Repeated UTIs, lack of test results

June 22, 2024 12:45 PM

Why do medical providers never give me the actual lab results for my UTI tests?

I get UTIs. When I got to urgent care or the doctor, they take a UA. They do a preliminary test at urgent care or the doctor's office and tell me that I will get full results in a few days. I usually leave with an antibiotic prescription regardless because the preliminary.

I've been to two separate places over the last few years for this issue, and both places have failed to send out my UA for testing and I don't get the results. In total this sequence has played out three times. I'm concerned that I'm taking an antibiotic that my infection might be resistant to, but also just that these places just don't seem to care about my medical problem.

Does anyone have insight into this? Does this mean that these providers are sloppy and I should seek out care elsewhere?

posted by emmatrotsky to Health & Fitness (13 answers total)

I take no view on whether it's sloppy or not but my understanding is that it is common practice and mainly because they don't anticipate making any change to your treatment based on the results.
posted by plonkee at 1:51 PM on June 22

I guess it may still be in the future, but your question reminded me of this recent news headline about more rapid UTI identification and mapping to appropriate Rx. Purely FYI.
posted by forthright at 4:24 PM on June 22 [2 favorites]

I think it’s sloppy. For my dad they always take a culture. (Mind you I think they return results too early sometimes, but at least they actually do the culture.) They’re supposed to call you if you need a different antibiotic. With repeated UTIs I can imagine your frustration.

I would just find someone else if that’s possible. Whether the problem is on the lab side or the office side they’re not going to change how they do things based on your concern.

Further, I would ask for a referral to a urologist or gynecologist (whichever is relevant).
posted by cotton dress sock at 5:07 PM on June 22 [1 favorite]

Oh God I’m gonna do the thing that makes me crazy when others do it to me and not actually answer the question please forgive me.

I’m also going to recommend something that is probably complete woo.

When I was getting a lot of UTIs I started using the 3-part Uqora supplements. I stayed on that program for almost a year and it helped me. I haven’t had a UTI since. I still keep some of the products around as “insurance”.
posted by hilaryjade at 6:10 PM on June 22 [1 favorite]

I'm going to do the same as cotton dress sock, sorry, but I hope one or both of these things brings you some relief. I'm not sure why my links aren't working, I'm hoping one of the mods can repair them, or just google the suggestions. There's good research for both. Vaginal estrogen has been found to be helpful for women with recurrent UTIs, as has d-Mannose.
posted by kate4914 at 6:38 PM on June 22 [4 favorites]

I’ve found most places will actually do a culture if you specifically request it when you go in. Explain that you have had several UTIs in a row and are concerned about resistance so you need a culture.

Also cranberry pills, peeing right after sex, and for some reason switching from condoms+bc pills to a Mirena really helped. (Frequent UTIs are no fun, take care of yourself and I hope they reduce soon).
posted by nat at 7:18 PM on June 22

No one should have repeated UTIs. You need to see a specialist and find the root cause.

Meanwhile, drink cranberry juice every day and wear clean cotton underwear. No thongs until the problem is solved.
posted by mumimor at 1:14 AM on June 23

To actually answer your question, yes this is pretty common, especially with urgent care, which has no investment in you as a patient. I recommend doing everything you can to see someone at your actually GP practice next time, and when you do, remind them that you've had a lot of UTIs lately and you'd really like to get the culture results this time.
posted by hydropsyche at 3:39 AM on June 23

I’m in the UK but had some luck recently getting test results for a blood test by saying they were for another doctor (they were just for me).
posted by ellieBOA at 4:13 AM on June 23

Best answer: It is sloppiness but it is also an extremely common sloppiness that happens even at "good" clinics, hospitals, etc. I wouldn't write off a care provider entirely if it happens once or even twice, but I tend to agree with the comments above that urgent care is generally a setting where longitudinal or follow up care is not valued, and therefore the likelihood of losing your urine culture is much higher. Why we are so much worse at completing tests on urine samples is, at least to me, a very interesting and multifaceted question (some possible answers: urine is not universally regarded as a valuable diagnostic specimen the way that blood seems to be, perhaps because it does not usually require an invasive procedure to obtain; chain of custody issues arise because urine is typically collected by the patient themselves, not a healthcare professional; etc etc).

For context: I'm a doctor who works in the ICU of a fairly well-regarded academic medical center, and I would estimate that I have had dozens of experiences where I am taking care of a patient who is near death from complications of a UTI yet somewhere between the emergency room and the ICU their urine sample is lost and never gets run as a culture (the diagnostic yield of a urine culture declines substantially after the first dose of antibiotics, which is why losing the first urine sample is such a big deal).
posted by telegraph at 3:06 PM on June 23 [1 favorite]

I have a special bladder. When my bladder issues started and I was a repeat patient at a local urgent care the NP referred me to a urologist and was like (nicely) stop coming here for this, you need longer term follow up care with this person. But I always got my culture results from them (either through phone call or by looking on the portal). So I would say sloppy and go see a urologist or urogyno.
posted by spacebologna at 3:19 PM on June 23 [1 favorite]

I second the recommendation of vaginal estrogen for recurrent UTI's. I was having frequent urinary pain and had some inconclusive cultures. I took vaginal estrogen for, no kidding, one week, and the problem has completely gone away even though I am not using the estrogen any more.

One thing that may be the source of this problem, is that for many patients they do a "urine dip," which does not culture the bacteria, conclude it is likely a UTI, and then treat without doing a culture by just giving first-line antibiotics. The culture is necessary for patients with recurring UTI's especially, because you may have bacteria that are resistant to a specific antibiotic. So I would specifically ask for a urine culture, not just a urine dip, and confirm with the care provider that they will do one.

You might also benefit from using MyChart or whatever patient portal they have available so that you can see your own test results, if you don't already have that.
posted by mai at 11:03 AM on June 24 [1 favorite]

I live in a place with Epic/My Chart, and have yet to experience a UA that wasn't followed by a culture whose results were automatically updated and shared with me. So +1 to mai's comment, if that's a thing you've got access to there might be some good data in there.

Also, would recommend a uro-gynecologist if you've got one in network/around. They can walk you through all the estrogen/d-mannose/hiprex/etc options, and also act as as a sort of +5 to accuracy next time you have to go to urgent care: e.g. "I get UTIs often, please send the results of the culture to my urogyn office at blah-blah-blah"

I am sorry you're going through it. They're the worst, even without the slow crumbling of the healthcare system on top of it. <3
posted by sazerac at 2:35 PM on June 24