UTI
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Introduction
History
Modern Dipsticks
Modern Diagnosis
Overdiagnosis
Underdiagnosis
Improved Diagnosis
NITR-Negative UTIs

Thrush
Circumcision
Main Page
Normal Foreskin
Foreskin Rasslin'
Penile Infection

Historical Background

In modern times, urine has been tested with dipsticks utilizing multiple chemical tests, and by microscopic examination. Until about 1990, there was not much on the dipstick that was genuinely helpful with UTI diagnosis. But this did not prevent doctors from kididng themselves into thinking otherwise -- i.e., thinking that the presence of protein or blood in the urine was a strong indicator of UTI. This was a part of the general tendency for doctors to look for excuses to prescribe antibiotics.

Under the microscope, infected urine will have lots of white blood cells (WBCs, the body's responses to infection) AND bacteria. The WBCs are easy to see -- the bacteria are not. The tendency therefore is to rely solely on the WBCs. I discovered in the late 1970s that, relying on patient symptoms ("It hurts when I pee") and WBCs resulted in misdiagnosis 80% of the time.

In order to figure this out, I had to look carefully at the urine culture results that came back three days later. When kids are seen for UTI they frequently do NOT get a urine culture. Moreover, even when a culture is done, the result takes so long to return that often no one pays any attention to it.

Modern Dipsticks