Tota: At-Home Urinary And Vaginal Microbiome Testing In The UK
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Can learning about your urinary microbiome help explain why your UTIs keep coming back?
If there’s one thing we’ve learned from our community, it’s that people living with recurrent or chronic UTIs are rarely short of symptoms and almost always short of answers. Test after test comes back negative, and you’re told everything is normal when you know it isn’t.
As we’ve covered before, there are several limitations of standard UTI testing. The gold standard urine culture was designed in the 1950s and is only able to grow a specific set of organisms. This means the vast majority of organisms living in the urinary tract are invisible to a standard test, whether or not they’re contributing to your symptoms.
UTI testing methods have improved over the years, and they keep evolving as researchers learn more about the urinary microbiome. The newest technologies can take years to reach mainstream healthcare, which means the test you’re offered often isn’t always the most comprehensive one available. In some cases, more advanced options can be ordered directly and used privately at home.
Tota is one option. They provide a UK at-home test that uses DNA sequencing to read all bacteria and fungi in your urine sample or vaginal swab. Rather than looking for a shortlist of usual suspects, the organisms are named at species level and are fully quantified.
Who Is Tota (And What Happened To Digital Microbiology)?
Is Tota the same company as Digital Microbiology?
Yes. Digital Microbiology became Tota in July 2026. It’s the same lab, the same team and the same ever-evolving test, with a new name. If you’ve come across Digital Microbiology while researching UTI testing options, or you ordered from them in the past, that’s the test now sold as Tota.
Tota emerged from Systems Biology Laboratory UK, a non-profit lab with 15 years of cancer immunotherapy and chronic fatigue syndrome research behind it. The team was inspired to build something better when family members suffered recurrent UTIs and reported frustration at receiving repeated negative UTI test results along with conflicting diagnoses and treatments. They turned their research towards using DNA sequencing technology to uncover the urinary and vaginal microbiomes.
Tota’s technology exists to report comprehensive urinary and vaginal microbiome profiles and their team wants to make it available directly to the people who need it. Find out more about Tota’s workflow in BMC Urology.
Tota is a family business, built for two women living with recurrent UTIs whose lives changed for the better once they understood what was going on in their own bodies. Read their stories.
“We firmly believe that clinicians can only properly understand and treat urogenital conditions by tracking every organism present in sample microbiomes along with accurate levels for each. Currently, clinicians are trying to make sense of a complex world using only the restricted keyhole view that most current culture and DNA-based tests offer. Healthcare professionals, researchers and sufferers all desperately need a better testing tool, and we think we’ve finally developed it.”
What Tests Does Tota Offer And What Do They Cost?
| Test | Sample | What it reads | Who it’s for | Results | Price |
| Urine Microbiome Test | Urine, collected at home | All bacteria and fungi in your urinary microbiome, species level, fully quantified in cells per mL | If recurrent UTIs or ongoing bladder symptoms are part of your life | 2 to 5 days from delivery of sample to lab | £299 |
| Vaginal Microbiome Test | Vaginal swab, collected at home | All bacteria and fungi in your vaginal microbiome, species level, quantified in cells per swab | If recurring thrush, BV or vaginal symptoms are part of your life, or you’re thinking about conceiving | 2 to 5 days from delivery of sample to lab | £299 |
| Vaginal and Urine Microbiome Test | Urine and vaginal swab, collected at home | Both microbiomes, presented together in one report | If bladder and vaginal symptoms come as a pair, or you want the fullest picture of both | 2 to 5 days from delivery of sample to lab | £449 |
How To Order A Tota Test
Test kits can be ordered directly from Tota’s website.
- Choose your test at www.tota.bio. No clinician signature needed.
- Your kit arrives within 1 to 2 working days if you order before 4pm Monday to Friday. The packaging is plain and discreet, with no scientific or medical branding visible.
- Register your kit by scanning the QR code in the box, or through your Tota website account.
- Collect your sample at home, following the instructions in the kit and the guidance above.
- Post it back to the lab in Oxfordshire. Tracked return postage is included.
- Results in 2 to 5 days from sample delivery at lab, in your secure account.
- Share the report with your doctor or other healthcare professional and decide together what it means for you.
The Science Behind Tota’s Microbiome Testing
What is metagenomic sequencing?
Metagenomic sequencing examines the full genetic material in a sample rather than looking for a shortlist of suspected organisms. Tota uses third-generation sequencing, the most recent technology available for non-targeted DNA sequencing, on long sequences of microbial DNA taken directly from your sample.
Your own cells are removed at the earliest stage of processing, so the method never analyses your personal DNA. What’s left is the microbial DNA, which is matched against Tota’s reference database and reported at species level, with a quantity attached to each organism.
Their database consists of 4,100+ different bacterial species, 300+ yeasts, almost 200 archaea (single-cell organisms), 11,000+ bacteriophages, and 21,000+ plasmids.
How is Tota different from other at-home microbiome tests?
Most consumer microbiome tests look for a limited list of organisms chosen in advance. Tota’s approach is non-targeted, so it examines all the bacteria and fungi in your sample, and tells you how much of each was there rather than just whether it was present.
