Follow-Up on Asymptomatic Urinary Tract Infection: When and What to Check - Urology

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When it comes to asymptomatic urinary tract infections (UTIs), the management and follow-up can be a bit nuanced. In your case, where both red and white blood cells were elevated in your urine during a health check, but you are not experiencing any symptoms, it is essential to approach this situation carefully.

Firstly, it is important to understand that the presence of red blood cells (hematuria) and white blood cells (leukocyturia) in urine can indicate various conditions, not solely a urinary tract infection. Hematuria can arise from a range of issues, including but not limited to urinary tract infections, kidney stones, trauma, or even malignancies. White blood cells in urine typically suggest an inflammatory response, which can be due to infection or other non-infectious causes.

Given that you are asymptomatic, many healthcare providers may recommend a wait-and-see approach. However, it is generally advisable to follow up with a repeat urinalysis within 1 to 2 weeks after the initial finding. This timeframe allows for any transient issues to resolve and provides a clearer picture of your urinary health. If the follow-up urinalysis shows a decrease in the number of red and white blood cells, it may indicate that the initial findings were due to a temporary condition rather than a persistent infection.

As for the criteria for improvement, a significant reduction in the number of red and white blood cells in the urine would be a positive sign. Specifically, the absence of white blood cells (or a very low count) and a normalization of red blood cell levels would suggest that any underlying issue may have resolved. If the follow-up urinalysis still shows elevated levels of these cells, further investigation may be warranted, including imaging studies or a referral to a urologist for a more detailed evaluation.

Regarding your specific question about the presence of leukocyte esterase (LEU) being positive or negative, it is essential to note that a positive LEU test typically indicates the presence of white blood cells, suggesting inflammation or infection. However, if you have a positive LEU result but no white blood cells are detected in the microscopic examination, this could indicate a false positive or a very early stage of infection that may not yet be fully established. In such cases, clinical correlation with symptoms and possibly further testing would be necessary.

In summary, if you have been diagnosed with an asymptomatic UTI based on urinalysis findings, it is prudent to schedule a follow-up urinalysis within 1 to 2 weeks. Improvement would be indicated by a decrease in both red and white blood cell counts. If abnormalities persist, further evaluation may be necessary to rule out other underlying conditions. Always consult with your healthcare provider for personalized advice and follow-up care based on your specific situation.