Guest blog entry: The Independent Urologist

I will return to the workers compensation blog series tomorrow, but today I am going to take one day of rest from that topic because I am happy to announce the beginning of what I hope to be a new weekly feature. That is, today is the first of our MedFriendly guest blog series. This entry was written specifically for the MedFriendly Blog. The first guest blog entry is from Dr. Richard Schoor who runs a very interesting and successful blog, entitled The Independent Urologist. I encourage you to visit his blog and read his posting below, which discusses some commonly misunderstood urological terms so you can better understand them. And with that, I give you...the Independent Urologist.

Two urologic terms I'd like to clarify.

Most people, if they live long enough, will develop a urologic condition, yet commonplace urology terms are not well understood, not just by lay people, but by many physicians as well. Here are 2 very common tests that I'd like to define in simple language.

The urine analysis (also known as UA): There are 2 varieties of UA, a dip stick UA and a microscopic UA. UA dip sticks look just like test strips used to check pH in a pool, and test for things like urine pH, ketones, sugar, etc. Dip sticks do not test directly for blood products, such as red or white blood cells, or for bacteria. Instead, the strips test indirectly for these elements and turn color in the presence various substances such as blood pigment in the case of red blood cells, leukocyte esterase (a white blood cell enzyme) in the case of white blood cells, and nitrate (which are bacterial breakdown products) in the case of bacteria in the urine.

In contrast, when performing a microscopic UA, the testing personnel look at a sample of the urine under a microscope and can see red blood cells, white blood cells, and bacteria directly. Being able to see red blood cells directly rather than indirectly, as in a dip stick UA, is an important distinction in the 2 tests, since, for example, the presence of blood pigment is normal, but the presence of blood cells in urine is not. So the next time your doctor says that you have blood in the urine or a urinary infection, as him if the diagnosis was based on a a dip stick UA or a micro UA. Knowledge that the correct test was used could save you from unnecessary worry and medical tests.

Urine culture: People are often told that they have a UTI (urine infection) based on a UA (see above). UA's do not diagnose UTIs reliably, only urine cultures can do that. A UA can only suggest that a UTI is present. Urine cultures are laboratory tests that involve taking a sample of urine and placing drops of it on petri dishes that contain special growth media (food) for bacteria. If the urine sample has bacteria in it, the bacteria will grow on the petri dishes and the media will look as if it has specks of mold on it. The number of specks of mold can be counted and used to determine bacterial counts. Many phsycians use these counts to determine whether or not to diagnose and treat a UTI.

Thanks for listening,

The Independent Urologist