Completing an at home UTI test can seem like a convenient approach. I mean, seriously, if you’re chained to a toilet, in pain, the last thing you want to do is leave home to get a test elsewhere.
Before you jump into ordering a home UTI test there are some important things you need to know.
The type of UTI test you choose can mean the difference between getting well or continuing to experience UTI symptoms. So we’ll cover 4 popular options for at home UTI tests, and let you decide.
Article Quick Links
- Four at home UTI test options for you to consider. >>>>
- At home UTI test strips. >>>>
- Standard urine culture at home test. >>>>
- Advanced UTI test methods. >>>>
- How to collect a home UTI test sample like a pro. >>>>
Four At Home UTI Test Options For You To Consider
One obvious consideration for UTI home test options, is that most options do not provide instantaneous results.
They typically involve collecting a urine sample, and shipping it or delivering it by hand. Clearly, if you’re taking care of that part yourself it’s not technically a stay at home UTI test.
Having said that, it can still be a lot more comfortable to do it this way, than to wait around in a clinic, particularly given that it’s better not to take anything to relieve your symptoms until you’ve provided a urine sample.
Home UTI testing options allow you to collect a sample quickly, then get straight to your pain relief routine, whatever that may be.
There are two standard ways to conduct an at home UTI test:
1. A rapid dipstick strip test, which can be done as an at home UTI test, or by your medical practitioner
2. A urine culture, where your sample is sent to a lab and is tested over the course of 24-48 hours.
And then there are other, more advanced testing methods, that also involve shipping a sample:
How Accurate Are Standard UTI Testing Methods?
Standard UTI tests include UTI test strips and urine culture. Despite being the global standards for UTI testing since the 1980s and 1950s respectively, both of these tests are extremely inaccurate.
We’ve covered UTI test inaccuracies in more detail, and it’s a good idea to brush up on the topic before your next test.
Accuracy Of Standard UTI Tests
An inaccurate UTI test can result in no treatment, or incorrect treatment, which can lead to prolonged or indefinite symptoms. Nobody wants that.
In fact, 26-44% of females will experience a recurrence of their first UTI. In this 26-44% it is likely the initial treatment failed, and this may be due to the type of test used.
It gets worse. Evidence suggests that with each recurrence of UTI, another recurrence becomes more likely.
The more UTIs you have, the more likely you are to get another.
Consider this before reaching for a home UTI test. It may not help you, and it may actually put you in a worse position.
So why don’t the standard UTI test methods provide the answers you need?
First, let’s take a quick look at those urine test strips you can use at home (or at the doctor’s office).
1. At Home UTI Test Strips
UTI home test strips are commonly used as a quick way to identify the presence of a urinary tract infection. The aim of at home UTI test strips is to allow you to perform a quick urine test and find out within minutes whether you have an infection, and whether it is bacterial.
How Do At Home UTI Test Strips Work?
Let’s take a look at what the little colored boxes on a home UTI test strip mean.
Bear in mind that some at home UTI test strips contain only two of the indicators listed below.
What Home UTI Strip Test Indicators Mean
|Indicator||Why It’s Used|
|pH Level||If your urine pH is outside the normal range of 5-7, there could be an issue.|
|Protein||Protein in the urine (proteinuria) can indicate kidney disease or other health issues, but it can also be caused by:|
- Urinary tract infection
- Stress or strenuous exercise
- Exposure to extreme cold
|Sugar||The most common cause of sugar in the urine is diabetes, but it can also indicate other rare health conditions.|
|Ketone||Ketones in the urine can also be caused by diabetes, but can also be a result of a state of ketosis, where the body burns fat instead of sugar for fuel.|
|Bilirubin||Bilirubin in the urine may be an early indicator of liver damage, however, this indicator is known to be highly inaccurate.|
|Urobilinogen||Urobilinogen is a by-product of Bilirubin production and may indicate issues with the liver, among other health issues.|
|Nitrite||Some bacteria that cause UTIs make an enzyme that changes urinary nitrates into nitrites. So if the strip is positive for nitrites, the conclusion is that you have a bacterial UTI. Note that many bacteria do not create nitrites in your urine.|
|Red blood cells (erythrocytes)||Blood can appear in urine due to strenuous exercise, but generally, blood in the urine is taken to be a sign of infection, inflammation, disease, or injury to the urinary tract.|
|White blood cells (leukocytes esterase)||A positive strip result for white blood cells in your urine indicates an infection in your urinary tract, or possibly, kidney disease.|
Why Is My Home UTI Test Negative When I Feel Like I Have A UTI?
