It depends on how much bacteria is growing; if it is more than 100,000 colony forming units its indicative of infection; less than that indicates contamination from collection of the specimen
A urine culture is our gold standard test to see if you had an infection. A urine culture should be obtained before you start any antibiotics, even though this is hard to do so. If you did in fact have a culture proven UTI, the second reason to have a culture is that we can find the right antibiotic. So the first two steps are to make sure you are infact having infections and second that it is being treated appropriately. I would really encourage you to not take antibiotics until a culture is sent so that you will know what antibiotic is appropriate. Antibiotic resistant organisms are a problem these days bred by improper antibiotic choices.
We divide recurrent UTIs into anatomic/structural abnormalities and functional abnormalities.
Anatomic abnormalities include kidney swelling, prostate abscess, and stone disease. This can be evaluated with a good rectal exam, CT scan of the abdomen and pelvis with and without contrast, and cystoscopy (telescope inside your bladder).
Functional abnormalities include high pressure voiding or incomplete emptying of your bladder. Recurrent infections in men are often due to incomplete emptying of the bladder or high pressure voiding and these are best checked with a urodynamic study (pressure flow study done by a urologist to see how your bladder fills and empties) and voiding cystourethrogram (contrast study by radiology to see how your bladder empties).
If you have not had imaging of your kidneys, cystoscopy, and a urodynamic study, it may be wise to consider.
Best of luck,