To diagnose a urinary tract infection (UTI), a physician will usually begin by compiling a medical history. This may include questions about the patient’s symptoms (including any burning or difficulty experienced when urinating), family history of UTI, amount of fluids normally consumed, and any existing conditions or diseases (e.g., pregnancy, diabetes). Sexually active patients may be asked about birth control methods used. A physical examination will likely include feeling the abdomen for tender or painful areas. In some cases, a complete pelvic examination may be performed.

In addition, the following tests may be performed:

• Urinalysis. Also known as a rapid urine test. A urine sample is collected to check for white blood cells (leukocytes), red blood cells (erythrocytes), protein and bacteria in the urine. Collection is most often done by “clean-catch,” where a patient provides a sample of mid-stream urine in a sterile cup provided. This test determines whether an infection is present.
  
  
• Urine culture. Bacteria from the urinalysis are allowed to grow in a laboratory dish to determine the type of bacteria causing the infection. The bacteria are then exposed to different antibiotics to determine what medications may be used to treat the infection (also known as a sensitivity test).

Patients who experience recurrent UTIs may be referred to a specialist (urologist). Additional tests for these patients may be required, including:

• Intravenous pyelogram (IVP). This test involves the injection of an opaque dye into the veins. The path of the dye in the urinary tract is viewed via x-rays. The results are interpreted by a radiologist (a physician specializing in x-ray technology).
  
  
• Voiding cystourethrogram (VCUG). In this test, a catheter is used to fill the bladder with fluid until the urge to urinate occurs and the patient urinates. This fluid can be seen on x-rays to determine whether there are any abnormalities or obstruction to the patient’s flow of urine.
  
  
• Ultrasound. A device that uses sound waves to produce pictures of the internal organs. A gel is spread on the skin of the area to be scanned and a technician passes a special probe over the area to produce the images on a monitor. The results are interpreted by a radiologist.
  
  
• Computed tomography (CT) scan. A series of x-rays from different angles that provide a three-dimensional look at internal organs, such as the kidneys and urinary system.
  
  
• Cystoscopy. This test involves looking inside the bladder using a special scope, with a tiny camera, inserted through the urethra. Sterile water or saline flows through the tube to fill the bladder and stretch it out, making it easier to see the bladder wall. If necessary, special instruments threaded through the tube are used to perform certain procedures (e.g., biopsy) during the viewing. A local anesthetic is provided ahead of time.
  
  
• Ureteroscopy. Similar to the cystoscopy, except that a specially designed scope is extended into the ureters. The procedure may be performed under a general anesthetic. This test is performed if obstruction of the ureters is suspected (e.g., due to kidney stones) or if the ureters need further study.