseases/NIH
Drawing of a urine sample and dipstick
A strip of chemically treated paper will change color when dipped in urine with too much protein.
Image by NIDDK Image Library
Struvite crystals (urine)
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.
Image by Doruk Salancı
Uric acid crystals (urine)
Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.
Image by Doruk Salancı
Male Figure with Urinary System
Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.
Image by TheVisualMD
Adequate water intake and kidney health
Adequate water intake and kidney health. Replacing the water lost through sweating and waste elimination is vital to our health. Remaining hydrated is one way to help prevent kidney stones, which can form when certain waste minerals are highly concentrated in the urine. In this 3-D visualization, a clear bottle pours water into a model of a human kidney.
Image by TheVisualMD
Urine
Sample of human urine
Image by Markhamilton
Urine Culture: Preventing UTIs
There are a number of ways you can help to prevent UTIs. Drinking plenty of liquids, especially water, not only aids your kidneys in filtering out wastes, it also dilutes your urine and makes you urinate more frequently. This flushes out bacteria and other pathogens from your urinary tract and helps to prevent infections. Urinating after having sex also helps to flush out bacteria. Women should wipe from front to back when using the toilet and change tampons and pads frequently during their periods.
Image by TheVisualMD
formation of urine
Anatomy and physiology of animals Summary of the processes involved in the formation of urine.
Image by Sunshineconnelly
male's urinary system
Urinary system in the male. Urine flows from the kidneys via the ureters into the bladder where it is stored. When urinating, urine flows through the urethra (longer in males, shorter in females) to exit the body
Image by BruceBlaus
Urine of patient with porphyria
Change in urine color before and after sun exposure Left figure is urine of the first day. Right figure is urine after sun exposure for 3 days. Urine color changed to “port wine” color after sun exposure. This color change is due to increased concentrations of porphyrin intermediates in the urine, indicating an abnormality in production and a partial block within the enzymatic porphyrin chain with metabolite formation. The urine color usually becomes darker with acute illness, even dark reddish or brown after sun exposure.
Image by Chen GL, Yang DH, Wu JY, Kuo CW, Hsu WH
Hematuria
James Heilman, MD
Hematuria by anatomic location
Copene
Phenazopyridine
James Heilman, MD
Drawing of a kidney with an inset of a nephron
NIDDK Image Library
Urine samples
TheVisualMD
Urine in Vial
TheVisualMD
Ureteropelvic junction obstruction
NIDDK Image Library
Bilirubin, Jaundice Urine
TheVisualMD
Urine Color Chart
OpenStax College
Healthy vs Damaged Kidney
The National Institute of Diabetes and Digestive and Kidney Diseases/NIH
Drawing of a urine sample and dipstick
NIDDK Image Library
Struvite crystals (urine)
Doruk Salancı
Uric acid crystals (urine)
Doruk Salancı
Male Figure with Urinary System
TheVisualMD
Adequate water intake and kidney health
TheVisualMD
Urine
Markhamilton
Urine Culture: Preventing UTIs
TheVisualMD
formation of urine
Sunshineconnelly
male's urinary system
BruceBlaus
Urine of patient with porphyria
Chen GL, Yang DH, Wu JY, Kuo CW, Hsu WH
Blood in Urine Test
Blood in Urine Test
Also called: Hematuria, Bloody urine
A blood in urine test is part of a urinalysis, a test that measures different cells, chemicals, and other substances in urine. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection,
Blood in Urine Test
Also called: Hematuria, Bloody urine
A blood in urine test is part of a urinalysis, a test that measures different cells, chemicals, and other substances in urine. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection,
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Related conditions
A test called a urinalysis can detect whether there is blood in your urine. A urinalysis checks a sample of your urine for different cells, chemicals, and other substances, including blood. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection, or liver disease.
A urinalysis, which includes a test for blood in urine, may be done as part of a regular checkup or to check for disorders of the urinary tract, kidney, or liver.
Your health care provider may have ordered a urinalysis as part of a routine exam. You may also need this test if you have seen blood in your urine or have other symptoms of a urinary disorder. These symptoms include:
Painful urination
Frequent urination
Back pain
Abdominal pain
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." It includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the needed amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
You don't need any special preparations before getting a test for blood in your urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having a urinalysis or a blood in urine test.
There are a variety of factors that can cause red or white blood cells to be present in the urine. Many are not cause for concern. Small amounts of blood in the urine may be due to certain medicines, intense exercise, sexual activity, or menstruation. If larger amounts of blood are found, your health care provider may request further testing.
Increased red blood cells in urine may indicate:
A viral infection
Inflammation of the kidney or bladder
A blood disorder
Bladder or kidney cancer
Increased white blood cells in urine may indicate:
A bacterial urinary tract infection. This is the most common cause of a high white blood cell count in urine.
Inflammation of the urinary tract or kidneys
To learn what your results mean, talk to your health care provider.
A blood in urine test is usually part of a typical urinalysis. In addition to checking for blood, a urinalysis measures other substances in the urine, including proteins, acid and sugar levels, cell fragments, and crystals.
Lab Tests Online: Blood in Urine (Hematuria) [accessed on Aug 19, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (12)
Urine Color Chart
Urine Color Chart - Hydration
Image by OpenStax College
Hematuria (Blood in the Urine)
Video by mdconversation/YouTube
Blood in the Urine: What does it mean?
Video by Frederick Memorial Hospital/YouTube
Blood in the Urine
Video by St. Mark's Hospital/YouTube
Hematuria
Microscopic hematuria
Image by Bobjgalindo
Hematuria
Hematuria Trauma : Gross hematuria due to kidney trauma.
Image by James Heilman, MD
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Image by Bobjgalindo
Hematuria by anatomic location
Source of Hematuria by anatomic location
Image by Copene
Microphotography - sample of urine with hematuria
Microphotography - sample of urine with hematuria
Image by J3D3
This browser does not support the video element.
Bleeding Tissue
Blood continues to flow into tissue after the piercing needle has left the finger. Camera starts off looking at the cut edges of bleeding capillaries in the tissue and then looks down at the cavity where blood is beginning to pool.
Video by TheVisualMD
Microhematuria
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Image by Bobjgalindo
Phenazopyridine
Pyridiumurine : The characteristic color of urine after taking pyridium.
Image by James Heilman, MD
Urine Color Chart
OpenStax College
12:53
Hematuria (Blood in the Urine)
mdconversation/YouTube
0:50
Blood in the Urine: What does it mean?
Frederick Memorial Hospital/YouTube
2:24
Blood in the Urine
St. Mark's Hospital/YouTube
Hematuria
Bobjgalindo
Hematuria
James Heilman, MD
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Bobjgalindo
Hematuria by anatomic location
Copene
Microphotography - sample of urine with hematuria
J3D3
0:08
Bleeding Tissue
TheVisualMD
Microhematuria
Bobjgalindo
Phenazopyridine
James Heilman, MD
PH of Urine Test
PH of Urine Test
Also called: Acid Loading Test, Urine pH, Alkaline Urine Test, Acidic Urine Test
A urine pH test is used to detect a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. Any pH higher than 8 is basic or alkaline, and any under 6 is acidic. A urine pH test is carried out as a part of a urinalysis.
PH of Urine Test
Also called: Acid Loading Test, Urine pH, Alkaline Urine Test, Acidic Urine Test
A urine pH test is used to detect a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. Any pH higher than 8 is basic or alkaline, and any under 6 is acidic. A urine pH test is carried out as a part of a urinalysis.
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Use the slider below to see how your results affect your
health.
pH
4.5
8
Your result is Normal.
A normal urine pH range is between 4.5 and 8.0.
Related conditions
A urine pH test is the analysis of the acidity/alkalinity of the urine. It is part of the chemical examination in a urinalysis. This test can be used to make an overall health evaluation of the urinary tract, but it also helps diagnose and monitor many other conditions.
Some of the most common uses of the urine pH test are:
Evaluate the risk of developing kidney stones (nephrolithiasis)
Assessment of metabolic acidosis
Monitor treatment of uric acid kidney stones
Help identify crystals in the urine
You will need to provide a urine sample.
No preparations are required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
Under normal conditions, the urine is acidic with pH levels that range from 4.5 to 8.0
A high urine pH (alkaline urine) can be found in people who eat large quantities of citrus fruit and vegetables. Other causes include:
Kidney failure
Urinary tract infection
Kidney stones made up from calcium carbonate, calcium phosphate, and struvite (magnesium ammonium phosphate)
Respiratory alkalosis
Metabolic alkalosis
A low urine pH (acid urine) can be found in people who eat large quantities of meat. Other causes include:
Metabolic acidosis
Respiratory acidosis
Kidney stones made up from xanthine, cystine, and uric acid
Diabetes
Diarrhea
Starvation
Fanconi syndrome
Milkman syndrome
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, and the time elapsed between the urine collection and its evaluation in the laboratory.
013037: pH, Urine | LabCorp [accessed on Jan 04, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Protein in Urine Test
Protein in Urine Test
Also called: Urine Protein
A protein in urine test measures how much protein is in your urine. A large amount of protein can indicate a problem with your kidneys.
Protein in Urine Test
Also called: Urine Protein
A protein in urine test measures how much protein is in your urine. A large amount of protein can indicate a problem with your kidneys.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Normal results vary based on the laboratory and the method used.
Related conditions
A protein in urine test measures how much protein is in your urine. Proteins are substances that are essential for your body to function properly. Protein is normally found in the blood. If there is a problem with your kidneys, protein can leak into your urine. While a small amount is normal, a large amount of protein in urine may indicate kidney disease.
A protein in urine test is often part of a urinalysis, a test that measures different cells, chemicals, and substances in your urine. Urinalysis is often included as part of a routine exam. This test may also be used to look for or to monitor kidney disease.
Your health care provider may have ordered a protein test as part of your regular checkup, or if you have symptoms of kidney disease. These symptoms include:
Difficulty urinating
Frequent urination, especially at night
Nausea and vomiting
Loss of appetite
Swelling in the hands and feet
Fatigue
Itching
A protein in urine test can be done in the home as well as in a lab. If in a lab, you will receive instructions to provide a "clean catch" sample. The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
If at home, you will use a test kit. The kit will include a package of strips for testing and instructions on how to provide a clean catch sample. Talk to your health care provider if you have any questions.
