The urine sample will be sent to a Lab. to see if it 'grows' any bugs which will be killed by antibiotics. If they grown something that isn't going to be treatable, that's a worry. Suitable anbitiobics deal with bugs - ABs do ease symptoms of VA along with over the counter pain relief and can be changed to appropriate ABs if there is a bug, however, more and more bugs are becoming resistant to ABs ............ which means that in a few years we will all be in danger because none of the bugs will be killed.
So it's a thin line as to appropriate treatment and it is a worry to me that the urogynaecologist can't be more positive and make positive suggestions about appropriate treatments. If a urine sample doesn't grow a bug then there isn't likely to be a necessity for ABs.
Sometimes I need to use
Ovestin more often along with over the counter pain relief. So if I get niggling symptoms I do a 3 night 'load' then back to every 3rd and every 6th night. I also find if my bowel is full that symptoms return

Because
Vagifem is a much lower dose than originally [10 instead of 25], many find that they need nightly applications in order to keep symptoms away, plus 'yes' or 'sylc' products. We have a thread about bladder problems: sorry can't remember the title

but it might be helpful with more advice.