It’s a great question, and one we hear a lot. And there’s a good answer:
Studies have shown that home UTI test strips cannot be used to rule out infection.
If you do an at home UTI test, and it indicates you don’t have an infection despite your symptoms, you have good reason to question the test itself.
Regardless of how many indicators are on the UTI test strip, it is not accurate.
Given the inaccuracy of home UTI test strips, particularly when it comes out negative, your symptoms may be a better indicator of a UTI.
This also applies to the UTI test strips used in clinics and hospitals. Despite what you may have been told, there is no such thing as an accurate UTI test strip.
|“My urine was visibly cloudy and it burned when I went to pee. My doctor used a UTI test strip in my urine sample and said everything on the test strip was normal. I was told I didn’t have an infection even though I’ve had UTIs before and I know exactly what they feel like.”|
Every brand of home UTI test works on the principles laid out above, and they all have the same limitations.
Should You Use At Home UTI Test Strips?
Hopefully, after reading the above, you already know how unhelpful an at home UTI test could be. To sum it all up:
- Studies show that UTI test strips may only be reliable about 30% of the time
- Other studies have bluntly concluded that UTI test strips should be abandoned as a tool for the diagnosis of UTIs in patients with lower urinary tract symptoms
- Given the low accuracy of UTI test strips, if the results are negative but you have UTI symptoms, it would generally be recommended that you pursue more accurate testing
Unfortunately, official guidelines allow for the use of test strips in diagnosing UTIs, so their use is extremely widespread, both at home and in clinical settings.
So what are your other options for UTI testing at home?
2. Standard Urine Culture Home UTI Test
Many labs will allow you to ship a urine sample from home, for a standard urine culture test. You may have organized this by ordering a UTI test kit online, or your doctor may have provided a kit in advance.
It can take a week or so to get results using this method, depending on the provider.
The process behind urine culture testing is easy enough to understand.
First, you provide a mid-stream urine (MSU) sample – also known as a clean-catch sample. See further down for instructions on how to collect a urine sample at home, for testing.
Your urine sample is sent to a lab, and (in its simplest form) this is what happens:
|Step One||A very small amount of your urine is placed on a plate with agar - a substance that encourages bacteria and fungi to grow.|
|Step Two||The plate is tightly sealed and placed in an incubator at body temperature.|
|Step Three||Any bacteria or fungi that are present are allowed to grow into small, circular colonies over the next 24-48 hours.|
|Step Four||If there is little or no growth, the test is considered negative.|
|Step Five||If there is growth, samples will be taken from each significant type of bacterial colony. A gram stain test will be done, which helps to differentiate between types of bacteria.|
|Step Six||Further testing is performed to identify specific types of bacteria present, then a susceptibility test is done to find out which antibiotic will be the most effective.|
|Step Seven||Results are forwarded to your doctor, or directly to you, showing which organism was found, in what concentration, and how it should be treated.|
|Step Eight||Your doctor prescribes you the recommended antibiotic or antifungal to treat the infection.|
This might sound logical, but there are some very important flaws which mean…
Standard urine culture testing is inaccurate in up to 50% of cases. The main test we rely on to shed light on UTIs leaves 1 in 2 females in the dark.
Standard Urine Culture Testing Tips
Although we know standard UTI testing is inaccurate, some individuals do find an answer.
|“I got this UTI that just would not go away. After a few rounds of antibiotics my doctor had my urine tested. The results showed the cause of my UTI was a different bacteria than she first suspected. She gave me a different antibiotic and it worked!”|
Standard UTI testing may be a road you wish to go down, particularly if you have not had your urine tested and you get acute UTI symptoms regularly.
Given the issues with UTI testing (which we’ve described in our UTI Test section), we thought we’d provide a few tips below on increasing the likelihood of getting an accurate result with standard urine testing, should you choose to pursue it.
While we don’t usually recommend using techniques that have been shown to be so flawed, there are very few options for UTI testing in most regions. So instead of dismissing it completely, we’ll discuss below how you can get the most out of what’s available.
The Issues With Standard UTI Testing You May Be Able to Minimize
As we covered in our testing section, one of the issues with the standard urine culture test is that the threshold for bacteria concentration in the urine is too high to catch many infections.
While many labs still use the threshold of a minimum colony forming unit (CFU) count of 105 per milliliter of cultured urine, females with symptomatic UTIs may present with CFU counts as low as 102/mL. For this reason, a number of recent guidelines recommend decreasing the threshold to 103/mL.