Your health care provider may also request you collect all your urine during a 24-hour period. This "24-hour urine sample test" is used because the amounts of substances in urine, including protein, can vary throughout the day. Collecting several samples in a day may provide a more accurate picture of your urine content.
You don't need any special preparations to test for protein in urine. If your health care provider has ordered a 24-hour urine sample, you will get specific instructions on how to provide and store your samples.
There is no known risk to having a urinalysis or a urine in protein test.
If a large amount of protein is found in your urine sample, it doesn't necessarily mean that you have a medical problem needing treatment. Strenuous exercise, diet, stress, pregnancy, and other factors can cause a temporary rise in urine protein levels. Your health care provider may recommend additional urinalysis tests if a high level of protein is found. This testing may include a 24-hour urine sample test.
If your urine protein levels are consistently high, it may indicate kidney damage or other medical condition. These include:
Urinary tract infection
Lupus
High blood pressure
Preeclampsia, a serious complication of pregnancy, marked by high blood pressure. If it is not treated, preeclampsia can be life-threatening to the mother and baby.
Diabetes
Certain types of cancer
To learn what your results mean, talk to your health care provider.
If you will be doing your urine test at home, ask your health care provider for recommendations on which test kit would be best for you. At-home urine tests are easy to do and provide accurate results as long as you carefully follow all instructions.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (2)
Urine Color Chart
Urine Color Chart - Hydration
Image by OpenStax College
When kidneys are diseased or damaged, their ability to filter out proteins is compromised, which allows protein to then leak into urine.
Urine Total Protein Test for Diseased Glomerulus : The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli, which remove waste products from the blood while preventing the loss of other components, including proteins, which are recycled in the body. When kidneys are diseased or damaged, however, their ability to filter out proteins is compromised, which allows protein to then leak into urine.
Image by TheVisualMD
Urine Color Chart
OpenStax College
When kidneys are diseased or damaged, their ability to filter out proteins is compromised, which allows protein to then leak into urine.
TheVisualMD
Urobilinogen Test
Urobilinogen Test
Also called: Urinary Urobilinogen
A urobilinogen in urine test looks for liver disease or damage. It may be included in a routine exam or if a liver problem is suspected.
Urobilinogen Test
Also called: Urinary Urobilinogen
A urobilinogen in urine test looks for liver disease or damage. It may be included in a routine exam or if a liver problem is suspected.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
A urobilinogen in urine test measures the amount of urobilinogen in a urine sample. Urobilinogen is formed from the reduction of bilirubin. Bilirubin is a yellowish substance found in your liver that helps break down red blood cells. Normal urine contains some urobilinogen. If there is little or no urobilinogen in urine, it can mean your liver isn't working correctly. Too much urobilinogen in urine can indicate a liver disease such as hepatitis or cirrhosis.
A urobilinogen test may part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. A urinalysis is often part of a routine exam.
Your health care provider may have ordered this test as part of your regular checkup, to monitor an existing liver condition, or if you have symptoms of a liver disease. These include:
Jaundice, a condition that causes your skin and eyes to turn yellow
Nausea and/or vomiting
Dark colored urine
Pain and swelling in the abdomen
Itchy skin
Your health care provider will need to collect a sample of your urine. He or she will provide you with special instructions to ensure the sample is sterile. These instructions are often called as the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
You don't need any special preparations. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having this test.
If your test results show too little or no urobilinogen in your urine, it may indicate:
A blockage in the structures that carry bile from your liver
A blockage in the blood flow of the liver
A problem with liver function
If your test results show a higher-than-normal level of urobilinogen, it may indicate:
Hepatitis
Cirrhosis
Liver damage due to drugs
Hemolytic anemia, a condition in which red blood cells are destroyed before they can be replaced. This leaves the body without enough healthy red blood cells
If your results are abnormal, it does not necessarily indicate you have a medical condition requiring treatment. Be sure to tell your health care provider about any medicines and supplements you are taking, as these can affect your results. If you are a woman, you should tell your health care provider if you are menstruating.
This test is only one measure of liver function. If your health care provider thinks you might have a liver disease, additional urine and blood tests may be ordered.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (4)
Bilirubin Metabolism
Video by Armando Hasudungan/YouTube
Urinalysis
Kidneys and Related Conditions : The value of routine urinalysis is that abnormal levels of substances such as protein or glucose, for example, will often appear in the urine before patients are aware they may have a problem. It is also used to detect disorders of the urinary tract, most commonly infections. Abnormal urine screens are typically followed up by more specific diagnostic tests.
Image by TheVisualMD
Alkaline Phosphatase, Liver
The liver is the body's central chemical plant, filtering blood and removing toxins, storing sugars, lipids, and vitamins, and producing important blood proteins. Liver function is typically evaluated by a panel of tests, including one for alkaline phosphatase (ALP), an enzyme made in liver cells, that help doctors distinguish among the many different possible causes of liver damage. Many types of liver damage, including hepatitis, cirrhosis, liver cancer or drug toxicity, can elevate ALP levels.
Image by TheVisualMD
Liver and Gallbladder with Associated Vessel
The liver is the body's central chemical plant, filtering blood and removing toxins, storing sugars, lipids, and vitamins, and producing important blood proteins such as albumin as well as those involved in blood clotting. The liver also produces most of body's cholesterol (the rest comes from food) as well as a quart of bile each day, a greenish-brown, alkaline fluid that aids digestion. The gallbladder stores bile for release into the small intestine; bile contains cholesterol, bile salts, and bilirubin, a yellowish pigment produced by the breakdown of red blood cells.
Image by TheVisualMD
8:44
Bilirubin Metabolism
Armando Hasudungan/YouTube
Urinalysis
TheVisualMD
Alkaline Phosphatase, Liver
TheVisualMD
Liver and Gallbladder with Associated Vessel
TheVisualMD
Nitrites in Urine Test
Nitrites in Urine Test
Also called: Urine Nitrite
A nitrites in urine test is part of a urinalysis, a test that measures different substances in urine. If nitrites are present, it may indicate an infection.
Nitrites in Urine Test
Also called: Urine Nitrite
A nitrites in urine test is part of a urinalysis, a test that measures different substances in urine. If nitrites are present, it may indicate an infection.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Even if no nitrites are found, you still may have an infection, because bacteria don't always change nitrates into nitrites.
Related conditions
A urinalysis, also called a urine test, can detect the presence of nitrites in the urine. Normal urine contains chemicals called nitrates. If bacteria enter the urinary tract, nitrates can turn into different, similarly named chemicals called nitrites. Nitrites in urine may be a sign of a urinary tract infection (UTI).
UTIs are one of the most common types of infections, especially in women. Fortunately, most UTIs are not serious and are usually treated with antibiotics. It's important to see your health care provider if you have symptoms of a UTI so you can start treatment right away.
Other names: urine test, urine analysis, microscopic urine analysis, microscopic examination of urine, UA
A urinalysis, which includes a test for nitrites in urine, may be part of a regular exam. It may also be used to check for a UTI.
Your health care provider may have ordered a urinalysis as part of a routine checkup or if you have symptoms of a UTI. Symptoms of a UTI may include:
Frequent urge to urinate, but little urine comes out
Painful urination
Dark, cloudy, or reddish colored urine
Bad smelling urine
Weakness and fatigue, particularly in older women and men
Fever
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider
You don't need any special preparations to test for nitrites in urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having a urinalysis or a nitrites in urine test.
If there are nitrites in your urine, it may mean that you have a UTI. However, even if no nitrites are found, you still may have an infection, because bacteria don't always change nitrates into nitrites. If you have symptoms of a UTI, your health care provider will also look at other results of your urinalysis, especially the white blood cell count. A high white blood cell count in urine is another possible sign of an infection. To learn what your results mean, talk to your health care provider.
If a urinalysis is part of your regular checkup, your urine will be tested for a variety of substances along with nitrites. These include red and white blood cells, proteins, acid and sugar levels, cell fragments, and crystals in your urine.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (2)
Urine Color Chart
Urine Color Chart - Hydration
Image by OpenStax College
Lower urinary tract infection (cystitis) - an Osmosis preview
Video by Osmosis/YouTube
Urine Color Chart
OpenStax College
0:45
Lower urinary tract infection (cystitis) - an Osmosis preview
Osmosis/YouTube
Red Blood Cells in Urine Test
Red Blood Cells in Urine Test
Also called: RBC urine
Red blood cells (RBCs), also known as erythrocytes, may also be found in a urinalysis, or a urine test. High levels of RBCs in your urine indicates that you have hematuria.
Red Blood Cells in Urine Test
Also called: RBC urine
Red blood cells (RBCs), also known as erythrocytes, may also be found in a urinalysis, or a urine test. High levels of RBCs in your urine indicates that you have hematuria.
{"label":"Red Blood Cells in Urine Reference Range","scale":"lin","step":0.1,"hideunits":false,"units":[{"printSymbol":"{cells}\/uL","code":"{cells}\/uL","name":"cells per microliter"}],"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":5},"text":"This indicates that only small traces of blood was found in your urine. It is considered normal and does not require further investigation.","conditions":[]},{"flag":"abnormal","label":{"short":"One cross (+)","long":"One cross (+)","orientation":"horizontal"},"values":{"min":5,"max":25},"text":"This indicates that small but significant traces of blood was found in your urine. Repeat test may be necessary and should be looked at in clinical setting.","conditions":["Persistent microscopic haematuria","Glomerular disorders","Glomerulonephritis","Systemic lupus erythematosus","Renal disorders","Polycystic kidney disease","Benign prostatic hyperplasia","Cancer","Cystitis","Pyelonephritis","Nephrolithiasis","Prostatitis","Intake or certain drugs","Trauma"]},{"flag":"abnormal","label":{"short":"Two crosses (++)","long":"Two crosses (++)","orientation":"horizontal"},"values":{"min":25,"max":100},"text":"This indicates that significant traces of blood was found in your urine. Further testing is necessary.","conditions":["Glomerular disorders","Glomerulonephritis","Systemic lupus erythematosus","Renal disorders","Polycystic kidney disease","Benign prostatic hyperplasia","Cancer","Cystitis","Pyelonephritis","Nephrolithiasis","Prostatitis","Intake or certain drugs","Trauma"]}],"value":2.5}[{"normal":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your
health.
