II. Methods
- Multiple reagent test strip or automated machine
- Urine Microscopic Exam
III. Technique: Urine Collection
- See Clean Catch Urine Collection
- Refrigerate urine sample if prompt testing is not available
- Obtain "dirty urine" first if testing for Sexually Transmitted Infection
- See STD Screening
- First-Stream Urine without Urethral Cleansing ("Dirty Urine")
- Preferred sample in men and women (equivalent to endocervical, vaginal or Urethral swabs)
IV. Labs: Urine Dipstick or Automated Machine Findings
- Background
- Read dipstick after 60-120 seconds of contact with urine
- Urine Leukocyte Esterase dipstick is most time sensitive
- Urine Nitrite dipstick will discolor if left in open air, unpackaged (False Positive)
- General Tests
- Kidney and Urinary Tract Disease Tests
- Urinary Tract Infection Tests
- Metabolic Disease Tests
V. Labs: Urine Microscopic Exam
- Collection
- First morning sample
- Midstream, clean catch collection
- Minimum volume of 3 ml (1 ml for children)
- Analyze within 1-2 hours or refrigerate
- Preparation of spun urine for microscopy
- Start with 10 ml of midstream urine
- Centrifuge for approximately 10 minutes (typically at near 2000 rpm)
- Discard supernatant
- Suspend sediment in 0.3 ml saline or supernatant
- Examine under microscopy at 400x (oil immersion) magnification
- Review at least 10-20 microscopic fields
- Findings (based on spun urine)
- Urine Red Blood Cells
- Microscopic Hematuria if 3 RBC/hpf or higher
- Urine White Blood Cells
- Urine squamous epithelial cells
- Suggests vaginal contaminant if >5 squamous epithelial cells/hpf
- Urine Bacteria
- Urine Red Blood Cells
- Advanced Method findings
- Urine Casts (Phase Contrast Microscope)
- Urine Crystals (Urine Crystals)