Urinalysis (cont.)
Siamak T. Nabili, MD, MPH
Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is a urinalysis?
- What can urinalysis results show?
- Who is involved in the interpretation of urinalysis?
- What does urinalysis involve?
- What is macroscopic urinalysis?
- What is urine dipstick chemical analysis?
- What are the pros and cons of dip sticks?
- What is microscopic urinalysis?
- How is microscopic urinalysis done?
- What kind of cells can be detected?
- What can the presence of red blood cells in the urine mean?
- What can the presence of white blood cells in the urine mean?
- Other than urinalysis, what are other common urine tests available?
Who is involved in the interpretation of urinalysis?
Interpretation of urinalysis is generally based on reviewing all the components of the test and correlating it with the clinical signs and symptoms of the patient and the physical examination. The results are reviewed and interpreted by the doctor who ordered the test.
What does urinalysis involve?
Urinalysis is done by collecting a urine sample from a patient. The optimal sample tends to be an early morning urine sample because it is frequently the most concentrated urine produced in the day. Typically, no fasting is required before the collection of urine sample and routine medications can be taken before the test, unless otherwise instructed by the ordering physician.
Methods of collection are slightly different for female and male patient.
- For females, the patient is asked to clean the area around the
urethra with a special cleansing wipe, by spreading the
labia of the external genitals and cleaning from front to back (toward the
anus).
- For men, the tip of the penis may be wiped with a cleansing pad prior to collection.
- The urine is then collected in a clean urine specimen cup while the patient is urinating. It is best to avoid collecting the initial stream of urine. After the initial part of urine is disposed of in the toilet, then the urine is collected in the urine container provided. Once about 30 to 60 ml (roughly 3 to 5 tablespoons) are collected in the container for testing, the remainder of the urine may be voided in the toilet again. This is called the clean catch or the midstream urine collection.
The collected urine sample should be taken to the laboratory for analysis, typically within one hour of collection. If transportation to the lab could take more than one hour, then the sample may be refrigerated.
In some patients who are unable to void spontaneously or those who are not able to follow instructions other methods may be used, such as placing a catheter (a small rubber tube) through the outside opening to the bladder (urethra) to collect the sample directly from the bladder.
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