If you know about UTIs and urinalysis, please come in!

vszapp

I'm hoping those of you who have been down this road can help me decipher what's going on... I have been having pain and discomfort down below for awhile - I am pretty sure I have some prolapse from 3 hours of pushing with DD, but my urethra is also sore. I don't have pain when I urinate, but in general I just have a ton of pressure and also some burning pain from time to time. No fever that I know of.

Anyway, I had an over the counter UTI dipstick test at home, so I took it last week. The leukocytes turned ragingly positive but the nitrites were negative. I went in for a urine culture and urinalysis, and nobody from the MW office ever called me about it (meaning it must have been negative). Well, the urinalysis results just got pushed to my electronic record. The leukocytes were negative (this was taken the day after the at-home test) but the pH was on the high side at 7.5 (cutoff is 8) and the RBCs were 3-5/HPF (range 0-2). Everything else was unremarkable.

Any ideas what is going on here? I have a nagging feeling that something isn't right (i'm pretty sure that even trace of blood are bad?), but it doesn't seem to be hitting the radar of the MW. I will of course talk to her, but I'm not sure she will have much insight. Not trying to find problems where they don't exist, but I also don't want to ignore a possible UTI...

TheBeeCharmer

I don't know a lot, but I do know you can still have a UTI if nitrates are negative. If Leukocytes are positive and PH is high, it can mean a non-e coli infection. (Ecoli produces nitrates). OTher bacterias sometimes don't. My daughter has a UTI right now with negative nitrates. 

Bootsie327

Yeah I'd say go to a doctor today, even a CVS Minute Clinic or something...they'll do the results right there and know what meds are safe for Pregnancy (I went to one for a UTI when we were TTC). I've had a ton of UTIs in my day, and from experience, as the minutes tick by, the worse and worse it will get!

vszapp

jennish11 said:

You need to go to the doctor.
Most doctors will let you come it to drop off a urine sample and then let you go home, no appointment.

It could be nothing, but it could also be a UTI and when pregnant it's best to get those taken care of early on.

I did get some odd pressure down there my first trimester - it was an odd burning/aching feeling and my doctor said it's probably just the pressure of everything growing... HOWEVER, she had me come in for a test anyways just in case.

No one can diagnose you online or over the phone, and trying to diagnose yourself can be dangerous when you are pregnant... if you have a strong feeling something is wrong, just go in.

I *did* call the doctor (midwife)! They told me to come in to drop off a urine sample, which I did. It was that urinalysis that came back with mildly high pH and a small amount of RBCs. The culture results have not come back yet, but since it's taken so long, I suspect it was negative. Not asking anyone to diagnose me, but to me this seems like something sub-clinical and not quite standard, so it's not setting of the "usual" UTI flags for the MW. Hence my questions...

CMarie11

vszapp said:

jennish11 said:

You need to go to the doctor.
Most doctors will let you come it to drop off a urine sample and then let you go home, no appointment.

It could be nothing, but it could also be a UTI and when pregnant it's best to get those taken care of early on.

I did get some odd pressure down there my first trimester - it was an odd burning/aching feeling and my doctor said it's probably just the pressure of everything growing... HOWEVER, she had me come in for a test anyways just in case.

No one can diagnose you online or over the phone, and trying to diagnose yourself can be dangerous when you are pregnant... if you have a strong feeling something is wrong, just go in.

I *did* call the doctor (midwife)! They told me to come in to drop off a urine sample, which I did. It was that urinalysis that came back with mildly high pH and a small amount of RBCs. The culture results have not come back yet, but since it's taken so long, I suspect it was negative. Not asking anyone to diagnose me, but to me this seems like something sub-clinical and not quite standard, so it's not setting of the "usual" UTI flags for the MW. Hence my questions...

I'm a PA who works in OB/GYN, and based off of just trace blood and a few leukocytes, I wouldn't treat you for a UTI. It's likely a contaminated specimen (meaning, contaminated with vaginal d/c). They're probably waiting for your culture to come back, which takes 2-3 days.

spinsoffresonance

When did you drop off the urine sample? I've had UTIs before that were negative on the dipstick but had a positive culture. It can take 3-4 days for the culture to be done though, so you just have to wait it out a little.

