FAQs

Digital Microbiology described what we do. It didn't capture why we do it. So we decided to change our name.

Tota is about giving you the total picture, everything that's happening in your vaginal and urinary microbiome, not a fraction of it. It's a name that's easier to say, easier to remember, and (we think) finally looks and sounds like a brand built for you, not a lab report.

What's staying exactly the same

• The same rigorous, non-targeted DNA sequencing behind every test
• The same team analysing your results
• The same commitment to explaining things clearly, honestly, and without hype
• The same purpose: to help you understand what's happening in your body, so you and your healthcare professional can make better decisions together

Until quite recently it was assumed that healthy urine was sterile.

With the advent of DNA based testing it’s now apparent that mixed populations of bacteria, yeast and other small microbes occur naturally in most people’s bladders. This collection of organisms is called the bladder or urine microbiome. The vagina has its own collection of microbes which are often very similar to the ones found in the urine of the same person; this is the vaginal microbiome.

Scientific research is still investigating what effect having different types of microbes, their abundance and the overall make-up of communities have on bladder or vaginal health. Some are thought to be harmless, some actively help protect against infection whilst others may cause symptoms. Bladder microbiomes will be different from person to person and may change over time.

The female bladder microbiome is heavily influenced by the vaginal and gut microbiomes. For individual microbes it seems that location is important; bacteria that have an important job in one location can be problematic if accidentally introduced into a different space. This is especially true of urine infections which often involve the unintentional spread of a bacteria from the gut, e.g. E coli, where it might be doing useful work, into the bladder where it can cause harm.

The science of microbiome analysis and the role they play in health is still new and there is a lot yet to understand.

Our UTI test collects DNA from any bacteria, yeast and other microbes.

We then analyse it and use the information to find unique matches to our database of over 4,000 different microbial species including bacteria and yeasts. This allows us to build up a highly accurate list of all the organisms present.

We also use an internal calibrator to estimate how many cells of each species were present in your sample. This gives us a quantitative and highly accurate profile of the full microbiome it contained.

We have a couple of cartoon explainer videos on our site which may help you understand our system better.

Our test is a wellness profile of your urinary or vaginal microbiome - it gives you and your clinician a detailed picture of what's there, but it isn't a regulated clinical diagnostic test, and isn't a substitute for the clinical assessment your GP or specialist will provide. Many of our customers share their results with their GP to inform a wider clinical conversation.

Our method was developed as an alternative to the way the NHS tests urine infections.

The NHS normally relies on dip-stick tests which look at chemical changes in your urine or culturing tests where a lab will try to grow and identify bacteria in your sample. Dip-sticks often miss infections if the chemical changes are not the right type or big enough. Culturing tests, even extended culturing, are limited to growing specific types of bacteria so can miss entire families of microbes that require particular conditions to grow.

There are some commercial services that, like us, test for DNA from microbes. However, these typically use a process called PCR, sometimes combined with DNA sequencing, to look at a specific marker gene called the 16S rRNA gene. PCR tests can be sensitive but are prone to reporting contaminants. Most commercial tests are limited to looking for around 20 pre-defined species of bacteria.

Our test uses long sequences of microbial DNA taken directly from your sample with no need for PCR. Identifying all microbial species of bacteria and fungi AND accurately reporting their levels is crucial information for you and your healthcare provider. Complete data given in a clear format. That's what makes our test better than others.

Our test is capable of routinely identifying organisms present at only a thousand, or even hundred cells per mL for a urine test or per swab for a vaginal test.

This is about x100 to x1000 times more sensitive than the standard NHS culture tests.

I’m afraid not.

Our testing service is not currently accredited to work directly with the NHS so it cannot be run as an NHS diagnostic. We are working hard towards getting this to happen though.

In the meantime we provide a method for you to print and share your results with your GP who may, or may not, use the information to guide further tests or treatments at their own discretion.

A Tota test costs £299 for a urinary microbiome test, £299 for a vaginal microbiome test, or £449 for both a urinary and vaginal microbiome test. If you live in the UK shipping is included in the cost. If you live outside the UK, shipping is calculated at checkout.

Bladder and vaginal infections affect people regardless of age, race or social status and we are acutely aware that the cost of our testing system may be beyond the reach of many sufferers.

At Tota we try hard to make this powerful new technology available directly but ultimately new high-tech services such as these are expensive to run

We are constantly striving to provide this service for the least cost so we have set our price at a level where we can continue to operate.

Hopefully, over-time, the operating costs of our service will reduce and we can pass these savings on to customers.

We are also working hard to try to get to a position where our tests can be available within the NHS or through private health care providers but this process is likely to take a long time.

This test is suitable for anyone who is looking to find out the exact identity and quantity of every microbe in their urine, bladder or vaginal microbiomes.

The test may be particularly useful for those suffering from recurrent UTIs and Vaginal infections such as BV or Thrush.

The NHS and other diagnostic labs commonly rely on dip-stick tests or extended culturing to identify the organism causing infection. These methods often miss entire families of microbes.

