Recommendation is to not screen for urinary tract infections during routine physical
by James Hubbard, M.D., M.P.H.
When you go for your periodic physical exam, you may not need to a urinalysis if you have no urinary tract infection symptoms such as burning or frequent urination, fever, lower back or abdominal pain. So says the new recommendation by the United States Preventive Services Task Force , a federal agency composed of experts who look over all available data and studies to determine whether or not to recommend a procedure or test. Pregnant women have a different set of recommendations. But what if your doctor does one anyway?
Old habits die hard, and there may be other ailments that can be picked up with a simple urine dipstick. The Task Force did mention these. Microscopic amounts of blood can be detected coming from major problems like cancer, kidney stones, to as minor as a little irritation of the bladder. A small amount of protein is frequently found in the urine of active teens and felt to be a normal variant. But, in others it may be an early sign of kidney disease. Bilirubin from liver damage can be picked up from the simple urine dipstick. In all or these cases finding something just suggests you a further workup of more accurate tests.
What if your doctor does find white blood cells in your urine that suggest infection but you have no symptoms? That is the dilemma that the task force is trying to avoid, the needless expense of further lab testing, and/or potential side effects of treatment for something that is probably not a real problem in the first place. The dipstick is only a screening test and not extremely accurate. But, usually, if we find a positive test, we feel obligated to follow through with a thorough work-up. In this case your urine might be sent to a lab to see if any bacteria grow out on a culture medium, what sort of bacteria and what is the best antibiotic to use to treat it. Other doctors might just give you some antibiotics for a few days and see if the urine clears.
The point here is that your doctor might suggest no treatment. With the information you have just learned, you might be able to give a more educated response.
Tags: recommendations, urinary health
July 10th, 2008 at 6:19 am
Good information as always….thank you!
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