Urine Collection - labsstudies

Urine Collection

Urine Collection

Urine collection refer to the process of collecting urine on it is container. This process take place in pre analytical phases.

In this article you will learn:

  • Introduction of Urine
  • Procedure for Urine Collection for Routine Examination
  • Procedure for Collecting Midstream Urine
  • Procedure for collecting terminal urine Specimen
  • Instruct patients to collect urine for routine analysis and culture

Introduction

  • Urine is formed and excreted by the kidneys.
  • The production and composition of urine depends on the glomerular filtration, tubular selective reabsorption and tubular secretion.
  • A urine sample is easily collected and will provide useful information about the metabolism status, kidney function and the urinary tract state.
  • A specimen can be examined macroscopically, chemically and microscopically to detect kidney and liver diseases, infections, glucose, protein, cells and the presence of micro-organisms.

Type of Urine Specimen

  • First urine (routine urine)
  • Midstream urine
  • Terminal urine

First urine

  • A first morning urine sample is used for detection of urinary tract infection especially Mycobacterium.

Midstream urine

  • Is used for microscopy and culture to investigate bacterial infection of the Urinary tract.

Terminal urine

  • A terminal urine sample is used to demonstrate ova of Schistosoma haematobium.
  • For routine examination urine is collected in a clean leak-proof container.
  • For culture purposes midstream urine is collected in a sterile leak proof container.

Mid-stream urine is the portion of urine that does not contain the first and last portions of the sample.

 

Procedure for Urine Collection for Routine Examination

  • Provide the patient with a clean container.
  • Instruct the patient to collect about 20 ml of urine directly into the clean container.
  • Receive the specimen from the patient. Adhere to infection prevention and control standards.
  • Secure the lid of the container immediately.
  • Label container with patients name, age and address and send to the laboratory for investigation with a filled in request form to perform the test.

 

Procedure for Collecting Midstream Urine Specimen

  • Provide the patient with a clean container.
  • Instruct the patient to collect urine specimen in the following steps:
  • Wash genital area.
  • Begin to urinate without collecting urine.
  • After a few ml have passed, collect urine in container (10-20 ml if possible)
  • Finish urinating without collecting.
  • Cover the container with its lid and send it to the clinician.

 

  • Procedure for collecting terminal urine Specimen
    Provide the patient with a clean container and tell the patient to.
  • Void most of the urine into toilet.
  • Collect last portion of urine to the container.
  • Secure the lid of container immediately.
  • Receive the specimen from the patient. Adhere to IPC.
  • Label the container with patients name, age and address and send to the laboratory for investigation with a filled in request form.
  • Tests on urine specimens should be performed within one hour to prevent the specimen from being contaminated due to bacterial growth.

Examination of urine sample

  • In this part , I explain more in Macroscopic examination is performed by reporting the physical appearance of a specimen and it is very involve when you need to collect Urine sample.
  • This report can include features like color, transparency and smell.
  • Normal urine appears yellow and clear with a characteristic aromatic smell.
  • Some changes in the physical appearance can indicate a disease.
  • Color changes in urine can also be caused by some foods or drugs.

Macroscopic appearance of urine

Urine Collection

  • Cloudy- Urinary tract infection (UTI)
  • Red and Cloudy-UTI, Schistosomiasis.
  • Brown and cloudy- Black water fever.
  • Silvery shine or milky- Pus, bacteria or epithelial cells.
  • Black- Certain poison e.g. phenol.
  • Colorless- Normal.
  • Yellow/green/brown- Liver disease, viral hepatitis, jaundice. Color due to presence of bile or urobilinogen.
  • Milky white- Bancroftion Filiraiasis.

 

PH of Urine

  • The normal PH of urine is slightly acidic (PH 5.5 – 6.5).
  • Alkaline urine usually indicates the presence of bacteria in the urine and other metabolic disorders.
  • Urine that has been left standing for many hours after collection can also turn to alkaline. PH because of bacterial activity or evaporation of acidic substances in the urine.
  • Strong acid urine is usually due to metabolic disorders of the body.

PH Testing of Urine

  • To test for the PH of urine use blue or red litmus paper or solution.

Interpretation of Results

  • Blue litmus turns red means the urine PH is Acid.
  • Red litmus turns blue means the urine PH is Alkaline.
  • Blue and red litmus that do not change their colors means the urine PH is alkaline.

 

Specific Gravity of Urine (SG)
  • The specific gravity of a liquid is the density of that liquid compared to that of distilled water which is one.
  • The normal specific gravity of the urine ranges between 1.015 – 1.025.
  • Low SG indicates problems in tubular selective secretion in the kidneys while high SG indicates the presence of abnormal substances in the urine e.g. glucose.
  • Testing SG of Urine; To test the SG of urine, use either a densitometer or a dipstick, which will give the value of SG directly.
  •  Osmolarity is more accurate measure of urine Concentration. 

Note: Parasites and Bacteria in Urine are:

  1. Schistosoma haematobium.
  2.   Trichomonas vaginalis trophozoite.
  3. Occasionally Schistosoma mansoni.

A variety of bacteria may also be associated with urinary tract infections.

 

References

  • Carter J, Lema.O. (1994) Practical laboratory manual for health centres in Eastern Africa. AMREF.
  • Cheesbrough M. (1998). District Laboratory Practice in Tropical Countries. Part 1. Tropical Health Technology, Gapson Papers Ltd, NOIDA, India.
  • Cheesbrough M. (2000). District Laboratory Practice in Tropical Countries. Part 2. Tropical Health Technology, Cambridge University Press UK.
  • Cheesbrough M. (1987). Medical Laboratory Manual for Tropical Countries. Volume 1 2nd Ed. ELBS Butterworth, Heinemann Ltd, Oxford.

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