When It Isn’t An Infection: UTI Symptoms But No UTI

Many patient struggle with recurrent UTIs (Urinary Tract Infections). Sometimes though, patients have UTI symptoms but no UTI present with urine cultures. This can frustrate patients because they have a difficult time finding relief of their symptoms with traditional UTI remedies. So what exactly is causing this and what can you do to remedy the symptoms?

First, it is important to note that you should ALWAYS have urine cultures taken. This is because there are many patients that experience UTI symptoms but no UTI is present on cultures. 

Unfortunately what we see happen too often is this cascade: Patients used to the feeling of having a UTI will call their physician and let them know that they think they have a UTI. The physician may be familiar with the patient and without running urine cultures will call in an antibiotic to manage. The antibiotic doesn’t work (because there is no true infection) and then the physician will call in a different antibiotic. This cascade continues without resolution in symptoms and more frustration from the patient.

Also, it is important to note that tension in the pelvic floor muscles can create the same sensation of a urinary tract infection. In the presence of pelvic floor muscle tightness, you can have UTI symptoms but no UTI. These symptoms include: urinary frequency, urgency, and possibly even burning.

In addition, sometimes pelvic floor muscle tightness can cause urinary tract infections. Therefore, if you first have cultures taken and they come back positive, but you continue with symptoms, you should have repeat cultures taken. This is because the residual symptom you may be experiencing could be the result of pelvic floor muscle tension and the possible cause of the UTI in the first place, instead of a lack of response to antibiotic treatment.

Things to avoid with urinary tract infection symptoms include:

• Performing Kegel exercises: The pelvic floor muscles are likely tight, and doing Kegels can just make the tightness worse

• Always assuming it is an infection: Always get cultures and when necessary, or when you’ve already gone through a course of antibiotics, get repeat cultures taken. This is due to the fact that you may have residual symptoms of a UTI, but the infection might be cleared.

If you are struggling with UTI symptoms but no UTI is present, please get in to see a knowledgeable pelvic floor physical therapist. 

In many cases, your symptoms are due to pelvic floor muscle tightness and treatment really needs to focus on getting the pelvic floor muscles to relax and to decrease tension through them. Often this includes hands on treatment, manual therapy, exercises, and lifestyle modifications. In addition, your therapist may be able to identify reasons for recurrent UTIs or UTI symptoms but no UTI.