Are GP dip tests for UTIs accurate?

[Cherryann]

Asking because a while ago I went to my GP with symptoms of agonising UTI. She did a dip test with urine sample & said no UTI. A few days later the pain was so bad I couldn’t move & ended up in hospital where they tested my urine & announced yes I had a UTI, with nitrates & white blood cells & other stuff present.

I had 7 days on Nitrofurantoin - stopped yesterday morning & already symptoms are returning. But if I go to GP again, will her UTI tests be accurate?

It could be that the UTI was only just starting when the GP did the first dip test, so it didn't pick it up. Even if the GP's dipstick test is negative, they should send a sample off to the lab to be cultured.

It’ll be the same test, it’s also the same as they do if it’s sent to a lab (although they can do additional tests too if requested) like pp it could have been to early to pick up, or it could have been too diluted.

https://www.nice.org.uk/guidance/qs90/chapter/Quality-statement-1-Diagnosing-urinary-tract-infections-in-women-under-65

NICE guidelines recently updated. A short answer is no not accurate and culture only works on more concentrated urine so don't drink lots beforehand.

That could be the wrong antibiotics for that type of uti and maybe you need some different ones?

You need a culture. You are at a high risk of urosepsis which is very serious. I lost so much muscle mass when this happened to me that I couldn't walk more than a few steps for a year. If they don't do a culture, it's negligence. I would be dead now if I had been in the UK.

I've on a number of occasions handed in sample which was pink to due bleeding it was so bad yet they said no infection found but luckily gave me the antibiotics before the results came back.

GP should dip test your urine and also send a sample for culture. Normally if dipping shows any abnormalities, first line antibiotics (Trimethoprim) are prescribed. When the results come back, they will show what antibiotics are needed to treat the infection.

Thanks very much all. I will request a culture.

Demand a culture! I stared death in the face from an ongoing UTI, if the ambulance hadn't have been available within 3 minutes and emergency was resourced so I could be diagnosed immediately, I would be dead. Please be careful.

I’ve had negative tests from UTI dip testing and cultures, but was still prescribed antibiotics as my GP could see that symptoms were clearly a UTI.

Did they send a urine sample off?
That's standard practice, that should been done when they dipped your urine with those symptoms.

I used to get a lot of UTIs and ended up seeing a urologist who said that the dipstick tests are only 50% accurate. He wrote a letter to my GP saying that I should be given antibiotics if I had UTI symptoms and not to wait for a dipstick or sample test.

I got nerve damage in my bladder having had lots of UTIs and my GP didn't give me antibiotics because the dipstick said it wasn't an infection. 3 years of chronic pain that could have been avoided if the GP hadn't relied on the dipsticks.

Both dipsticks and cultures are not accurate. GP should be treating you bases on symptoms otherwise you could end up with an embedded infection.

But what do you do as the NHS do not recognise embedded UTI? I started last August with my first ever UTI, I was given Nitrofurantoin but I felt that it did nothing, I had 3 x 3 day courses of it but a couple of weeks later ended up at the hospital due to high fever, muscle aches, the pelvic pain and pressure is just awful. I had Cephalexin for 5 days but the pain continued . I had a cystoscopy in Nov, got another high fever, muscle aches , teeth chattering again, NHS 111 gave me Co-Amoxiclav and i was pain free for 2 weeks but then it all came back again. I had another bout of the fever and aches and shivering in Feb. The urologist who did the cystoscopy said no sign of infection and said i have painful bladder syndrome. I have since had a phone appointment and a different doctor has booked me a CT KUB but i am at a loss as to what is wrong with me. The lower pelvic pain and bloating is hideous and I cannot even sit comfortably any more. I was ok before that night it all started.

Painful bladder syndrome is a rubbish diagnosis. Something is causing the pain in your bladder. The Luts team at the Whittington treat embedded infections on the NHS but your urologist has to refer you it can't be a GP. I ended going private to the Prof Malone-Lees team. Also you could try asking your urologist for hiprex if they won't prescribe antibiotics.

Thanks for that, I will look into Hiprex but as they say no infection I doubt they will consider it. The doctor just said if this CT scan is normal they will ask GP to refer me to some other specialty (not sure which) regarding my recurrent fevers 🙄(which I never had before the August UTI)

When I had urosepsis my urine culture and stickwas clear but the 4 huge tubes of blood they cultured showed a rare infection plus an underlying virus. Luckily they started me on the sepsis pathway straight away and managed to reduce the 41c fever and get my BP up. If I had been in the UK I definitely wouldn't be alive because it depended on instant response and treatment. British GPs have forgotten how to examine patients and use their brains and just spout their crappy money saving workflows. Or worse, having to see some dippy nurse with an algorithm. Sod that for a laugh.

took me 12 weeks to even see a GP, constant ringing and filling in econsults and just taking samples in, they were very resistant to giving out an actual face to face appointment and then when i got one, i was given a 2 week referral as i had haematuria

I can't imagine living like that, I can self refer anytime to a urologist if I want but I don't need to because my GP clinic sees me anytime without an appointment and has an onside lab.

yeah, its shit but what can you do? I have just accepted that I will be in this pain for the rest of my life now, I have been in agony since August, nothing I can do except take painkillers.

How do you get in touch with the Malone-Lees clinic? I can’t find it online

https://www.chronicutiinfo.com/treatment/conventional-medicine/uk-treatment/prof-malone-lee/ here is a link to their details. It is best to email them.

Thank you!