If you want to make sure you are on the right track to treating a urinary tract infection, you have to first make sure that is what it is. The best way to go about doing that is by having a doctor take a sample of urine, and then it will be tested to see which antibiotics work the best and if bacteria can indeed grow in that sample of urine.
The problem that is run into most commonly is getting a decent sample that you can use to test. Even just urination into a cup is sometimes not enough to stop bacteria on the skin, even more so with girls. If you are able to control your urination, you can try a clean-catch sample. In that situation you would start with cleaning the area around the meatus and the meatus itself with antiseptics. Then you would urinate a little in the toilet before urinating in the sample cup. Then you would finish your urination in the toilet. This is a great way to make sure you have a legitimate sample.
The problem we run into is that you can’t do that kind of testing with small children, and even if they are toilet trained, it is still going to be nearly impossible to get that kind of cooperation. There is a method that can be used with a bag to collect urination, but it is almost always going to have skin contamination as far as bacteria goes. This kind of testing is not as reliable and not used very often for initial diagnoses.
A sterile catheter inserted in to the bladder via the urethra is what is currently most commonly used for the initial diagnoses of UTI in small children. It may sound a little harsh when you hear it at first, but think about it, it is really the only way that we have at the moment to tell if it really is a UTI or not. In small babies it may have to be taken a step further if they are septic, and a needle will be used to draw urine out of the bladder. But, when you have a newborn or a very small baby, the stakes are high and we don’t have time to decide if something is too barbaric or not, we have to figure out what it is quickly and get to a resolution.
A patient that is diagnosed with a urinary tract infection is then treated with antibiotics. There are a variety of antibiotics that may be prescribed by your physician to help treat a UTI. If the doctors are sure that you have a UTI right after they are done with the urine analysis, they will almost immediately start you on the antibiotic regiment. They can then analyze if that antibiotic is working or not, and make any adjustments if necessary. Usually after 3 to 5 days they will go back and do another urine test and culture, and then make sure things are going in the right direction, and if they are not than the doctor can adjust once again.
Another step that will be taken by a physician is to ensure that the infection did not proceed beyond the bladder. They will also make sure that there is no damage to the kidneys, as that can definitely result in bigger problems. They will use “nuclear scans” for this, which is basically where they shoot a tiny bit of radioactive medicine into the bloodstream and it will then head to the kidneys to be excreted. Then the doctors will be able to take x rays of the kidneys, and then be able to tell if any damage has been done. They use the nuclear scans method for the x rays because it is much less harmful than normal x rays.
They may also use ultrasound images to see if there are any abscesses in the bladder, kidneys, and ureter. They can also show just about any abnormalities as well. They won’t be able to see where microscopic bleeding is coming from with an ultrasound though. But chances are if it is that small it will be treated with the infection.
A VCUG, or voiding cystourethrogram, is an x ray in which the kidneys and bladder have a medicine that is injected to create a contrast medium. The reason for this is to look for reflux. When reflux is present, the contrast medium will be higher in the ureters, and if it is severe you might even see it in the kidneys as well. Although it is not that comfortable of a process for the patients, it is one of the only sure-fire ways to tell if there is reflux. If the reflux is considered to be serious, it can be dealt with using surgery. Some of the milder cases can be treated with antibiotics.