Over half of people with vaginas will get a urinary tract infection (UTI) at some point in their lives, but even more experience symptoms of one. Sometimes, people will have all the telltale signs of a UTI — a constant urge to pee even when nothing's in there, burning while peeing, bladder pain — but their urine cultures will come up negative. Does this mean you have a UTI that's just not showing up on tests, or does it point toward a different health issue? It turns out those are both possibilities.
Why does it matter, you ask? Well, it affects how you should go about treating it. Dr. Dana Rice, M.D., board-certified urologist and creator of the UTI Tracker app, cautions against taking antibiotics if you have no confirmed UTI, even if you have symptoms. "In a world with increasing significant multi-drug resistant (MDR) bacteria, I am not a fan of antibiotics without culture positive results," she tells Bustle. "I think that part of the increase in MDR organisms is the overuse of antibiotics for urinary symptoms that feel like a classic UTI but are not truly infectious in nature." In addition, there are healthy bacteria in your bladder that you don't want to eliminate if you can avoid it, she says.
How do you know if you actually have a UTI or something else, though? And what else could it be? Here are a few things UTI symptoms with negative test results could point toward — and what steps you and your doctor might need to take next.
If UTIs go untreated, they'll often clear out on their own, but sometimes, they can make their way up to the kidneys, and a kidney infection requires immediate attention, Linehan says. If you begin to experience signs of a kidney infection, like blood in your urine, fever, or back pain, talk to your doctor right away.
Experts:
Dr. Jennifer Linehan, M.D.
Dr. Sheryl Recinos, M.D
Dr. Dana Rice, M.D.
Studies cited:
Faubion, S. S., Shuster, L. T., & Bharucha, A. E. (2012). Recognition and management of nonrelaxing pelvic floor dysfunction. Mayo Clinic proceedings, 87(2), 187–193. https://doi.org/10.1016/j.mayocp.2011.09.004
Gasiorek, M., Hsieh, M. H., & Forster, C. S. (2019). Utility of DNA Next-Generation Sequencing and Expanded Quantitative Urine Culture in Diagnosis and Management of Chronic or Persistent Lower Urinary Tract Symptoms. Journal of clinical microbiology, 58(1), e00204-19. https://doi.org/10.1128/JCM.00204-19
Heytens, S., De Sutter, A., Coorevits, L., Cools, P., Boelens, J., Van Simaey, L., Christiaens, T., Vaneechoutte, M., & Claeys, G. (2017). Women with symptoms of a urinary tract infection but a negative urine culture: PCR-based quantification of Escherichia coli suggests infection in most cases. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 23(9), 647–652. https://doi.org/10.1016/j.cmi.2017.04.004