Every kit is valid for six months from the date of purchase, so you don’t have to use the test immediately.
Who reviews your results?
Every report is reviewed by two scientists before it’s released. You’ll get an email when your results are ready, and you can view them in Tota’s secure online portal.
Watch our video interview with Dr. Nick Parkinson on DNA-based testing.
When UTIs Keep Coming Back: What A Urinary Microbiome Investigation Shows You
A urinary microbiome test gives you a full breakdown of which organisms are present in your urine sample and at what levels. You can read about each organism, what scientific research says about it, and whether it is a known pathogen associated with UTIs. It gives you more information to share with your doctor.
What if your urine culture is negative but you still have symptoms?
If you’ve had repeated negative tests but you’re still experiencing symptoms, or you simply feel that something still isn’t right, understanding your urinary microbiome could be a useful next step.
An imbalance in your urinary microbiome may be associated with symptoms even when nothing conventional shows up. Or you may see organisms present at levels that wouldn’t show up as a positive result in other tests. These insights can be useful for your doctor, who can then decide how to approach any treatment.
What is a polymicrobial infection?
A polymicrobial infection involves more than one organism, rather than a single culprit. Many questions remain in the understanding of polymicrobial UTI, and it is not yet fully understood across the medical profession. A test that examines everything present and quantifies it gives you a picture of the whole microbial community and may help your doctor identify the presence of a polymicrobial infection.
You might consider testing if…
- UTIs keep coming back after treatment
- You’ve had symptoms without clear answers
- You’ve been told everything is normal, but you don’t feel it
- Bladder symptoms come alongside recurring thrush or BV
- Symptoms flare around your cycle, sex, or menopause
- You want a baseline before starting a fertility journey
Why Your Vaginal Microbiome Matters If You Get UTIs
Two major advancements in women’s health research have provided insights that have changed the way we see UTI testing. In 2014, it was established that urine isn’t sterile and that the bladder has a microbiome of its own. Since then, it’s become clear that the urinary and vaginal microbiomes are interconnected, and a disruption in the vaginal microbiome can be associated with recurrent or chronic UTIs.
Because the two microbiomes affect each other, one sample may only show you half the story. Testing both the urinary and vaginal microbiomes at the same time provides a more complete picture.
The Vaginal Microbiome And Fertility
It’s important to state up front that Tota doesn’t assess fertility. However, a vaginal microbiome test may be an important part of a fertility journey. Scientific research is increasingly focused on vaginal microbiome composition and its association with positive fertility and pregnancy outcomes.
How are the vaginal microbiome and fertility linked?
So far, research has focused on Lactobacillus-dominant vaginal microbiomes and their association with successful implantation and IVF outcomes. A consistent pattern has emerged, although the evidence is still evolving: women whose microbiomes are dominated by Lactobacillus bacteria tend to have better reproductive outcomes than women with less protective profiles.
Researchers have several theories about why this link exists. Three of the strongest are:
- Protecting the reproductive tract. Lactobacillus bacteria produce lactic acid, which keeps the vagina slightly acidic. That makes it harder for harmful bacteria to take hold or travel further into the reproductive tract. Researchers think this may help create a healthier environment for conception.
- Creating better conditions for sperm. For pregnancy to happen, sperm need to survive the journey to the egg. The vaginal environment needs to strike a careful balance: acidic enough to keep harmful bacteria under control, but still able to support sperm as they continue their journey towards the egg.
- Reducing the risk of imbalances like bacterial vaginosis (BV). When Lactobacillus becomes less dominant, other bacteria take over. This is called vaginal dysbiosis, and its most common form is bacterial vaginosis, or BV. Because BV has been linked to poorer reproductive outcomes, researchers are investigating whether preventing these imbalances could also support fertility.
When should you test during a fertility journey?
There are three points during a fertility journey where people tend to find it useful to test.
- At the start, when you want to establish a baseline
- After you’ve been trying for a while and you’re looking for parts of the picture nobody has examined so far
- Before or during IVF, when you’re doing everything you can to achieve a healthy and successful pregnancy, and the vaginal microbiome hasn’t been looked at
Speak to your fertility clinic or healthcare professional to discuss how a vaginal microbiome test might fit into your care, and whether they will look at your results with you.
You can read more about the link between the vaginal microbiome and fertility or about fertility readiness on Tota’s blog.
What about UTIs in pregnancy?
Tota’s tests are non-invasive and can be used during pregnancy. Being able to capture a healthy image of your vaginal and urinary microbiome and keeping tabs on them throughout your pregnancy could help mitigate the chances of a UTI and, if necessary, offer appropriate treatment options.
How To Collect Your Tota Sample
Your kit comes with full instructions, but here are the questions we get most often.
When is the best time to collect a urine sample?
First thing in the morning. Tota prefers the first wee of the day because it contains an overnight build-up of sloughed skin cells and bacteria, which is where a lot of the bacteria are. Unlike some testing systems that ask for a mid-stream sample, Tota requests that the first part of the stream be included.
Use the intimate wipe in the kit to clean carefully around the urethra first, and the pop-up cardboard collection container to catch the sample before pouring it into the sample shipping tube.