{cells}/uL
5
25
Your result is Normal.
This indicates that only small traces of blood was found in your urine. It is considered normal and does not require further investigation.
Related conditions
Red blood cells (RBCs), also known as erythrocytes, are cells that can be found circulating in the blood. They are produced in the bone marrow (the spongy tissue inside some of your bones), and their function is to carry a protein called hemoglobin through the body, which in turn delivers oxygen to the tissues and organs.
This test is part of the microscopic characteristics evaluated in a urinalysis, or urine test. This means that RBCs are invisible to the naked eye, and can only be seen through a microscope.
This test is not usually ordered alone but rather as part of a urinalysis. It can be helpful in the following cases:
Overall check up
To monitor pregnant women
If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
To monitor a medical condition, such as diabetes or kidney disease
You will need to give a clean catch urine sample.
This requires following these simple steps;
Clean your genitals
Start to urinate in the toilet
Stop halfway through
Collect about two ounces of midstream urine in the container
Stop again and close the container
Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
No preparation is required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
Is not unusual to find RBCs in a urine sample; however, 3 or more red blood cells per high-powered field are regarded as a sign of hematuria (blood loss through urine).; further information should be gathered to make a diagnose.
Presence of RBC’s in urine may be due to:
Glomerular disorders
Glomerulonephritis
Systemic lupus erythematosus
Renal disorders
Polycystic kidney disease
Benign prostatic hyperplasia
Cancer
Cystitis
Pyelonephritis
Nephrolithiasis
Prostatitis
Intake or certain drugs
Trauma
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, menstruation traces, and the time elapsed between the urine collection and its evaluation in the laboratory.
Urinalysis: Reference Range, Interpretation, Collection and Panels [accessed on Jan 10, 2019]
Urinalysis [accessed on Jan 10, 2019]
Urinalysis: A Comprehensive Review - - American Family Physician [accessed on Jan 10, 2019]
https://www.cambridgeshireandpeterboroughccg.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=7479 [accessed on Jan 10, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Hematuria
Hematuria Trauma : Gross hematuria due to kidney trauma.
Image by James Heilman, MD
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Image by Bobjgalindo
Hematuria by anatomic location
Source of Hematuria by anatomic location
Image by Copene
Microhematuria
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Image by Bobjgalindo
Phenazopyridine
Pyridiumurine : The characteristic color of urine after taking pyridium.
Image by James Heilman, MD
Hematuria
James Heilman, MD
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Bobjgalindo
Hematuria by anatomic location
Copene
Microhematuria
Bobjgalindo
Phenazopyridine
James Heilman, MD
White Blood Cells, Urine Test
White Blood Cells, Urine Test
Also called: Leukocytes in Urine
White blood cells (WBCs), also known as leukocytes, may also be found in a urinalysis, or a urine test. High levels of WBCs in your urine suggest that you have a urinary tract infection (UTI).
White Blood Cells, Urine Test
Also called: Leukocytes in Urine
White blood cells (WBCs), also known as leukocytes, may also be found in a urinalysis, or a urine test. High levels of WBCs in your urine suggest that you have a urinary tract infection (UTI).
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Use the slider below to see how your results affect your
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{cells}/uL
10
100
Your result is Normal.
Normal reference ranges can slightly vary depending on the laboratory and the method used for testing.
Related conditions
White blood cells (WBCs), also known as leukocytes, are part of the immune system. These cells protect your body against viruses, bacteria, parasites, fungus, and any other strange organism or substance that may want to enter into your system.
This test is part of the microscopic characteristics evaluated in a urinalysis, or urine test. This means that WBCs are invisible to the naked eye, and can only be seen through a microscope.
This test is not ordered alone but rather as part of a urinalysis. It can be helpful in the following cases:
Overall check up
To monitor pregnant women
If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
You will need to give a clean catch urine sample.
This requires following these simple steps;
Clean your genitals
Start to urinate in the toilet
Stop halfway through
Collect about two ounces of midstream urine in the container
Stop again and close the container
Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
No preparation is required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
The normal range for WBCs in urine is:
<10 WBC/µl: not significant
10-100 WBC/µl: usually not significant but still requires further clinical assessment
>100 WBC/µl: suggestive of infection
It is also considered normal to have less than 5 WBCs/hpf. A high number of WBCs may indicate a urinary tract infection or inflammation, especially if bacteria is also present.
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, and the time elapsed between the urine collection and its evaluation in the laboratory.
Urinalysis: Reference Range, Interpretation, Collection and Panels [accessed on Jan 10, 2019]
Urinalysis [accessed on Jan 10, 2019]
Urinalysis: A Comprehensive Review - - American Family Physician [accessed on Jan 10, 2019]
https://www.cambridgeshireandpeterboroughccg.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=7479 [accessed on Jan 10, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (1)
Pyuria
Pyuria : White blood cells seen under a microscope from a urine sample.
Image by Bobjgalindo
Pyuria
Bobjgalindo
Epithelial Cells in Urine Test
Epithelial Cells in Urine Test
The test measures the amount of epithelial cells in urine. A large amount may indicate an infection, kidney disease, or other serious medical condition. This test is part of a urinalysis, a test that measures different substances in your urine.
Epithelial Cells in Urine Test
The test measures the amount of epithelial cells in urine. A large amount may indicate an infection, kidney disease, or other serious medical condition. This test is part of a urinalysis, a test that measures different substances in your urine.
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Use the slider below to see how your results affect your
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Your result is Few.
"Few" cells are generally considered in the normal range.
Related conditions
Epithelial cells are a type of cell that lines the surfaces of your body. They are found on your skin, blood vessels, urinary tract, and organs. An epithelial cells in urine test looks at urine under a microscope to see if the number of your epithelial cells is in the normal range. It's normal to have a small amount of epithelial cells in your urine. A large amount may indicate an infection, kidney disease, or other serious medical condition.
An epithelial cells in urine test is a part of a urinalysis, a test that measures different substances in your urine. A urinalysis may include a visual examination of your urine sample, tests for certain chemicals, and an examination of urine cells under a microscope. An epithelial cells in urine test is part of a microscopic exam of urine.
Your health care provider may have ordered an epithelial cells in urine test as part of your regular checkup or if your visual or chemical urine tests showed abnormal results. You may also need this test if you have symptoms of a urinary or kidney disorder. These symptoms may include:
Frequent and/or painful urination
Abdominal pain
Back pain
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container. The container will have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
You don't need any special preparations for the test. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having the test.
Results are often reported as an approximate amount, such as "few," moderate," or "many" cells. "Few" cells are generally considered in the normal range. "Moderate" or "many" cells may indicate a medical condition such as:
Urinary tract infection
Yeast infection
Kidney disease
Liver disease
Certain types of cancer
If your results are not in the normal range, it doesn't necessarily mean that you have a medical condition that requires treatment. You may need more tests before you can get a diagnosis. To learn what your results mean, talk to your health care provider.
There are three types of epithelial cells that line the urinary tract. They are called transitional cells, renal tubular cells, and squamous cells. If there are squamous epithelial cells in your urine, it may mean your sample was contaminated. This means that the sample contains cells from the urethra (in men) or the vaginal opening (in women). It can happen if you do not clean well enough when using the clean catch method.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Uric acid crystals (urine)
Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.
Image by Doruk Salancı
Struvite crystals (urine)
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.
Image by Doruk Salancı
Urine Test
Image by frolicsomepl/Pixabay
Urine
Sample of human urine
Image by Markhamilton
Cancer screening
Screening for Cancer: Urine Tests : Urine samples may contain tumor markers, which can suggest cancer. Urinalysis is commonly a part of routine health screening. It is simply an analysis of the urine that can be performed in many healthcare settings including doctors' offices, urgent care facilities, laboratories, and hospitals. Urinalysis can disclose evidence of diseases, even some that have not caused significant signs or symptoms.
Image by TheVisualMD
Uric acid crystals (urine)
Doruk Salancı
Struvite crystals (urine)
Doruk Salancı
Urine Test
frolicsomepl/Pixabay
Urine
Markhamilton
Cancer screening
TheVisualMD
Urinary Casts Test
Urinary Casts Test
Also called: Urine Casts
Urinary casts are tiny structures that can be seen in a urine test (urinalysis) when certain kidney diseases or conditions are present.
Urinary Casts Test
Also called: Urine Casts
Urinary casts are tiny structures that can be seen in a urine test (urinalysis) when certain kidney diseases or conditions are present.
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Your result is Negative.
Related conditions
Urinary casts are tiny cylindrical, tube-shaped structures that are produced by the kidneys and may be found in a urinalysis test when certain diseases or conditions are present.
This test usually forms part of a urine test (urinalysis), which can be ordered as part of a normal routine check-up, or when kidney diseases are suspected.
You will be asked to provide a urine sample by urinating into a sterile urine container.
To adequately do this, you need to clean your genitals, and then discard the first stream of urine into the toilet (this is done to “clean” your urethra), proceeding then to collect about two ounces of midstream urine in the container.
No fasting or other preparations are necessary for this test. Follow the instructions provided by your healthcare professional.
There are no known risks associated with this test.
Hyaline casts: the presence of a few of these casts is usually normal and can occur in physiologic states (e.g., after exercise).
Fatty casts: these casts can be found in people who have lipids (fat) in the urine and are usually related to a kidney disease complication, such as nephrotic syndrome, glomerulonephritis, or other forms of chronic renal diseases.
Granular casts: these casts might be found after exercise, but also when certain kidney diseases are present.
Red blood cell casts: these casts are related to a very small amount of bleeding from the kidney. Red blood cell casts are seen in many kidney diseases.
Epithelial cell casts: the apparition of these casts implies damage to cells in the kidneys. These casts are seen in conditions such as heavy metal poisoning, and kidney transplant rejection, among others.
Waxy casts: these casts can be found in people with long-term (chronic) kidney disease and chronic kidney failure.
White blood cell (WBC) casts: these casts can be found when acute kidney infections are present.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Urine Culture
Urine Culture
Also called: Urine Culture and Sensitivity
A urine culture is a test that is used to diagnose a urinary tract infection and identify the specific kind of bacteria that is causing the disease. This test does not detect the presence of viruses or parasites.
