Urine sample every visit? No, thanks!

Dear Dr. Roach: My urologist’s receptionist asks every person to leave a urine sample for testing. They ask without knowing the reason for the visit. My reason for most appointments is for a follow-up of BPH urination frequency. When I ask if the test is medically indicated, the receptionist has no good response. So I say no. When I see the doctor, he never brings up that the test should be done.

To me, this pervasive urine testing by this office is nothing but a money grab. Am I wrong? — J.S.

I strongly disagree with this practice.

I do understand why they ask. In a urologist’s office, the likelihood of an abnormal urine test is very high, and knowing these results early can be a time saver. Even in men with BPH (benign prostatic enlargement), urine infections are common and need to be ruled out as a cause for those men who note worsening symptoms. However, not everyone needs them, and it doesn’t save that much time.

I do not think the underlying rationale is greed. I think the urologist wants to avoid missing any unsuspected urine infections. However, I think tests should be driven by symptoms. I agree with your refusal with the testing.

Dear Dr. Roach: I take 500 milligrams of valacyclovir daily to prevent outbreaks of ocular herpes. Since this antiviral drug is used to treat shingles, does that mean I don’t need to get the shingles shot? I’ll be 65. — P.W.B.

I would still recommend you get the shingles shot. Your dose of valacyclovir (Valtrex) is insufficient to prevent shingles, and there is resistance to antiviral drugs among herpes viruses like varicella-zoster virus, which causes shingles.

You may have a lower risk of shingles because of the Valtrex, but in my judgment, the benefits of the shot still outweigh the risks.