Follow-Up on Asymptomatic Urinary Tract Infection: When and How to Recheck - Urology

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When it comes to asymptomatic urinary tract infections (UTIs), the management and follow-up can be nuanced. In your case, where a routine health check revealed elevated levels of red blood cells (RBCs) and white blood cells (WBCs) in the urine but no symptoms, the approach typically involves monitoring rather than immediate treatment.


Follow-Up Timing
For asymptomatic UTIs, the general recommendation is to recheck the urine after a period of 1 to 3 months. This timeframe allows for any transient abnormalities to resolve naturally. If the initial findings were isolated and the patient remains asymptomatic, waiting a few months before retesting is reasonable.

Criteria for Improvement
When you return for follow-up, the criteria for improvement would typically include:
1. Normalization of Urinalysis: This means that both the RBC and WBC counts should return to normal ranges. Normal urine should have no more than a few RBCs and WBCs per high-power field (HPF).


2. Absence of Symptoms: The absence of any urinary symptoms such as burning during urination, increased frequency, urgency, or flank pain is also a good indicator of improvement.

3. Negative Culture: If a urine culture is performed, a negative result would indicate that there is no active infection.


Interpretation of Urinalysis Results
Regarding your specific results of "LEU +/- but no white blood cells and presence of red blood cells," it is important to interpret these findings carefully:
- LEU (Leukocyte Esterase): This test indicates the presence of WBCs in the urine. A positive result suggests inflammation or infection, but a negative result does not rule out a UTI, especially if there are RBCs present.


- Red Blood Cells: The presence of RBCs can indicate several conditions, including trauma, stones, or even benign causes like exercise-induced hematuria. It does not necessarily confirm a UTI, especially in the absence of WBCs.


Conclusion
In summary, for asymptomatic UTIs, a follow-up urinalysis in 1 to 3 months is advisable. Improvement is indicated by normalization of urinalysis results and the absence of symptoms. The presence of RBCs without WBCs may not indicate a UTI but could suggest other underlying issues that may need further investigation. If you have any concerns or if symptoms develop, it is always best to consult with a healthcare provider for personalized advice and potential further testing.