Urine Culture
Also called: Urine Culture and Sensitivity
A urine culture is a test that is used to diagnose a urinary tract infection and identify the specific kind of bacteria that is causing the disease. This test does not detect the presence of viruses or parasites.
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Use the slider below to see how your results affect your
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CFU/mL
1000
Your result is Negative.
A negative result will read something like “no growth seen in 24 or 48 hours”.
Related conditions
A urine culture is a test where a sample of your urine is added to a substance that promotes germ growth.
This is useful to determine whether you have a urinary tract infection (UTI), and if that’s the case, detect and identify the specific microorganism that is causing said infection.
This test also helps minimize the use of unnecessary antibiotic treatment, therefore reducing the chance of bacterial resistance to antibiotics (which happens when a bacteria is no longer killed by an antibiotic that has been previously used).
Your doctor may want to order this test if you have signs and symptoms of a UTI, such as:
Back pain
Abdominal pain
A burning sensation when you urinate
An increase of voiding frequency
Blood in the urine
You will be asked to provide a urine sample by voiding into a sterile urine container.
To adequately do this, you need to clean your genitals, and then discard the first stream of urine into the toilet (this is done to “clean” your urethra), proceeding then to collect about two ounces of midstream urine in the container.
If you are unable to provide a clean urine sample, a catheter (a thin rubber tube) may be inserted through your urethra and into your bladder to collect a urine sample. In rare cases, if a catheter cannot be used, a needle can be inserted into your abdomen to aspirate a urine sample directly from your bladder.
No test preparation is needed. Your doctor may advise you to refrain from starting any antibiotic treatment before the sample is collected.
There are no known risks associated with this test when using the “clean catch” technique. If the urine sample is collected through a catheter or by needle aspiration, you may feel mild pain during the procedure.
In rare cases, your urethra or bladder can be perforated when using a catheter; or you can get an infection in the puncture site from a needle aspiration procedure.
The urine culture test result will come back as positive or negative.
A negative result will read something like “no growth seen in 24 or 48 hours”.
A positive result will report the name and number of the bacteria that is the causal agent of the infection. Usually, the presence of more than 100,000 colony forming units (CFU)/mL of a microorganism is indicative of UTI.
However, in the presence of symptoms, or when the urine sample was collected through catheterization or needle aspiration, lower numbers (1,000 up to 100,000 CFU/mL) may indicate UTI.
If there are more than 2 types of microorganisms above 10,000 CFU/mL identified, then it’s probable that the urine specimen was contaminated, either by improper sample collection or handling.
Once a urine culture test has come back positive, automatically the laboratory will also run a susceptibility test, which is done to determine the specific antibiotics that can be used to inhibit the growth of the harmful bacteria causing the infection. This way your doctor can start you on the appropriate therapy as soon as possible.
You should avoid taking non-prescribed antibiotics to treat yourself. If you do so, you risk having your urine culture test result to come back negative even if the bacteria is still present, therefore making it more difficult for your doctor to prescribe you with the correct treatment.
https://medlineplus.gov/ency/article/003751.htm [accessed on Mar 14, 2019]
https://medlineplus.gov/ency/article/003752.htm [accessed on Mar 14, 2019]
https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/8105 [accessed on Mar 14, 2019]
https://labtestsonline.org/tests/urine-culture [accessed on Mar 14, 2019]
https://www.labcorp.com/test-menu/36361/urine-culture-comprehensive [accessed on Mar 14, 2019]
https://www.labcorp.com/test-menu/36371/urine-culture-routine [accessed on Mar 14, 2019]
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=urine_culture [accessed on Mar 14, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Male Figure with Urinary System
Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.
Image by TheVisualMD
Urine Culture: Urinary Tract Infections (UTIs)
The kidneys filter wastes from the blood and eliminate them in the urine. Two tubes called ureters connect the kidneys to the bladder, which holds urine until it is excreted. It was long thought that urine is sterile up to the point when it reaches the urethra, but recently researchers found that bacteria can be present in the bladders of some healthy women. Most UTIs, however, are thought to be caused by bacteria that enter the urethra through its opening near the vagina. According to the American Urological Association, urinary tract infections result in more than 7 million visits to doctors; offices each year (about 5% of all visits to primary care physicians).
Image by TheVisualMD
Urine Culture: Preventing UTIs
There are a number of ways you can help to prevent UTIs. Drinking plenty of liquids, especially water, not only aids your kidneys in filtering out wastes, it also dilutes your urine and makes you urinate more frequently. This flushes out bacteria and other pathogens from your urinary tract and helps to prevent infections. Urinating after having sex also helps to flush out bacteria. Women should wipe from front to back when using the toilet and change tampons and pads frequently during their periods.
Image by TheVisualMD
Urine Culture: UTIs During Pregnancy
Pregnant women are more vulnerable to getting UTIs because of all the many changes, physical and hormonal, that occur during pregnancy. The kidneys enlarge, and the ureters (the tubes that lead from the kidneys to the bladder) and the bladder are compressed by the growing uterus, often preventing the bladder from emptying fully. The urine itself becomes less acidic and contains more sugars, proteins, and hormones. To help prevent UTIs, pregnant women should drink plenty of fluids, avoid taking baths, wipe from front to back, and wear loose, comfortable clothing and cotton underwear. It's important to treat UTIs to prevent serious complications for both mother and fetus. Fortunately, there are antibiotics that are safe to take during pregnancy, such as fosfomycin and ceftibuten.
Image by TheVisualMD
Urine cultured on Oxoid Brilliance UTI Agar plate. 1uL of urine spread onto agar surface. Top sample is from patient with clinical urinary tract infection (UTI). Bottom sample is a mixed culture.
Urine cultured on Oxoid Brilliance UTI Agar plate. 1uL of urine spread onto agar surface. Top sample is from patient with clinical urinary tract infection (UTI). Bottom sample is a mixed culture.
Image by Nathan Reading from Halesowen, UK
Male Figure with Urinary System
TheVisualMD
Urine Culture: Urinary Tract Infections (UTIs)
TheVisualMD
Urine Culture: Preventing UTIs
TheVisualMD
Urine Culture: UTIs During Pregnancy
TheVisualMD
Urine cultured on Oxoid Brilliance UTI Agar plate. 1uL of urine spread onto agar surface. Top sample is from patient with clinical urinary tract infection (UTI). Bottom sample is a mixed culture.
Nathan Reading from Halesowen, UK
Cystoscopy
Cystoscopy
Also called: Bladder Endoscopy
A cystoscopy is a procedure to look inside the urethra and bladder using a thin camera called a cystoscope. The test can help find problems with the urinary tract, including early signs of cancer, infection, narrowing, blockage, or bleeding.
Cystoscopy
Also called: Bladder Endoscopy
A cystoscopy is a procedure to look inside the urethra and bladder using a thin camera called a cystoscope. The test can help find problems with the urinary tract, including early signs of cancer, infection, narrowing, blockage, or bleeding.
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Use the slider below to see how your results affect your
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Your result is Normal.
The bladder wall should look smooth. The bladder should be of normal size, shape, and position. There should be no blockages, growths, or stones.
Related conditions
Cystoscopy uses a cystoscope to look inside the urethra and bladder. A cystoscope is a long, thin optical instrument with an eyepiece at one end, a rigid or flexible tube in the middle, and a tiny lens and light at the other end of the tube. By looking through the cystoscope, the urologist can see detailed images of the lining of the urethra and bladder. The urethra and bladder are part of the urinary tract.
A urologist performs a cystoscopy to find the cause of urinary tract problems such as
Frequent urinary tract infections (UTIs)
Hematuria—blood in the urine
Urinary frequency—urination eight or more times a day
Urinary urgency—the inability to delay urination
Urinary retention—the inability to empty the bladder completely
Urinary incontinence—the accidental loss of urine
Pain or burning before, during, or after urination
Trouble starting urination, completing urination, or both
Abnormal cells, such as cancer cells, found in a urine sample
During a cystoscopy, a urologist can see
Stones—solid pieces of material in the bladder that may have formed in the kidneys or in the bladder when substances that are normally in the urine become highly concentrated.
Abnormal tissue, polyps, tumors, or cancer in the urethra or bladder.
Stricture, a narrowing of the urethra. Stricture can be a sign of an enlarged prostate in men or of scar tissue in the urethra.
In many cases, a patient does not need special preparations for a cystoscopy. A health care provider may ask the patient to drink plenty of liquids before the procedure, as well as urinate immediately before the procedure.
A urologist performs a cystoscopy or ureteroscopy during an office visit or in an outpatient center or a hospital. For some patients, the urologist will apply an anesthetic gel around the urethral opening or inject a local anesthetic into the urethra.
After the anesthetic has taken effect, the urologist gently inserts the tip of the cystoscope into the urethra and slowly glides it through the urethra and into the bladder. A sterile liquid—water or salt water, called saline—flows through the cystoscope to slowly fill the bladder and stretch it so the urologist has a better view of the bladder wall. As the bladder fills with liquid, the patient may feel some discomfort and the urge to urinate. The urologist may remove some of the liquid from the bladder during the procedure. As soon as the procedure is over, the urologist may remove the liquid from the bladder or the patient may empty the bladder.
When a urologist performs a cystoscopy to make a diagnosis, both procedures—including preparation—take 15 to 30 minutes. The time may be longer if the urologist removes a stone in the bladder or a ureter or if he or she performs a biopsy.
After a cystoscopy or ureteroscopy, a patient may
Have a mild burning feeling when urinating
See small amounts of blood in the urine
Have mild discomfort in the bladder area or kidney area when urinating
Need to urinate more frequently or urgently
These problems should not last more than 24 hours. The patient should tell a health care provider right away if bleeding or pain is severe or if problems last more than a day.
The health care provider may recommend that the patient
Drink 16 ounces of water each hour for 2 hours after the procedure
Take a warm bath to relieve the burning feeling
Hold a warm, damp washcloth over the urethral opening to relieve discomfort
Take an over-the-counter pain reliever
The health care provider may prescribe an antibiotic to take for 1 or 2 days to prevent an infection. A patient should report any signs of infection—including severe pain, chills, or fever—right away to the health care provider.