Identifying all microbial species AND accurately reporting their levels is crucial information for healthcare providers.

Only when they see the full picture can they determine which organism might be causing an infection and administer the correct treatment. This is essential to get rid of that infection and to ensure that it does not return.

Yes men can test their urine microbiome. Our testing service works for male urine samples. If you have symptoms or recurrent symptoms of UTI you may want to consider testing and sending Tota a urine sample for analysis.

Yes - the vaginal and urinary microbiome tests are non-invasive and can be done during pregnancy. If you're concerned about a specific issue (e.g. recurrent UTI, BV, or fertility-related questions), we'd suggest taking the test when you're experiencing your concern and sharing the result with your obstetric team, who can use it alongside their clinical assessment.

Very much so. The vaginal microbiome changes significantly around and after menopause, often with reduced Lactobacillus and increased diversity that can predispose to discomfort, recurrent UTIs and atrophy-related symptoms. Many of our customers in this stage of life find the test particularly informative, especially if they're considering or already using vaginal oestrogen and probiotic pessary products — the test can help track the microbiome's response over time.

Yes. When you place the order, use your own details for billing and the recipient's details for shipping. If you'd like a gift message included, drop us a note when you order and we'll add it.
A few things worth knowing if you're buying for someone else: our test is most useful to the person taking it; we won't share results with anyone other than the person who registered the kit; and our refund policy applies to the original purchaser only, so any qualifying refund will go back to your card.

We currently check each sample for around 4,000 different species of bacteria, 300 types of yeast and 300 species of Archaea. A full list can be found in our 'Learn' section. All detected organisms are reported to species level — our report will never list unknown members of a particular bacterial family.

Yes - we test for both Ureaplasma and Mycoplasma.

We check all our samples for over 4,000 organisms including these species. The Tota test looks for every bacteria and fungi species present in your sample. We don't work from a pre-determined list of organisms like other tests do, that's what makes us special.

Some DNA-based testing labs offer advice based on the presence of known genes that can change the response of bacteria to antibiotics. We do screen for these genes, but currently do not report the results as they only represent a fraction of the genes that cause antibiotic resistance, so reporting them could be misleading.

While our sequencing technology can pick up many of the organisms that cause sexually transmitted infections - including bacteria such as Chlamydia, Gonorrhoea, Syphilis and the organisms behind some forms of urethritis or PID - we don't include STI findings on your report.

Yes. We can see over 300 types of yeast and fungi, many of which can cause Thrush. All yeast, moulds and fungi will be reported if present. Not all are equal and knowing which microorganisms are in your microbiome is key information for you and your healthcare provider to work towards an accurate diagnosis and appropriate treatment.

Any sample you submit will have some cells from your own body, which in turn will contain your DNA.

Our method works hard to remove your cells from the sample at the earliest stage of processing whilst leaving the microbial cells intact.

This means that the vast majority of DNA sequences we get back are from your microbiome, not from you.

We will never use our method to look at or analyse any of your personal DNA that may remain in the sample.

We are currently able to test urine or vaginal swabs samples.

We are always looking at other applications for our exciting new tech so please keep checking back for new services.

We have done experiments that suggest most bacteria are in the heavier material contained in the wee. This is most likely to be chunks of bacterial biofilms or sloughed skin cells from the bladder lining. Our process breaks open and degrades the skin cells to release any bacteria ready for testing.

Yes, it is quite common and perfectly natural to see bacteria and yeast in the vaginal microbiome appearing in the urine too. There seems to be a high degree of overlap in the vaginal and urine microbiomes of the same person. This science is still new and a greater understanding of this relationship will likely be useful to healthcare providers.

Different species of bacteria and yeast have different characteristics.

Some will exist floating freely but many of the bacteria known to cause UTIs use a type of 'glue' they produce to attach themselves to the cells lining your bladder. This glue can also be used to stick the bacteria to each other and encase themselves in larger protective capsules called biofilms.

Other bacteria are known to invade, live and grow within the bladder lining itself.

These methods allow bacteria to thrive inside the highly challenging environment of the urinary tract where there is a constant risk of being flushed out.

Our lab is open and processes samples Monday to Friday. If you have a query, our team is available 8:00am to 4:30pm from Monday to Friday, excluding bank holidays.

Yes, but only viruses that use DNA as their instruction manual. Most of these viruses only infect bacteria. Yes, unbelievably bacteria catch colds too ! Hence, not only can we can find bacteria that might be causing symptoms, we can also see what bacterial viruses, or bacteriophages, might be infecting them in turn.

Many viruses that cause serious human health issues, such as HIV and Coronavirus, are RNA based and we cannot currently detect these. However, we can detect some human viruses such as Epstein-Barr virus that commonly cause glandular fever.

We do not currently provide an antibiotic sensitivity testing. This is something we hope to provide in the future.

Antibiotic sensitivity testing typically is much slower than our DNA based profiling, as culturing and testing can take many days. For this reason, we prefer to use our current database to supply instant advice that should be relevant in most cases.