Symptoms Of Uti But Clear Urine Test – In 2015, Jessica Price, a 29-year-old Air Force veteran in Illinois, developed symptoms of a urinary tract infection, including an urge to urinate and bladder pain. But the standard dipstick test, where a doctor dips a plastic stick into a urine sample to check for signs of bacteria, kept coming back negative. Based on her symptoms and negative tests, doctors told Price she had interstitial cystitis (IC), an incurable syndrome of unknown cause, and recommended several invasive procedures that only made her pain worse.

“I took more medications than I can remember, none of which helped, and some of which made the symptoms worse,” she recalls. “The urologists told me things like, ‘It’s like blue or brown eyes; you were destined for it.’ ”

Symptoms Of Uti But Clear Urine Test

Symptoms Of Uti But Clear Urine Test

But when a nurse turned to a new type of test that used a DNA analysis of her urine, she discovered bacteria that she said were abnormal, and Price began a two-year course of antibiotics that finally brought her relief after some time.

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Urinary tract infections are one of the most common ailments women face, and at least 40 to 60 percent of them will develop them in their lifetime, according to the National Institutes of Health. They are usually diagnosed with a dipstick test, such as Price’s, or by sending a urine sample to a lab to look for bacteria. For most people, a course of antibiotics resolves the problem quickly. But for some people, like Price, the agony persists even when testing shows nothing, and the pain and urgency become chronic.

Chronic UTI is not a commonly accepted diagnosis, but James Malone-Lee, emeritus professor of medicine at University College London, believes that most people diagnosed with interstitial cystitis, also known as bladder pain syndrome, actually have chronic UTIs.

The National Institute of Diabetes and Digestive and Kidney Diseases reports that “IC is common. The condition may affect 3 million to 8 million women and 1 million to 4 million men in the United States.

Although there is no standard treatment for such cases, New York City urologist David Kaufman, who specializes in bladder and pelvic pain, says he believes new tests could help diagnose and treat many people.

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“I think the failure . . . to definitively diagnose chronic, low-grade infections in these patients is a result of the failure of [standard] two- to three-day commercial cultures to identify the infection. Hopefully that will change soon as laboratories begin to use molecular systems to identify microbial DNA and RNA in urine,” Kaufman says. “I think DNA sequencing testing is going to be a game-changer.”

Part of the problem with standard UTI culture tests used in the 1950s is that they can only grow the bacteria for 24 to 48 hours because they use solid agar cultures, he says. This means that infections caused by small amounts of bacteria may not grow enough for doctors to detect. Although Kaufman does not use DNA tests because they are not yet licensed by New York State, he does use another new test called liquid broth cultures, which allow the bacteria to grow for eight days.

“Protocols and guidelines around the world support dipsticks and cultures, so these guidelines are hopelessly incomplete,” says Malone-Lee. “Those women pay the price by being denied treatment and being told they don’t have a UTI when they do.”

Symptoms Of Uti But Clear Urine Test

A 2017 study of 306 women (220 with UTI symptoms and 86 without) published in the journal Clinical Microbiology and Infection found that 1 in 5 women with UTI symptoms tested negative on standard tests, but a DNA analysis test detected the bacteria E. coli. known to cause UTIs in 96 percent of symptomatic women’s urine.

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For a small study published in December 2018 in the Journal of Clinical Microbiology, researchers at University College London used both a standard urine culture test and a DNA test in 63 people (88 percent of them women, because most UTI patients are women) who had diagnosed with a UTI. based on symptoms and white blood cells in urine and 29 controls without UTI. It found that the standard test “failed to detect a variety of bacterial species”, including those recognized as “uropathogenic”, and could not differentiate between urine samples from people with symptoms and controls.

Despite these results, Malone-Lee, one of the co-authors of this 2018 study, says he thinks it’s too early to use DNA analysis and broth culture tests for diagnostic purposes because it’s unclear which bacteria may be naturally occurring in the bladder. of people being tested. As a result, bacteria identified by these newer, more sensitive tests may not always cause infections.

DNA tests are also not widely available and typically cost between $200 and $800 out of pocket. Insurance doesn’t cover them because there’s not yet enough data to prove they’re better than regular cultures, says Jennifer Linehan, a Santa Monica urologist and associate professor of urology at St. John’s Health Center in Providence.

“It’s possible that [DNA testing] will change the management of UTIs because the current approach of urinalysis and urine culture is not comprehensive enough to identify all the microbes that require treatment. However, we’re not there yet,” says David Fishbein Yao, a urologist and the Ronald Reagan UCLA School of Medicine. center researcher.Consequently, for now, “the best diagnostic method for UTI is standard UTI testing with urinalysis and urine culture if the urinalysis is abnormal.”

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Instead, Malone-Lee has returned to a diagnostic method used from the 1920s to the 1950s: Once a urine sample is provided, he uses a microscope to check for white blood cells, which the body produces to fight infections. Both the standard and newer tests also look for white blood cells, but because it takes time to send the urine to the lab, these cells have burst and scattered by the time they get there.

But Malone-Lee acknowledges that, as with the DNA and broth methods, microscopy is not a perfect solution. Many doctors don’t have the proper training to perform the analysis in the office, he says. And Kaufman says that seeing white blood cells isn’t always definitive because “not all white blood cells in the urine are due to a UTI. Often they’re just there because of contamination in the urine sample.

Lorraine Schylarski, a 35-year-old communications executive in Edinburgh, Scotland, who had chronic pain and other symptoms, was told she had IC, but Malone-Lee discovered she had a chronic UTI using fresh urine microscopy. After more than a year of antibiotics and the antibacterial drug Hiprex, she finally feels symptom-free.

Symptoms Of Uti But Clear Urine Test

“I went from my dream life to day after day on my parent’s couch, trying to cope with the pain, googling symptoms and treatments, making excuses not to see friends, not eating or sleeping, and taking too many painkillers,” recalls Shilarski. “I had no life. Not being able to take care of myself or even make money anymore was terrifying. I think this is my life now, at 33, for the rest of my life.

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Sheela Swamy, an obstetrician and gynecologist at University College London who was the lead author of the 2018 study, estimated that patients had been suffering for an average of 6.4 years before coming to her chronic UTI clinic, which uses microscopic analysis of fresh urine.

Regardless of the method chosen, many experts believe that clinicians should entertain chronic UTIs before using IC as a diagnosis.

Linehan says she now routinely performs DNA testing on patients with chronic urinary tract pain. In the past, she had to guess based on a patient’s red or white blood cell count or response to antibiotics.

Based on patient test results and response to treatment, Kaufman says he believes most people who come to him with chronic bladder pain and are told they have IC actually have chronic UTIs. However, he acknowledged that some chronic bladder infections can lead to IC if left untreated, so it’s important to identify and treat the infections early.

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America Ramirez, a 38-year-old banker in Georgia, developed bladder lesions characteristic of IC after several months of living with a UTI.

She said the pain continued for 10 years, causing marital problems and depression, before she finally traveled to England to be seen by Malone-Lee. “Why don’t all urologists here in the U.S. do a simple test [like urine microscopy]? Why don’t we test for DNA or let urine cultures sit longer to see if the bacteria is really there? she says. “I want instead of having and told again that there is no cure for what I have and that I just have to live with the pain, I would have had more opportunities to find out the root of my problem.”

As for Price, after two years of not being able to focus on anything but her constant desire to

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