Investigations – UTI
Urine and blood tests
Urine can be dip tested in the clinic looking for blood or evidence of infection. A formal microscopic analysis and culture can be performed in the laboratory if required.
Basic blood parameters such as renal function, calcium and uric acid levels can be checked with a blood sample taken in clinic and the results are usually available within 24 hours
Imaging
Ultrasound is the simplest imaging test. ‘Jelly’ is placed on the side and front of your tummy which allows the radiologist to slide a probe over your skin. It uses sound waves to generate an image. There is no radiation used and therefore it is safe, even for pregnant ladies. It can miss some stones.
CT scanning gives much more detail but does utilise radiation. Performed without contrast injection it is the best test to look for stones and will define the number, size and position within the urinary tract. If intravenous contrast is also given then even more detail is available. This is helpful to define precise anatomy and to assess other abnormalities in more detail. This scan takes between 10 & 30 minutes. The patient lies on a narrow bed that is moved through a large white ring (often likened to a large polo mint!)
Nuclear medicine scans are used to define the split function between kidneys (normal is approx 50:50 for left and right kidney). They can also help define if a kidney is obstructed
Cystoscopy
This is an endoscopic inspection of the lining of the urethra, bladder and, in men, the prostate. It is usually carried out under local anaesthetic in the endoscopy suite or outpatient clinic. It takes about 30mins in total. The images are on screen and your surgeon would be delighted to show you around if you wish! Patients often experience some mild stinging or burning for the first 2-3 voids and approximately 1 in 100 may see some blood or have an infection. The procedure can also be performed under general anaesthetic, but that takes approximately half a day in hospital, requires starvation before hand and you cannot drive for 24 hours afterwards. Your surgeon will advise the best approach for you.
Flow rate and bladder scan
This is a fairly simple test to assess bladder function. It is most commonly performed when assessing men to predict whether their bladder is blocked by the prostate or narrowing of the water pipe. You would be asked to arrive at the clinic with a reasonably full bladder. Once you feel ready to pass urine you will be asked to void (wee) into a special funnel that measures the volume passed and the rate at which it came. The test is only valid if you pass over 150mls, hence the need for the full bladder. If you are early for the appointment and desperate for the toilet, don’t hesitate to speak with the receptionist or nurse who will be able to get you to do the test before seeing your surgeon. After voiding a mini ultrasound is used on your tummy to assess how well the bladder has emptied.