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Last reviewed: 16 Mar 2025
Last updated: 27 Feb 2025

Summary

Definition

History and exam

Key diagnostic factors

  • dysuria
  • urinary frequency
  • hematuria
  • back/flank pain
  • costovertebral angle tenderness
  • fever

Other diagnostic factors

  • urinary urgency
  • suprapubic pain and tenderness

Risk factors

  • sexual activity
  • spermicide use
  • postmenopause
  • positive family history of UTIs
  • history of recurrent UTI
  • presence of a foreign body
  • insulin-treated diabetes
  • high lifetime number of UTIs
  • recent antibiotic use
  • poor bladder emptying
  • increasing age

Diagnostic tests

1st tests to order

  • urine dipstick
  • urine microscopy
  • urine culture and sensitivity

Tests to consider

  • postvoid residual (PVR)
  • renal ultrasound
  • abdominal/pelvic CT scan
  • cystoscopy

Treatment algorithm

Contributors

Authors

Una J. Lee, MD
Una J. Lee

Female Pelvic Medicine and Reconstructive Surgery

Section of Urology and Renal Transplantation

Virginia Mason Medical Center

Seattle

WA

Disclosures

UJL declares that she has no competing interests.

Acknowledgements

Dr Una J. Lee would like to gratefully acknowledge Dr Elliot Blau for his contribution to this monograph, and Dr Bhavin N. Patel and Dr Howard B. Goldman, previous contributors to this topic.

Disclosures

EB, BNP, and HBG declare that they have no competing interests.

Peer reviewers

Priyanka Sharma, MD

Associate Staff

Cleveland Clinic Foundation

Cleveland

OH

Disclosures

PS declares that she has no competing interests.

Timothy J. Benton, MD

Associate Residency Director

Texas Tech University Health Sciences Center

Amarillo

TX

Disclosures

TJB declares that he has no competing interests.

Paul Little, BA (Oxon), MBBS, MRCP, MSc, FRCGP, MD

Professor of Primary Care Research

Community Clinical Sciences Division

University of Southampton

Southampton

UK

Disclosures

PL declares that he has no competing interests.

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