Can you collect a vaginal swab during your period?
It’s not ideal to collect a vaginal swab during menstruation. If possible, it’s best to wait until bleeding has stopped and ideally about a week afterwards. Small amounts of blood on the swab aren’t a problem, but heavy menstrual flow is best avoided.
What if you’re taking antibiotics, Hiprex or D-mannose?
Antibiotics and some supplements can affect your results by suppressing bacterial levels, so the answer depends on what you want to see. If you want a picture of what’s there while you’re symptomatic, test when your symptoms are at their worst. If you want to see where your microbiome has settled after treatment, wait around seven days after your final dose.
Don’t change or stop prescribed treatment in order to take a test, and speak to your doctor if you’re unsure about timing.
What about vaginal creams, pessaries or probiotics?
Wait one to two days after your last application of a topical cream or pessary. For vaginal probiotics, we recommend waiting at least 3 days. Oral probiotics don’t usually need to be stopped, as they don’t significantly affect the vaginal or urinary microbiome.
Wait one to two days after penetrative sex before swabbing. Semen has its own microbiome, and barrier lubricants can temporarily affect the vaginal flora.
What if something goes wrong with your sample?
Don’t post it. If you spill the sample, break the swab, swab the wrong area or make any other mistake, email [email protected] with your order number, and Tota will send a replacement kit free of charge.
What Your Tota Results Look Like
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You can view a Tota sample report to see how your results will appear within your own secure portal. You can access the secure portal by creating an account at the time of purchase or when you receive your first test kit.
Your results arrive in this secure personal account. You can choose whether to share them with your doctor either via the platform or by downloading your report. Your secure account allows you to:
- Review a report from each test you’ve completed, outlining which organisms were found in your sample above the reporting threshold by default, with the option to see everything below the threshold too.
- Read a plain-language description of each organism identified in your sample, what’s known about it from published research, including whether it’s commonly commensal.
- Test again later and compare your results over time in the portal, so you can see how your microbiome changes.
- Download your reports to take to your primary doctor or specialist.
How long do Tota results take?
Tota test results arrive 2 to 5 days after the lab receives your sample, depending on the day it arrives and the lab’s workload. The lab processes samples Monday to Friday, so a sample posted late in the week will be processed on the next working day. Preservatives in the sample tubes mean that this isn’t an issue for testing accuracy, but posting on a Monday will get you an answer sooner.
What if nothing shows up in your results?
This can happen, and it doesn’t mean nothing is going on. A very dilute sample, ongoing suppressive treatment, or a very new infection can all mean levels are too low to detect. No testing system is completely bulletproof, and Tota is clear that any system can miss something. It’s worth discussing an unexpected result with your clinician or reaching out to Tota rather than treating it as a final answer.
Can you share your results with your doctor?
Yes, you can download your full report as a PDF from your dashboard and take it to any appointment.
With the full picture of what’s in your sample, you and your clinician can see how the state of your urinary or vaginal microbiome may be contributing to your symptoms and decide together what it means for you.
Tota is a laboratory test provided for information and education. It is not a substitute for medical care and is not intended to diagnose any condition. If you have symptoms or health concerns, speak to your doctor or other healthcare professional.
Tota FAQs
How much does a Tota test cost?
- Urine Microbiome Test, £299
- Vaginal Microbiome Test, £299
- Vaginal and Urine Microbiome Test, £449
UK postage is included in all three.Â
Where does Tota ship to?
The UK, EU countries, Canada, Norway, Switzerland and Liechtenstein. International orders go by FedEx International Priority with a shipping supplement added at checkout and return postage is pre-paid.Â
Do you need a doctor’s signature to order?
No. You order directly from Tota and no clinician signature is required.
Is Tota available on the NHS?
Not at the moment. Tota isn’t currently accredited to work directly with the NHS, so the test can’t be run as an NHS test. Tota is pursuing that pathway.
For clinicians
Can men take the test?
Yes. Men can test their urine microbiome.
Do you test for Ureaplasma and Mycoplasma?
Yes, both are included.
Does the test look at your own DNA?
No. Your cells are removed at the earliest stage of processing, and Tota never analyses your personal DNA.
Can someone else buy a kit for you?
Yes. Use your details for billing and the recipient’s for shipping. Results are only shared with the person who registered the kit.
Can you register a kit under a pseudonym?
Yes, as long as you use it consistently across any further test orders. This allows us to always provide your results in the same place so you can compare them.
How often should you retest?
Tota recommends every 4 to 8 weeks if you’re tracking changes alongside symptoms or every 3 to 6 months for a periodic check.
How long is a kit valid for?
Six months from the date of purchase.
Can you get a refund?
Before dispatch, yes. After dispatch but before you’ve sent your sample, you can get a refund minus a £20 fulfilment fee per kit, within 14 days. Once your sample has been sent, no. Damaged kits are replaced free within 30 days.
This article was written in collaboration with Tota. Clinicians or patients seeking information are encouraged to visit the Tota FAQ page, and those wishing to make contact can do so via the contact form.