CopperPoppy

Ok so I don't have the specific info I think you are looking for but I can share my experience. Before I got pregnant I had chronic UTIs and always treated with ciprofloxin. There were times when I felt like I had all the symptoms of a UTI and had trace amounts of blood in my urine but there were no other indicators of UTI so my doctor made me wait.

I took cranberry pills and it cleared up fine on its own. My OB said cranberry pills are fine to take while pregnant. But I would be concerned about getting some answers if it doesn't go away soon.

Allibob

They typically only look at leukocytes and nitrate for a UTI. If they were both negative, it's not likely a UTI. Rarely you can have a positive culture with negative LE/nitrate, but I would expect your MW to call with those results. Trace blood is not uncommon & no big deal.

vszapp

Cool, thanks. I guess it was the really, really positive home test (for leukocytes only) plus the symptoms that had me concerned. I have an appt on Friday, so unless I go majorly downhill, I guess I'll wait to follow up. 

drjwj

The UA sounds pretty normal. More than 5-10 red blood cells on more than 3 urine samples is worrisome, but a little bit doesn't mean anything. Maybe the doctor test is better and that's why the LE was negative there? Or you cleaned better with their little wipey?

delatl

I guess I'd say based on my own experience to be assertive with your MW/dr.'s office. I had a UTI that was not properly diagnosed, went on too long, and left me with chronic UTI issues for years. They really need the culture to tell for sure. But if you are still feeling unsure about how it's being handled, get a second opinion. I had a UTI when I was pregnant last year (ended in m/c). I went to urgent care (on Jan 1, ugh) and when they called me a couple days later about my culture, they said it was "uncertain" and so they didn't prescribe me anything. Two days later, much worse, I called my OB on call. She said with a pregnant woman, they err heavily on the side of treating, so an uncertain would be treated.

deren1em

Results look fine. Cultures take a few days to yield growth so results on that won't be final yet. I don't expect they would treat you for a UTI unless the culture shows something. And even then, some "positive" cultures are common contaminates from not getting a really clean sample. I would sit tight for now if you can stick it out. Good luck.

jenb_99

I had what I thought were chronic UTIs when I was pregnant with DS, starting around 17w. Burning sensation, constant need to pee but inability to empty bladder completely, and bladder/urethral spasms. I was treated twice due to testing positive for bacteria upon initial lab result, but when my cultures all came back negative and the urinary problems came and went but never got any worse, the nurse determined that it had something to do with the position of my uterus. It was causing my bladder to be compressed in an odd way or something. And what I thought were spasms were likely just DS bouncing around on it.

Snowflake312

Does it just state leukocytes, or does it say leukocte esterase? Usually on the micro portion of the urinalysis it list WBC's (leukocytes- inflammatory cells). On the dip portion it lists leukocyte esterase. The combination of both, along with bacteria would be more suspicious for UTI. Also, you should note if your sample contains epithelial cells. if so, it is a contaminated specimen with cells from the vagina. Epithelial cells are not found in the bladder- making all the other findings essentially unreliable. The culture will give you the confirmation either way.

sws684

I'd go to doc. I've had a ton of UTIs and always have had trace blood. But I've also had work ups with specialists since I was a child due to a family history of kidney dz. I wouldn't settle until I got a credible answer that made me comfortable.

vszapp

OK, so the urine culture results just came back through my e-record, and the result was "mixed urethral flora". I have a graduate degree in infectious diseases (epidemiology, not medical practice) and definitely cleaned everything well before giving the specimen. I would assume this is a true polymicrobial (mixed) infection. Nobody from the midwife practice, which is part of a world-class medical school, has even called me yet!! The results were official on 11/28. That is another issue, but I'm guessing I had better call them this morning. I am pretty peeved that I may have an infection that hasn't been addressed. It seems like they should at the very least have asked me to give another specimen, if not begin treatment...

sws684

I agree!

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