The dipstick test and the mid-stream urine (MSU) culture test are still the most common way to diagnose UTI. These tests are seriously flawed and miss between 60 and 90% of infections(i). Some specialists now use different tests to diagnose an infection.

Methods of urine testing for UTIs

The analysis of your urine can be broken down into seven diagnostic methods:

  • A urine dipstick analysis test
  • Mid-stream urine culture (MSU)
  • Broth culture analysis of the urine
  • Expanded Quantitative Urine Culture (EQUC)
  • PCR (polymerase chain reaction) testing
  • Next Generation Sequencing (NGS)
  • Fresh urine microscopy

Click on each test to find out more.

A urine dipstick analysis

Mid-Stream Urine Culture (MSU)

Broth cultures

Expanded Quantitative Urine Culture (EQUC)

PCR or polymerase chain reaction testing

Next Generation Sequencing (NGS)

Fresh urine microscopy

Don’t rely on a mid-stream urine culture to diagnose your chronic UTI

The dipstick analysis, often the first analysis used in a primary care setting, miss at least 60% of chronic UTI infections according to studies (i).

Research shows that a mid-stream urine (MSU) laboratory culture miss 90% of chronic UTI infections (i).

Find out about the problems with standard dipstick tests and mid-stream urine cultures.

A number of specialists now use alternative urine diagnostic methods. These tests include:

  • Alternative methods of culturing including broth, Expanded Quantitative  and DNA/NGS analysis
  • Focusing on the innate immune system response of the body to infection (the production of white blood cells and epithelial cells) via fresh urine microscopy

What about patient symptoms?

Key to new approaches is the belief that symptoms are as significant as diagnostic test results.

Specialists acknowledge that the urinary microbiome is an evolving area of study that must include a greater understanding of the effects of bacteria, fungi, diet, hormones, existing health issues and the patient’s own immune response on the urinary tract.

Bacterial strains can produce different symptoms. Listening to patient symptoms and where necessary, patient examination, helps inform diagnosis and find the correct treatment.

Where can I get a specialist culture?

We list the main urine analysis test options in the UK and US.

Find out how urine samples are tested and interpreted.


(i) Sathiananthamoorthy, S., et al., Reassessment of Routine Midstream Culture in Diagnosis of Urinary Tract Infection. J Clin Microbiol, 2018

Gill, K., et al., A blinded observational cohort study of the microbiological ecology associated with pyuria and overactive bladder symptoms. Int Urogynecol J, 2018