In plain language, a cut off point of 105 CFU/mL means your cultured urine sample could contain 90,000 colony forming units of bacteria per milliliter, but because the threshold is set at 100,000 (105), your test result will be reported as negative.
This doesn’t necessarily mean you should accept that answer.
|“There’s an old expression, if it looks like a duck, walks like a duck, and quacks like a duck. It's gotta be a duck. And so to have somebody who has pain, urgency, frequency and burning, and yet they're told they don't have an infection because a urine culture was negative, who do you believe? Are you treating a lab result? Or are you treating a person?” |
Getting back to standard urine testing… On top of the issues with the CFU threshold, some guidelines suggest the standard incubation time of 24-48 hours may be insufficient to grow all pathogens present in a urine sample.
Certain types of bacteria or fungi may be much slower growing, and will only appear in significant concentrations after 3-5 days. It is also believed that some pathogens may never grow on an agar plate, which is the standard technique used for UTI testing.
Changes To Request For A Standard Urine Culture Test
|If you are unable to access more accurate UTI testing methods, and choose to have your urine cultured via the standard UTI testing method, you can request:|
- Decrease the colony forming units (CFU) threshold from 105 to 103 or 102 .
- Ensure a susceptibility test be completed if your test is positive for bacteria or yeast even at lower levels. This should be done automatically, and is essential to identify which antibiotic or anti-yeast treatment should be prescribed.
- Lengthen the incubation period, to encourage the growth of more types of pathogens.
These changes aren’t always possible, so you should ask your doctor about it, or request it directly at a lab if you test independently.
In most US states, you have the right to pursue UTI testing independently, and the right to request your lab test results without seeing a doctor first. This is not the case in all countries.
If your test is negative, you can discuss this with your doctor or lab. It may make sense to conduct another test at a different time of day (see our tips below), or to test for different pathogens that could be causing your symptoms.
Given the inaccuracies of standard UTI testing, a negative result may also be a prompt to pursue more accurate testing methods, like those below.
3. Next Generation Sequencing: PCR And 16s Technology
PCR and 16s technology use DNA sequencing to isolate and identify specific fragments of microbial DNA present in a human sample. One company that provides this type of service is MicroGenDX, a US based molecular laboratory.
MicroGenDX states that their tests identify 100% of the known bacteria, fungi and parasites in a urine sample from a database of >30,000 species, with 99.9% accuracy.
|“We strongly believe MicroGenDX Laboratory can provide better diagnostic information to treat chronic UTIs by utilizing Next-Gen Sequencing. NGS takes the guesswork out of microbial detection allowing for targeted utilization of antimicrobials." |
We’ve covered the UTI testing service offered by MicroGenDX in much more detail here.
4. Deep Shotgun Metagenomics UTI Testing
Deep shotgun metagenomics is also based on sequencing the DNA of microbes in human samples. However, this technology is less specific, and enables all known organisms – bacteria, fungi, parasites and viruses – to be identified via any fragment of microbial DNA present.
Aperiomics is currently the only provider of this type of testing, globally. Patients can order a UTI testing kit online, collect a urine sample at home, then ship it back. Practitioners can order testing kits on behalf of patients here.
|“The traditional health-care system has never had the right tools to see what’s going on. We have the tool, and our goal is to change everything about how infections are identified.”|
We’ve covered the UTI testing service offered by Aperiomics in much more detail here.
How To Collect A Home UTI Test Sample Like A Pro
Whatever home UTI test you opt for, you’ll need a top notch urine sample for the most accurate results.
Fortunately, all of these testing methods require urine to be collected in a similar way. It’s always best to double check any instructions provided in an at home UTI test kit, but below are some basic guidelines.
|"I’ve provided so many urine samples now, but I’m never sure how full the container should be. So I make it different each time, hoping the doctor will say ‘oh wow, that’s way more than we need,’ or maybe, ‘great job, that’s perfect.’ But he never reacts. His poker face is unbreakable."|
There’s no need to worry what your sample looks or smells like. After all, that’s why you’re getting tested – because there is an issue. We’re sure you’re doing a good job already, but here are a few tips to check your urine sample technique against:
|1. Wash your hands. Then use disposable gloves if possible.|
|2. Remove the sample container lid, being careful not to touch the inside. Place the lid face down on a clean tissue.|
|3. If you’ve been supplied with cleansing sponges, use them to clean the area around your urethra - this helps minimize contamination from other organisms. Avoid touching your urethra or the area around it with your hands.|
|4. Find a position over the toilet that seems viable for getting urine in the container and NOT on the floor. Some people prefer to straddle the toilet backwards.|
|5. Use your fingers to hold the folds of skin around the vagina away from your urethra, and keep holding until you have collected your sample. This also helps minimize contamination.|
|6. Urinate first into the toilet for a second or two, then without stopping, aim for the sample container, filling it to about two-thirds (there’s your answer to the, ‘Is this enough? Is this too much?’ question).|
|7. Congratulate yourself on getting it mostly into the container.|
|8. Continue urinating into the toilet until your bladder is empty.|
|9. Without touching inside the container or lid, screw the lid back onto the container.|
|10. Use paper towel to wipe off excess urine on the outside of the container (this isn’t a rule, but we know you missed at least a little bit).|
|11. Wash your hands!|
If you’re posting your sample, you will most likely be given a few additional collection instructions. Pay close attention to these!