Most patients go home the same day as the procedure. Recovery depends on the type of anesthesia. A patient who receives only a local anesthetic can go home immediately. A patient who receives general anesthesia may have to wait 1 to 4 hours before going home. A health care provider usually asks the patient to urinate before leaving. In some cases, the patient may need to stay overnight in the hospital. A health care provider will provide discharge instructions for rest, driving, and physical activities after the procedure.
The risks of cystoscopy and ureteroscopy include
UTIs
Abnormal bleeding
Abdominal pain
A burning feeling or pain during urination
Injury to the urethra, bladder, or ureters
Urethral narrowing due to scar tissue formation
The inability to urinate due to swelling of surrounding tissues
Complications from anesthesia
Seek immediate medical care
A patient who has any of the following symptoms after a cystoscopy or ureteroscopy should call or see a health care provider right away:
The inability to urinate and the feeling of a full bladder
Burning or painful urination that lasts more than 2 days
Bright red urine or blood clots in the urine
A fever, with or without chills
Severe discomfort
Cystoscopy & Ureteroscopy | NIDDK [accessed on Jan 08, 2019]
Cystoscopy: MedlinePlus Medical Encyclopedia [accessed on Jan 08, 2019]
Cystoscopy for Women - Health Encyclopedia - University of Rochester Medical Center [accessed on Jan 08, 2019]
Cystoscopy - NHS [accessed on Jan 08, 2019]
What is Cystoscopy? - Urology Care Foundation [accessed on Jan 08, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (7)
How is a Urinary Tract Infection (UTI) Diagnosed?
Diagram showing a cystoscopy for a man and a woman.
Image by Cancer Research UK / Wikimedia Commons
X-ray of urinary bladder filled with contrast media.
Image by Lucien Monfils
Drawing of cystoscope in the bladder
None
Image by NIDDK Image Library
Cystoscopy Female Surgery PreOp® Patient Education
Video by PreOp.com Patient Engagement - Patient Education/YouTube
Hydrate and complete the cleansing of the kidneys and bladder
Image by TheVisualMD
Treatment for Bladder Infection (Urinary Tract Infection—UTI) in Adults
How do health care professionals treat a bladder infection?
If you have a bladder infection caused by bacteria, a health care professional is likely to prescribe antibiotics. If the diagnosis is not certain, based on your symptoms or lab test results, you may not need antibiotics. Instead, your health care professional will work to find the cause and the best treatment for your symptoms.
Medicines
Which antibiotic you take is based on the type of bacteria causing your infection and any allergies you may have to antibiotics.
The length of treatment depends on
how severe the infection is
whether your symptoms and infection go away
whether you have repeated infections
whether you have problems with your urinary tract
Men may need to take antibiotics longer because bacteria can move into the prostate gland, which surrounds the urethra. Bacteria can hide deep inside prostate tissue.
Follow your health care professional’s instructions carefully and completely when taking antibiotics. Although you may feel relief from your symptoms, make sure to take the entire antibiotic treatment.
If needed, a health care professional may prescribe other medicines to relieve any pain or discomfort from your bladder infection.
At-home treatments
Drink a lot of liquids and urinate often to speed healing. Water is best. Talk with a health care professional if you can’t drink a lot of liquids due to other health problems, such as urinary incontinence, urinary frequency, or heart or kidney failure.
A heating pad on your back or abdomen may help you manage pain from a kidney or bladder infection.
Research
Researchers are studying ways to treat or prevent bladder infections without taking antibiotics. The bacteria that cause these infections can become stronger and harder to fight when a person takes antibiotics repeatedly. Alternate approaches include probiotics, vaginal estrogen, and "watchful waiting." Talk to your health care professional about any treatment for a bladder infection before you start it, including home remedies and supplements. Some supplements can have side effects or react poorly with other medications you take.
Drink lots of liquids and urinate often to speed healing. Water is best.
How can I prevent a bladder infection?
Changing some of your daily habits and lifestyle choices may help you prevent repeated bladder infections.
Drink enough liquids
Most people should try drinking six to eight, 8-ounce glasses of liquid a day. Talk with a health care professional if you can’t drink this amount due to other health problems, such as urinary incontinence, urinary frequency, or heart or kidney failure.
Be aware of your bathroom habits
Take enough time to fully empty your bladder when urinating—don’t rush it. Urinate after sex to flush away bacteria that may have entered the urethra during sex. Clean the genital area before and after sex.
If you’re a woman, wipe from front to back, especially after a bowel movement, to keep bacteria from getting into the urethra.
Wear loose-fitting clothing
Consider wearing cotton underwear and loose-fitting clothes so air can keep the area around the urethra dry.
Consider switching birth control methods if you have repeat bladder infections
If you have trouble with repeat bladder infections, talk with a health care professional about your birth control. Consider switching to a new form of birth control if you use diaphragms, unlubricated condoms, or spermicide, all of which can increase your chances of developing a bladder infection. Consider using lubricated condoms without spermicide or using a nonspermicidal lubricant.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (12)
Waste Removal
Water plays many important roles in the body. It aids in the excretion of waste in urine and feces. Our bodies utilize water to preventive and therapeutic effect similarly to how we use water in daily activities. Just as we wash dirt from our skin (or our cars, for that matter), surfaces inside the body are cleansed and lubricated as their cells are bathed in water. Tears, for instance, clear dirt from the eyes. Due to its ability to cool and warm the body, the water in your bloodstream is sometimes likened to the antifreeze that circulates in a car engine. The simile is appropriate, too, except that your body is far smarter than an automobile. Not only does it have the ability to cool the body on a need basis; it can even adjust to different temperatures at specific sites. Water is a key ingredient in nutrient metabolism, which is the process of converting food into energy. And water helps transport nutrients from the foods we eat throughout our bodies.
Image by TheVisualMD
Amoxicillin
Amoxicillin - Antibiotics
Image by Brett Hondow
Bladder infection - Causes and treatment
Video by Healthchanneltv / cherishyourhealthtv/YouTube
Staphylococcus aureus Antibiotics Test plate
Staphylococcus aureus - Antibiotics Test plate
Image by CDC / Provider: Don Stalons
Bottle of Doxycycline
Capsules of the antibiotic doxycycline spill from a medication bottle. Oral antibiotics, such as doxycycline or amoxicillin, are often prescribed after exposure to tickborne Lyme disease.
Image by NIAID
Blood Vials Representing Hydrated and Dehydrated Blood Volumes
This image features two test tubes filled with centrifuged blood samples. The sample of the left represents healthy blood volume in a hydrated person; the sample on the right represents low blood volume from a dehydrated person. Because water is a major component of blood, lack of water decreases overall blood volume. It also destabilizes the body's balance between water and salt. The measurement of blood currently within the circulatory system is referred to as intravascular volume. The status of your intravascular volume is constantly in flux. The two basic components of blood, in nearly even proportions, are red blood cells and plasma. Plasma is primarily made up of water, so plasma volume fluctuates depending on your state of hydration and the water forever being exchanged between the bloodstream and tissues. In a healthy adult, blood plasma volume can swing by as much as 10% or 20%. Thirst is triggered when plasma volume drops by 8% - 10%.
Image by TheVisualMD
Your Body of Water
Image by TheVisualMD
Woman Drinking Water with Visible Skeletal, Digestive, Muscular and Cardiovascular Systems
This image features a woman holding a plastic water bottle after exercising outdoors. Her skeletal, digestive, muscular, and cardiovascular systems are revealed. Water helps your body eliminate waste through sweat, urine, and defecation. Some of water's other leading responsibilities in the body include: protection, cushioning, and lubrication of your tissues, organs, and joints; thermoregulation, such as sweat cooling the body; nutrient breakdown, such as when water helps dissolve nutrients in food so they can be used by the body; and nutrient transport when blood (of which water is a key component) carries nutrients and oxygen throughout the body.
Image by TheVisualMD
Woman Swimming with Visible Skeletal, Respiratory and Cardiovascular Systems
This image features a woman swimming and splashing in a lake. Her cardiovascular, respiratory, and skeletal systems are revealed. Everywhere in the world, water is the basis of life. Water has the unique trait of being both innocuous and critical at nearly every site in the body. Extremely adaptable and required for every function, water is biology's ultimate multitasker. It even changes state when perspiration evaporates off the skin surface; and, in the act of being discharged through the skin, urine, or bowels, creates the ongoing demand for its own replenishment.
Image by TheVisualMD
Man Playing Tennis with Background
Regular physical activity helps to maintain fitness levels, which directly reduce the risk of disease and death. Even individuals with preexisting heart conditions are frequently prescribed mild exercise regimens by their healthcare professional in order to keep their health from deteriorating further. If you are overweight or have a medical condition, speak to your healthcare professional about how best to begin an exercise program. If you have not been physically active, it is a good idea to start slowly with moderate physical activity like walking, and gradually build up to the American Heart Association and the USDA recommended 30 minutes of physical activity a day. A half hour of more vigorous activities 3 to 5 times a week - such as jogging, swimming, or team sports - can have additional health benefits in strengthening and building muscles and bone mass. Physical activity can also help relieve day-to-day stress and tension.
Image by TheVisualMD
Your Body of Water
Two atoms of hydrogen attached to one atom of oxygen; a chemical triad as familiar as air. Yet, the properties water possesses in the physical world, which are as fantastic as they are simple, are central to how the element functions within our bodies. Like the shapes that waves and ripples take on the ocean surface, the forms and functions of water in the body are innumerable. The characteristics of water evident to a physicist or chemist provide some understanding of how water keeps us alive. Water plays important roles as a solvent, with thermoregulation, and in the transport of nutrients.
Image by TheVisualMD
Water at Work
Water plays many important roles in the body. It aids in the excretion of waste in urine and feces. Our bodies utilize water to preventive and therapeutic effect similarly to how we use water in daily activities. Just as we wash dirt from our skin (or our cars, for that matter), surfaces inside the body are cleansed and lubricated as their cells are bathed in water. Tears, for instance, clear dirt from the eyes. Due to its ability to cool and warm the body, the water in your bloodstream is sometimes likened to the antifreeze that circulates in a car engine. The simile is appropriate, too, except that your body is far smarter than an automobile. Not only does it have the ability to cool the body on a need basis; it can even adjust to different temperatures at specific sites. Water is a key ingredient in nutrient metabolism, which is the process of converting food into energy. And water helps transport nutrients from the foods we eat throughout our bodies.
