II. Methods

  1. Multiple reagent test strip or automated machine
  2. Urine Microscopic Exam

III. Technique: Urine Collection

  1. See Clean Catch Urine Collection
  2. Refrigerate urine sample if prompt testing is not available
  3. Obtain "dirty urine" first if testing for Sexually Transmitted Infection
    1. See STD Screening
    2. First-Stream Urine without Urethral Cleansing ("Dirty Urine")
    3. Preferred sample in men and women (equivalent to endocervical, vaginal or Urethral swabs)

IV. Labs: Urine Dipstick or Automated Machine Findings

  1. Background
    1. Read dipstick after 60-120 seconds of contact with urine
    2. Urine Leukocyte Esterase dipstick is most time sensitive
    3. Urine Nitrite dipstick will discolor if left in open air, unpackaged (False Positive)
  2. General Tests
    1. Urine Appearance (Urine Color)
    2. Urine Odor
    3. Urine Specific Gravity
    4. Urine pH
  3. Kidney and Urinary Tract Disease Tests
    1. Urine Protein
    2. Urine Blood
      1. Gross Hematuria
      2. Microscopic Hematuria
  4. Urinary Tract Infection Tests
    1. Urine Leukocyte Esterase
    2. Urine Nitrite
  5. Metabolic Disease Tests
    1. Urine Glucose
    2. Urine Ketones
    3. Urine Bilirubin
    4. Urine Urobilinogen

V. Labs: Urine Microscopic Exam

  1. Collection
    1. First morning sample
    2. Midstream, clean catch collection
    3. Minimum volume of 3 ml (1 ml for children)
    4. Analyze within 1-2 hours or refrigerate
  2. Preparation of spun urine for microscopy
    1. Start with 10 ml of midstream urine
    2. Centrifuge for approximately 10 minutes (typically at near 2000 rpm)
      1. Discard supernatant
      2. Suspend sediment in 0.3 ml saline or supernatant
    3. Examine under microscopy at 400x (oil immersion) magnification
      1. Review at least 10-20 microscopic fields
  3. Findings (based on spun urine)
    1. Urine Red Blood Cells
      1. Microscopic Hematuria if 3 RBC/hpf or higher
    2. Urine White Blood Cells
    3. Urine squamous epithelial cells
      1. Suggests vaginal contaminant if >5 squamous epithelial cells/hpf
    4. Urine Bacteria
  4. Advanced Method findings
    1. Urine Casts (Phase Contrast Microscope)
    2. Urine Crystals (Urine Crystals)

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Related Studies

Ontology: Urinalysis (C0042014)

Definition (NCI_NCI-GLOSS) A test that determines the content of the urine.
Definition (NCI) Laboratory analysis of urine, commonly used to aid in the diagnosis of disease or to detect the presence of a specific substance. It involves examination of the urine by physical or chemical means as well as microscopic examination that helps to screen for urinary tract infections, renal disease, and diseases of other organs, that result in abnormal metabolites (break-down products) appearing in the urine.
Definition (CSP) physical, chemical or microscopic analysis or examination of urine.
Definition (MSH) Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically.
Concepts Laboratory Procedure (T059)
MSH D016482
SnomedCT 269878006, 167229001, 144455000, 167589003, 269966008, 144466007, 144814007, 167218000, 144454001, 142760004, 27171005, 167217005
CPT 81005, 81099, 1011229, 1011223
LNC LP32744-2, LP7851-1, MTHU008386, MTHU000144
English Urinalyses, Urinalysis, Urine exam. - general, Urine exam. - general NOS, Urine test NOS, urinalysis (lab test), urinalysis, urine tests, urine tests (lab test), U/A (urinalysis), Urine analysis, UA, urinalyses, urine test procedure, general urine exam, testing urine, testings urine, analysis urine, examination urine, tests urine, Test;urine, urine analysis, urine examination, procedures test urine, tested urine, test urine, Urinalysis - general, Urine examination - general (procedure), Urine test NOS (procedure), Urine test, Urine examination - general NOS (procedure), Urine exam. - general NOS (procedure), Urine examination - general, Urine examination - general NOS, Analysis of urine, Urinalysis studies, Urinalysis Procedures, Urine--Analysis, Urine examination, Urinalysis (procedure), Urinalysis procedure, Urine examination (procedure), Urinalysis, NOS, Urinalysis procedure, NOS, urine test
Italian Esame delle urine, Esame dell'urina
Spanish Analítica de orina, examen de orina - general, SAI, análisis de orina - general, SAI, prueba de orina, SAI (procedimiento), análisis de orina - general, SAI (procedimiento), Urine exam. - general NOS, examen urinario - general, SAI, Urine test NOS, prueba de orina, SAI, examen de orina - general, examen de orina - general (procedimiento), análisis de orina (procedimiento), análisis de orina, examen de orina (procedimiento), examen de orina, procedimiento de análisis de orina, Análisis de orina, Urinálisis
Japanese 尿検査, 検尿, ケンニョウ, ニョウケンサ
Swedish Urinprov
Finnish Virtsatutkimukset
French Analyse urinaire, Analyse d'urine, Analyse des urines
Russian URINALIZIS, УРИНАЛИЗИС
Czech Vyšetření moči, Analýza moči, moč - biochemie, vyšetření moči, chemické vyšetření moči, biochemie moči, moč - analýza, analýza moči
Polish Analiza moczu
Hungarian Vizelet elemzés, Vizeletvizsgálat
Croatian URINALIZA
Norwegian Urinprøve, Urinanalyse
Portuguese Análise de urina, Urinálise
Dutch urineanalyse, Analyse, urine-, Urine-analyse
German Harnanalyse, Urinanalyse, Urinuntersuchung, Harnuntersuchung

Ontology: Urine dipstick test (C0430370)

Concepts Laboratory Procedure (T059)
SnomedCT 144463004, 252383007, 167226008
English dipstick testing urine, urine dipstick test, dipstick urine test, urinalysis by dipstick, urinalysis by dipstick (lab test), Urine dipstick test, Urine dipstick test (procedure)
Spanish prueba de tira reactiva para orina (procedimiento), prueba de tira reactiva para orina