When To Collect A Urine Sample
For Standard UTI Testing, Always Keep A Urine Sample Container On Hand. Why?
If you frequently experience UTIs, and plan to collect your urine sample at home, you’re more likely to get an accurate result if you collect your urine sample at the height of your symptoms.
Symptoms tend to flare up when the concentration of bacteria in your bladder increases, so this is the perfect time to get a snapshot of what is happening in your urine.
If you suffer from recurrent UTIs, ask your doctor or your chosen lab for a sterile sample container to take home or order a UTI test kit online. Make sure this is provided inside a sterile package, to prevent contamination before you need to use it.
Next time you get acute symptoms, pee in that container before you start guzzling fluids, trying home remedies, or popping pills. Drinking excessive amounts of fluids before collecting your sample will only dilute your urine, decreasing the likelihood of an accurate test.
Other things to avoid before collecting your sample:
- Vitamin C
- Other antimicrobials such as herbal remedies
And while you obviously can’t control the timing of a UTI, it helps to collect a urine sample when you are not menstruating. Menstrual blood can contaminate your sample and affect your test results.
Taking a sample at the height of your symptoms, and before intervention, gives you the highest chance of an accurate test.
For a standard urine culture, it’s important to put your urine sample in a sealed plastic bag. Then drop it in to your doctor or lab within an hour. Testing methods based on DNA sequencing don’t require such a quick turnaround. You’ll find more information about that in the test kits.
Oh, and put your name on your sample container BEFORE getting to the doctor or lab. Or be prepared to put it on display and name it while you’re there.
When you don’t have a sterile sample container on hand, do your best to get to the doctor or lab asap.
If you’re in the habit of popping antibiotics at the first sign of a UTI, think twice, and get tested first.
|For chronic or ongoing low level UTI symptoms without acute episodes, the best time to collect a urine sample is first thing in the morning. Your urine is at its most concentrated after hours of sleeping and not peeing. A higher concentration of any potential pathogens may provide a better chance for an accurate result.|
|“When my first round of UTI testing came back negative my doctor had me submit urine samples at 3 different times throughout the day, over the course of a week. She found a huge amount of bacteria in my morning urine samples. I got the right antibiotic, and miraculously, after 15 years of recurrent UTIs, I was suddenly free of symptoms!”|
If you have previously had your urine tested, only to receive inconclusive or negative results, it could be worth submitting multiple urine samples, at different times of the day, to track the presence of pathogens in your urine.
Ultimately, you may never get an accurate test result from standard UTI testing, and it’s always better if you can pursue a more accurate alternative.
How To Talk To Your Doctor About Recurrent UTI
Get Your UTI Test Results Organised!
- Request copies of your previous UTI testing results. You can do this yourself by calling clinics that have arranged testing for you, or you can ask your doctor to make these requests on your behalf.
- Always ensure you receive a copy of any future test results and store all your results in chronological order for easy reference.
- Familiarize yourself with your historical results. Note any patterns and anything that stands out. Highlight specific aspects that seem unusual and make note of any questions you have regarding your results.
- When you are ready, take your collated results and questions to your doctor. This information can be very valuable, particularly when you find the right practitioner – who is willing to investigate your recurrent UTIs further.
- Arm yourself with knowledge and references regarding recurrent/chronic UTI – you should be prepared to discuss this concept, and to stand your ground.
- If your doctor is unwilling to listen to your concerns, you should feel empowered to search for a practitioner who will.
|“I’d had so many UTIs and so many lab tests at different clinics. I always made sure I got a copy of my results. Every test showed low levels of something, but no full blown infection. Showing my results to my own doctor helped her piece together the fact that I did have a chronic infection. That was a turning point for me.”|
As always, you’re most welcome to leave any questions or comments below.