Image by TheVisualMD
Waste Removal
TheVisualMD
Amoxicillin
Brett Hondow
2:47
Bladder infection - Causes and treatment
Healthchanneltv / cherishyourhealthtv/YouTube
Staphylococcus aureus Antibiotics Test plate
CDC / Provider: Don Stalons
Bottle of Doxycycline
NIAID
Blood Vials Representing Hydrated and Dehydrated Blood Volumes
TheVisualMD
Your Body of Water
TheVisualMD
Woman Drinking Water with Visible Skeletal, Digestive, Muscular and Cardiovascular Systems
TheVisualMD
Woman Swimming with Visible Skeletal, Respiratory and Cardiovascular Systems
TheVisualMD
Man Playing Tennis with Background
TheVisualMD
Your Body of Water
TheVisualMD
Water at Work
TheVisualMD
Eating, Diet, and Nutrition
Hydration
Image by 5598375
Hydration
Hydration to stave off disease and optimize wellness.
Image by 5598375
Eating, Diet, & Nutrition for Bladder Infection (Urinary Tract Infection—UTI) in Adults
Can my eating, diet, and nutrition help prevent bladder infections?
Experts don’t think eating, diet, and nutrition play a role in preventing or treating bladder infections. Although some research shows that cranberry juice, extract, or pills may help prevent these infections, not enough evidence shows this. Research shows that cranberry products are not effective in treating a bladder infection if you already have one.
Can drinking liquid help prevent or relieve bladder infections?
Yes. Drink six to eight, 8-ounce glasses of liquid a day. Talk with a health care professional if you can’t drink this amount due to other health problems, such as urinary incontinence, urinary frequency, or kidney failure. The amount of liquid you need to drink depends on the weather and your activity level. If you live, work, or exercise in hot weather, you may need more liquid to replace the fluid you lose through sweat.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (5)
Water at Work
Water plays many important roles in the body. It aids in the excretion of waste in urine and feces. Our bodies utilize water to preventive and therapeutic effect similarly to how we use water in daily activities. Just as we wash dirt from our skin (or our cars, for that matter), surfaces inside the body are cleansed and lubricated as their cells are bathed in water. Tears, for instance, clear dirt from the eyes. Due to its ability to cool and warm the body, the water in your bloodstream is sometimes likened to the antifreeze that circulates in a car engine. The simile is appropriate, too, except that your body is far smarter than an automobile. Not only does it have the ability to cool the body on a need basis; it can even adjust to different temperatures at specific sites. Water is a key ingredient in nutrient metabolism, which is the process of converting food into energy. And water helps transport nutrients from the foods we eat throughout our bodies.
Image by TheVisualMD
Fasting - A Glass of Water on an Empty Plate
Fasting - A glass of water on an empty plate
Image by Jean Fortunet/Wikimedia
Water (H2O) Molecule
Water is a simple molecule (H2O) comprised of two hydrogen atoms attached to one oxygen atom. Water has a neutral pH of 7, yet dissolves more substances than any other liquid. Unique physical and chemical properties enable water to be consumed in the diet, absorbed into the bloodstream, exchanged with organ tissues, and released as a liquid (urine) or gas (perspiration, breath).
Image by TheVisualMD
Water Molecule
Water is a simple molecule comprised of two hydrogen atoms attached to one oxygen atom. Water has a neutral pH of 7, yet dissolves more substances than any other liquid. Unique physical and chemical properties enable water to be consumed in the diet, absorbed into the bloodstream, exchanged with organ tissues, and released as a liquid (urine) or gas (perspiration, breath). In this model, both hydrogen and oxygen atoms are shown in blue. Interactive also available on white background. Please contact us at image@thevisualmd.com for details.
Image by TheVisualMD
The Truth About Cranberry and UTIs
Video by SciShow/YouTube
Water at Work
TheVisualMD
Fasting - A Glass of Water on an Empty Plate
Jean Fortunet/Wikimedia
Water (H2O) Molecule
TheVisualMD
Water Molecule
TheVisualMD
5:01
The Truth About Cranberry and UTIs
SciShow/YouTube
Antibiotic Use
Amoxicillin
Image by Brett Hondow
Amoxicillin
Amoxicillin - Antibiotics
Image by Brett Hondow
Urinary Tract Infection and Antibiotic Use
Do you have pain or burning when you urinate? You might have a urinary tract infection (UTI).
Antibiotics treat UTIs. Your healthcare professional can determine if you have a UTI and what antibiotic you need.
What is a urinary tract infection (UTI)?
UTIs are common infections that happen when bacteria, often from the skin or rectum, enter the urethra, and infect the urinary tract. The infections can affect several parts of the urinary tract, but the most common type is a bladder infection (cystitis).
Kidney infection (pyelonephritis) is another type of UTI. They’re less common, but more serious than bladder infections.
Risk Factors
Some people are at higher risk of getting a UTI. UTIs are more common in females because their urethras are shorter and closer to the rectum. This makes it easier for bacteria to enter the urinary tract.
Other factors that can increase the risk of UTIs:
A previous UTI
Sexual activity
Changes in the bacteria that live inside the vagina, or vaginal flora. For example, menopause or the use of spermicides can cause these bacterial changes.
Pregnancy
Age (older adults and young children are more likely to get UTIs)
Structural problems in the urinary tract, such as enlarged prostate
Poor hygiene, for example, in children who are potty-training
Symptoms
Symptoms of a bladder infection can include:
Pain or burning while urinating
Frequent urination
Feeling the need to urinate despite having an empty bladder
Bloody urine
Pressure or cramping in the groin or lower abdomen
Symptoms of a kidney infection can include:
Fever
Chills
Lower back pain or pain in the side of your back
Nausea or vomiting
Younger children may not be able to tell you about UTI symptoms they are having. While fever is the most common sign of UTI in infants and toddlers, most children with fever do not have a UTI. If you have concerns that your child may have a UTI, talk to a healthcare professional.
When to Seek Medical Care
Talk to your healthcare professional if you have symptoms of a UTI or for any symptom that is severe or concerning.
Taking antibiotics, prescribed by a healthcare professional, at home can treat most UTIs. However, some cases may require treatment in a hospital.
Talk to a healthcare professional right away if your child is younger than 3 months old and has a fever of 100.4 °F (38 °C) or higher.
Treatment
Your healthcare professional will determine if you have a UTI by:
Asking about symptoms
Doing a physical exam
Ordering urine tests, if needed
Bacteria cause UTIs and antibiotics treat them. However, any time you take antibiotics, they can cause side effects. Side effects can include rash, dizziness, nausea, diarrhea, and yeast infections. More serious side effects can include antibiotic-resistant infections or C. diff infection, which causes diarrhea that can lead to severe colon damage and death. Call your healthcare professional if you develop any side effects while taking your antibiotic.
Sometimes other illnesses, such as sexually transmitted diseases, have symptoms similar to UTIs. Your healthcare professional can determine if a UTI or different illness is causing your symptoms and determine the best treatment.
How to Feel Better
If your healthcare professional prescribes you antibiotics:
Take antibiotics exactly as your healthcare professional tells you.
Do not share your antibiotics with others.
Do not save antibiotics for later. Talk to your healthcare professional about safely discarding leftover antibiotics.
Drink plenty of water or other fluids. Your healthcare professional might also recommend medicine to help lessen the pain or discomfort. Talk with your healthcare professional if you have any questions about your antibiotics.
Prevention
You can help prevent UTIs by doing the following:
Urinate after sexual activity.
Stay well hydrated.
Take showers instead of baths.
Minimize douching, sprays, or powders in the genital area.
Teach girls when potty training to wipe front to back.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (4)
Medicine
Image by qimono/Pixabay
Viruses or Bacteria: What's got you sick?
Antibiotics are only needed for treating certain infections caused by bacteria. Viral
illnesses cannot be treated with antibiotics. When an antibiotic is not prescribed, ask
your healthcare professional for tips on how to relieve symptoms and feel better.
Document by Centers for Disease Control and Prevention (CDC)
Biotechnology
Antibiotics are chemicals produced by fungi, bacteria, and other organisms that have antimicrobial properties. The first antibiotic discovered was penicillin. Antibiotics are now commercially produced and tested for their potential to inhibit bacterial growth. (credit "advertisement": modification of work by NIH; credit "test plate": modification of work by Don Stalons/CDC; scale-bar data from Matt Russell)
Image by CNX Openstax (credit "advertisement": modification of work by NIH; credit "test plate": modification of work by Don Stalons/CDC; scale-bar data from Matt Russell)
Be Antibiotic Aware
What antibiotics treat and won’t treat
Image by CDC
Medicine
qimono/Pixabay
Viruses or Bacteria: What's got you sick?
Centers for Disease Control and Prevention (CDC)
Biotechnology
CNX Openstax (credit "advertisement": modification of work by NIH; credit "test plate": modification of work by Don Stalons/CDC; scale-bar data from Matt Russell)
Be Antibiotic Aware
CDC
UTI in Women
Pregnancy and Urinary Tract Infection
Image by TheVisualMD / CDC
Pregnancy and Urinary Tract Infection
Pregnancy and Urinary Tract Infection
Image by TheVisualMD / CDC
Urinary Tract Infections in Women
Urinary tract infections (UTIs) are most often caused by bacteria (germs) that get into the bladder, which is part of the urinary tract. UTIs are also called bladder infections. UTIs are common, especially in women. More than half of women will have at least one UTI at some point in life. UTIs are serious and often painful. But most UTIs are easy to treat with antibiotics.
What is a urinary tract infection (UTI)?
UTIs can happen anywhere in the urinary system (which includes the kidneys, ureters, bladder, and urethra). UTIs are most common in the bladder. A UTI in the bladder is called cystitis. Infections in the bladder can spread to the upper part of the urinary tract or the kidneys. A UTI in the kidneys is called pyelonephritis or "pyelo."
Who gets UTIs?
Women get UTIs up to 30 times more often than men do. Also, as many as 4 in 10 women who get a UTI will get at least one more within six months.
Women get UTIs more often because a woman's urethra (the tube from the bladder to where the urine comes out of the body) is shorter than a man's. This makes it easier for bacteria to get into the bladder. A woman's urethral opening is also closer to both the vagina and the anus, the main source of germs such as Escherichia coli (E. coli) that cause UTIs.
Are some women more at risk for UTIs?
Yes. You may be at greater risk for a UTI if you:
Are sexually active. Sexual activity can move germs that cause UTIs from other areas, such as the vagina, to the urethra.
Use a diaphragm for birth control or use spermicides (creams that kill sperm) with a diaphragm or with condoms. Spermicides can kill good bacteria that protect you from UTIs.
Are pregnant. Pregnancy hormones can change the bacteria in the urinary tract, making UTIs more likely. Also, many pregnant women have trouble completely emptying the bladder, because the uterus (womb) with the developing baby sits on top of the bladder during pregnancy. Leftover urine with bacteria in it can cause a UTI.
Have gone through menopause. After menopause, loss of the hormone estrogen causes vaginal tissue to become thin and dry. This can make it easier for harmful bacteria to grow and cause a UTI.
Have diabetes, which can lower your immune (defense) system and cause nerve damage that makes it hard to completely empty your bladder
Have any condition, like a kidney stone, that may block the flow of urine between your kidneys and bladder
Have or recently had a catheter in place. A catheter is a thin tube put through the urethra into the bladder. Catheters drain urine when you cannot pass urine on your own, such as during surgery.
What are the symptoms of a UTI?
If you have a UTI, you may have some or all of these symptoms:
Pain or burning when urinating
An urge to urinate often, but not much comes out when you go
Pressure in your lower abdomen
Urine that smells bad or looks milky or cloudy
Blood in the urine. This is more common in younger women. If you see blood in your urine, tell a doctor or nurse right away.
Feeling tired, shaky, confused, or weak. This is more common in older women.
Having a fever, which may mean the infection has reached your kidneys
What causes UTIs?
UTIs are caused by bacteria or, rarely, yeast getting into your urinary tract. Once there, they multiply and cause inflammation (swelling) and pain. You can help prevent UTIs by wiping from front to back after using the bathroom.
How is a UTI diagnosed?
To find out whether you have a UTI, your doctor or nurse will test a clean sample of your urine. This means you will first wipe your genital area with a special wipe. Then you will collect your urine in midstream in a cup. Your doctor or nurse may then test your urine for bacteria to see whether you have a UTI, which can take a few days.
If you have had a UTI before, your doctor may order more tests to rule out other problems. These tests may include:
A cystogram. This is a special type of x-ray of your urinary tract. These x-rays can show any problems, including swelling or kidney stones.
A cystoscopic exam. The cystoscope is a small tube the doctor puts into the urethra to see inside of the urethra and bladder for any problems.
How is a UTI treated?
UTIs are treated with antibiotics prescribed by your doctor. You may feel better in one or two days. Make sure to finish taking all of the antibiotics as prescribed, even if you feel better after a day or two.
What can happen if a UTI is not treated?
If treated right away, a UTI is not likely to damage your urinary tract. But if your UTI is not treated, the infection can spread to the kidneys and other parts of your body. The most common symptoms of kidney infection are fever and pain in the back where the kidneys are located. Antibiotics can also treat kidney infections.
Sometimes the infection can get in the bloodstream. This is rare but life-threatening.
How do UTIs affect pregnancy?
Changes in hormone levels during pregnancy raise your risk for UTIs. UTIs during pregnancy are more likely to spread to the kidneys.
If you're pregnant and have symptoms of a UTI, see your doctor or nurse right away. Your doctor will give you an antibiotic that is safe to take during pregnancy.
If left untreated, UTIs could lead to kidney infections and problems during pregnancy, including:
Premature birth (birth of the baby before 39 to 40 weeks)
Low birth weight (smaller than 5 1/2 pounds at birth)
High blood pressure, which can lead to a more serious condition called preeclampsia
How can I prevent UTIs?
You can take steps to help prevent a UTI. But you may follow these steps and still get a UTI.
Urinate when you need to. Don't go without urinating for longer than three or four hours. The longer urine stays in the bladder, the more time bacteria have to grow.
Try to urinate before and after sex.
Always wipe from front to back.
Try to drink six to eight glasses of fluid per day.
Clean the anus and the outer lips of your genitals each day.
Do not douche or use feminine hygiene sprays.
If you get a lot of UTIs and use creams that kill sperm (spermicides), talk to your doctor or nurse about using a different form of birth control instead.
Wear underpants with a cotton crotch. Avoid tight-fitting pants, which trap moisture, and change out of wet bathing suits and workout clothes quickly.
Take showers, or limit baths to 30 minutes or less.
Can cranberry juice help prevent UTIs?
Maybe. Studies on whether cranberry juice or products prevent or treat UTIs show mixed results.
Cranberries may help prevent bacteria from attaching to cells in the wall of the urinary tract and causing infection. If you get recurrent UTIs, talk to your doctor or nurse about taking cranberry products to prevent UTIs.
What should I do if I keep getting UTIs?
Women who get two UTIs in six months or three in a year have recurrent UTIs. Your doctor or nurse might do tests to find out why. If the test results are normal, you may need to take a small dose of antibiotics every day to prevent infection. Your doctor may also give you a supply of antibiotics to take after sex or at the first sign of infection.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Additional Materials (7)
Depiction of a person with Urinary Tract Infection (UTI)
Depiction of a lady who has a Urinary Tract Infection (UTI). The typical symptoms of UTI have been shown.
Image by https://www.myupchar.com
Urinary Tract Infection In Women | Causes & Treatment
Mayo Clinic Minute: Treating Urinary Tract Infections
Mayo Clinic/YouTube
13:27
Urinary Tract Infection - Overview (signs and symptoms, pathophysiology, causes and treatment)
Armando Hasudungan/YouTube
Bacterial Infections
Staphylococcus aureus
Image by USDA/Eric Erbe, Christopher Pooley
Staphylococcus aureus
Bacterial cells of Staphylococcus aureus, which is one of the causal agents of mastitis in dairy cows. Its large capsule protects the organism from attack by the cow's immunological defenses.
This image was taken at 50,000X magnification on a Transmission Electron Microscope of a heavy-metal coated replica of a freeze dried sample, (TEM) Plate.
Image by USDA/Eric Erbe, Christopher Pooley
Bacterial Infections of the Urinary System
Urinary tract infections (UTIs) include infections of the urethra, bladder, and kidneys, and are common causes of urethritis, cystitis, pyelonephritis, and glomerulonephritis. Bacteria are the most common causes of UTIs, especially in the urethra and bladder.
Cystitis
Cystitis is most often caused by a bacterial infection of the bladder, but it can also occur as a reaction to certain treatments or irritants such as radiation treatment, hygiene sprays, or spermicides. Common symptoms of cystitis include dysuria (urination accompanied by burning, discomfort, or pain), pyuria (pus in the urine), hematuria (blood in the urine), and bladder pain.
In women, bladder infections are more common because the urethra is short and located in close proximity to the anus, which can result in infections of the urinary tract by fecal bacteria. Bladder infections are also more common in the elderly because the bladder may not empty fully, causing urine to pool; the elderly may also have weaker immune systems that make them more vulnerable to infection. Conditions such as prostatitis in men or kidney stones in both men and women can impact proper drainage of urine and increase risk of bladder infections. Catheterization can also increase the risk of bladder infection.
Gram-negative bacteria such as Escherichia coli (most commonly), Proteus vulgaris, Pseudomonas aeruginosa, and Klebsiella pneumoniae cause most bladder infections. Gram-positive pathogens associated with cystitis include the coagulase-negative Staphylococcus saprophyticus, Enterococcus faecalis, and Streptococcus agalactiae. Routine manual urinalysis using a urine dipstick or test strip can be used for rapid screening of infection. These test strips (Figure 23.5) are either held in a urine stream or dipped in a sample of urine to test for the presence of nitrites, leukocyte esterase, protein, or blood that can indicate an active bacterial infection. The presence of nitrite may indicate the presence of E. coli or K. pneumonia; these bacteria produce nitrate reductase, which converts nitrate to nitrite. The leukocyte esterase (LE) test detects the presence of neutrophils as an indication of active infection.
Low specificity, sensitivity, or both, associated with these rapid screening tests require that care be taken in interpretation of results and in their use in diagnosis of urinary tract infections. Therefore, positive LE or nitrite results are followed by a urine culture to confirm a bladder infection. Urine culture is generally accomplished using blood agar and MacConkey agar, and it is important to culture a clean catch of urine to minimize contamination with normal microbiota of the penis and vagina. A clean catch of urine is accomplished by first washing the labia and urethral opening of female patients or the penis of male patients. The patient then releases a small amount of urine into the toilet bowl before stopping the flow of urine. Finally, the patient resumes urination, this time filling the container used to collect the specimen.
Bacterial cystitis is commonly treated with fluoroquinolones, nitrofurantoin, cephalosporins, or a combination of trimethoprim and sulfamethoxazole. Pain medications may provide relief for patients with dysuria. Treatment is more difficult in elderly patients, who experience a higher rate of complications such as sepsis and kidney infections.
Figure 23.5 A urine dipstick is compared against a color key to determine levels of various chemicals, proteins, or cells in the urine. Abnormal levels may indicate an infection. (credit: modification of work by Suzanne Wakim)
CASE IN POINT
Cystitis in the Elderly
Robert, an 81-year-old widower with early onset Alzheimer’s, was recently moved to a nursing home because he was having difficulty living on his own. Within a few weeks of his arrival, he developed a fever and began to experience pain associated with urination. He also began having episodes of confusion and delirium. The doctor assigned to examine Robert read his file and noticed that Robert was treated for prostatitis several years earlier. When he asked Robert how often he had been urinating, Robert explained that he had been trying not to drink too much so that he didn’t have to walk to the restroom.
All of this evidence suggests that Robert likely has a urinary tract infection. Robert’s age means that his immune system has probably begun to weaken, and his previous prostate condition may be making it difficult for him to empty his bladder. In addition, Robert’s avoidance of fluids has led to dehydration and infrequent urination, which may have allowed an infection to establish itself in his urinary tract. The fever and dysuria are common signs of a UTI in patients of all ages, and UTIs in elderly patients are often accompanied by a notable decline in mental function.
Physical challenges often discourage elderly individuals from urinating as frequently as they would otherwise. In addition, neurological conditions that disproportionately affect the elderly (e.g., Alzheimer’s and Parkinson’s disease) may also reduce their ability to empty their bladders. Robert’s doctor noted that he was having difficulty navigating his new home and recommended that he be given more assistance and that his fluid intake be monitored. The doctor also took a urine sample and ordered a laboratory culture to confirm the identity of the causative agent.
Why is it important to identify the causative agent in a UTI?
Should the doctor prescribe a broad-spectrum or narrow-spectrum antibiotic to treat Robert’s UTI? Why?
Kidney Infections (Pyelonephritis and Glomerulonephritis)
Pyelonephritis, an inflammation of the kidney, can be caused by bacteria that have spread from other parts of the urinary tract (such as the bladder). In addition, pyelonephritis can develop from bacteria that travel through the bloodstream to the kidney. When the infection spreads from the lower urinary tract, the causative agents are typically fecal bacteria such as E. coli. Common signs and symptoms include back pain (due to the location of the kidneys), fever, and nausea or vomiting. Gross hematuria (visible blood in the urine) occurs in 30–40% of women but is rare in men.2 The infection can become serious, potentially leading to bacteremia and systemic effects that can become life-threatening. Scarring of the kidney can occur and persist after the infection has cleared, which may lead to dysfunction.
Diagnosis of pyelonephritis is made using microscopic examination of urine, culture of urine, testing for leukocyte esterase and nitrite levels, and examination of the urine for blood or protein. It is also important to use blood cultures to evaluate the spread of the pathogen into the bloodstream. Imaging of the kidneys may be performed in high-risk patients with diabetes or immunosuppression, the elderly, patients with previous renal damage, or to rule out an obstruction in the kidney. Pyelonephritis can be treated with either oral or intravenous antibiotics, including penicillins, cephalosporins, vancomycin, fluoroquinolones, carbapenems, and aminoglycosides.
Glomerulonephritis occurs when the glomeruli of the nephrons are damaged from inflammation. Whereas pyelonephritis is usually acute, glomerulonephritis may be acute or chronic. The most well-characterized mechanism of glomerulonephritis is the post-streptococcal sequelae associated with Streptococcus pyogenes throat and skin infections. Although S. pyogenes does not directly infect the glomeruli of the kidney, immune complexes that form in blood between S. pyogenes antigens and antibodies lodge in the capillary endothelial cell junctions of the glomeruli and trigger a damaging inflammatory response. Glomerulonephritis can also occur in patients with bacterial endocarditis (infection and inflammation of heart tissue); however, it is currently unknown whether glomerulonephritis associated with endocarditis is also immune-mediated.
Leptospirosis
Leptospira are generally harmless spirochetes that are commonly found in the soil. However, some pathogenic species can cause an infection called leptospirosis in the kidneys and other organs (Figure 23.6). Leptospirosis can produce fever, headache, chills, vomiting, diarrhea, and rash with severe muscular pain. If the disease continues to progress, infection of the kidney, meninges, or liver may occur and may lead to organ failure or meningitis. When the kidney and liver become seriously infected, it is called Weil’s disease. Pulmonary hemorrhagic syndrome can also develop in the lungs, and jaundice may occur.
Leptospira spp. are found widely in animals such as dogs, horses, cattle, pigs, and rodents, and are excreted in their urine. Humans generally become infected by coming in contact with contaminated soil or water, often while swimming or during flooding; infection can also occur through contact with body fluids containing the bacteria. The bacteria may enter the body through mucous membranes, skin injuries, or by ingestion. The mechanism of pathogenicity is not well understood.
Leptospirosis is extremely rare in the United States, although it is endemic in Hawaii; 50% of all cases in the United States come from Hawaii.3 It is more common in tropical than in temperate climates, and individuals who work with animals or animal products are most at risk. The bacteria can also be cultivated in specialized media, with growth observed in broth in a few days to four weeks; however, diagnosis of leptospirosis is generally made using faster methods, such as detection of antibodies to Leptospira spp. in patient samples using serologic testing. Polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA), slide agglutination, and indirect immunofluorescence tests may all be used for diagnosis. Treatment for leptospirosis involves broad-spectrum antibiotics such as penicillin and doxycycline. For more serious cases of leptospirosis, antibiotics may be given intravenously.
Figure 23.6 (a) Dark field view of Leptospira sp. (b) A scanning electron micrograph of Leptospira interrogans, a pathogenic species, shows the distinctive spirochete morphology of this genus. (credit b: modification of work by Janice Carr, Centers for Disease Control and Prevention)
CHECK YOUR UNDERSTANDING
What is the most common cause of a kidney infection?
What are the most common symptoms of a kidney infection?
Nongonococcal Urethritis (NGU)
There are two main categories of bacterial urethritis: gonorrheal and nongonococcal. Gonorrheal urethritis is caused by Neisseria gonorrhoeae and is associated with gonorrhea, a common STI. This cause of urethritis will be discussed in Bacterial Infections of the Reproductive System. The term nongonococcal urethritis (NGU) refers to inflammation of the urethra that is unrelated to N. gonorrhoeae. In women, NGU is often asymptomatic. In men, NGU is typically a mild disease, but can lead to purulent discharge and dysuria. Because the symptoms are often mild or nonexistent, most infected individuals do not know that they are infected, yet they are carriers of the disease. Asymptomatic patients also have no reason to seek treatment, and although not common, untreated NGU can spread to the reproductive organs, causing pelvic inflammatory disease and salpingitis in women and epididymitis and prostatitis in men. Important bacterial pathogens that cause nongonococcal urethritis include Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasma urealyticum, and Mycoplasma hominis.
C. trachomatis is a difficult-to-stain, gram-negative bacterium with an ovoid shape. An intracellular pathogen, C. trachomatis causes the most frequently reported STI in the United States, chlamydia. Although most persons infected with C. trachomatis are asymptomatic, some patients can present with NGU. C. trachomatis can also cause non-urogenital infections such as the ocular disease trachoma. The life cycle of C. trachomatis is illustrated in Figure 4.12.
C. trachomatis has multiple possible virulence factors that are currently being studied to evaluate their roles in causing disease. These include polymorphic outer-membrane autotransporter proteins, stress response proteins, and type III secretion effectors. The type III secretion effectors have been identified in gram-negative pathogens, including C. trachomatis. This virulence factor is an assembly of more than 20 proteins that form what is called an injectisome for the transfer of other effector proteins that target the infected host cells. The outer-membrane autotransporter proteins are also an effective mechanism of delivering virulence factors involved in colonization, disease progression, and immune system evasion.
Other species associated with NGU include Mycoplasma genitalium, Ureaplasma urealyticum, and Mycoplasma hominis. These bacteria are commonly found in the normal microbiota of healthy individuals, who may acquire them during birth or through sexual contact, but they can sometimes cause infections leading to urethritis (in males and females) or vaginitis and cervicitis (in females).
M. genitalium is a more common cause of urethritis in most settings than N. gonorrhoeae, although it is less common than C. trachomatis. It is responsible for approximately 30% of recurrent or persistent infections, 20–25% of nonchlamydial NGU cases, and 15%–20% of NGU cases. M. genitalium attaches to epithelial cells and has substantial antigenic variation that helps it evade host immune responses. It has lipid-associated membrane proteins that are involved in causing inflammation.
Several possible virulence factors have been implicated in the pathogenesis of U. urealyticum (Figure 23.7). These include the ureaplasma proteins phospholipase A, phospholipase C, multiple banded antigen (MBA), urease, and immunoglobulin α protease. The phospholipases are virulence factors that damage the cytoplasmic membrane of target cells. The immunoglobulin α protease is an important defense against antibodies. It can generate hydrogen peroxide, which may adversely affect host cell membranes through the production of reactive oxygen species.
Treatments differ for gonorrheal and nongonococcal urethritis. However, N. gonorrhoeae and C. trachomatis are often simultaneously present, which is an important consideration for treatment. NGU is most commonly treated using tetracyclines (such as doxycycline) and azithromycin; erythromycin is an alternative option. Tetracyclines and fluoroquinolones are most commonly used to treat U. urealyticum, but resistance to tetracyclines is becoming an increasing problem.4 While tetracyclines have been the treatment of choice for M. hominis, increasing resistance means that other options must be used. Clindamycin and fluoroquinolones are alternatives. M. genitalium is generally susceptible to doxycycline, azithromycin, and moxifloxacin. Like other mycoplasma, M. genitalium does not have a cell wall and therefore β-lactams (including penicillins and cephalosporins) are not effective treatments.
Figure 23.7 Ureaplasma urealyticum microcolonies (white arrows) on agar surface after anaerobic incubation, visualized using phase contrast microscopy (800×). The black arrow indicates cellular debris. (credit: modification of work by American Society for Microbiology)
CHECK YOUR UNDERSTANDING
What are the three most common causes of urethritis?
What three members of the normal microbiota can cause urethritis?
DISEASE PROFILE
Bacterial Infections of the Urinary Tract
Urinary tract infections can cause inflammation of the urethra (urethritis), bladder (cystitis), and kidneys (pyelonephritis), and can sometimes spread to other body systems through the bloodstream. Figure 23.8 captures the most important features of various types of UTIs.
Figure 23.8
Source: CNX OpenStax
Additional Materials (5)
Your Health: Bladder Health and UTIs
Video by UMMCVideos/YouTube
Staphylococcus aureus (MRSA) bacteria
Under a magnification of 2390X, this digitally-colorized scanning electron microscopic (SEM) image depicted numerous clumps of methicillin-resistant Staphylococcus aureus (MRSA) bacteria.
Image by CDC/ Jeff Hageman, M.H.S.; Photo credit: Janice Haney Carr
Hospital-Associated Methicillin-resistant Staphylococcus aureus (MRSA) Bacteria : Interaction of MRSA (green bacteria) with a human white cell. The bacteria shown is strain MRSA252, a leading cause of hospital-associated infections in the United States and United Kingdom.
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Urinary Tract Infections
You may have a urinary tract infection (UTI) if you feel a burn while urinating or have frequent and intense urges to urinate. Discover more UTI symptoms and how to treat the infection.