Introduction to Urinalysis

• Random/ Occasional/Single - routine and qualitative urinalysis
• Thomas Addis - examination of urine sediment
• Hippocrates - first documented the importance of sputum examination
• First Morning - Ideal specimen for Routine urinalysis and Pregnancy testing (hCG)
• Second Morning/ Fasting - 2nd voided urine after a period of fasting (for glucose determination)
• 2-hour post-prandial - for diabetic screening or monitoring (preferred for testing glucose)
• Midstream Clean-Catch - for routine screening and bacterial culture of urine (sterile)
• Catheterized - urethral, bacterial culture (sterile)
• Suprapubic Aspiration - abdominal wall is punctured and urine is directly aspirated from the bladder (sterile)
• Three-Glass technique - for prostatic infection

  • first portion is voided urine
  • middle portion of voided urine (control) for bladder and kidney infection
  • urine after prostatic massage
• Prostatitis - if the no. of WBC and bacteria in the 3rd specimen is 10x GREATER than that of the 1st specimen
• Stamey-Meares Test for Prostatitis - FOUR-glass method

  • Initial Voided Urine (VB1)
  • Midstream Urine (VB2)
  • Expressed Prostatic Secretions (EPS)
  • Post-Prostatic Massage Urine Specimen (VB3)
• VB1 test - urethral infection or inflammation
• VB2 test for URINARY BLADDER INFECTION
• 12-hour for ADDIS COUNT
• 4-hour/1st Morning - for NITRITE determination
• Urine remains in Bladder for at least 4 HOURS before voiding
• AFTERNOON (2-4pm) - for UROBILINOGEN determination (diurnal variation)
• Chain of Custody (COC) - process providing documentation of proper sample ID from the TIME of Collection to the receipt of laboratory results
• Required Urine Volume: 30-45mL
• Container Capacity: 60mL
• Urine Temperature: 32.5-37.7C

  *if out of range, record temperature and CONTACT SUPERVISOR immediately
• Blueing agent (dye) - added to the toilet water reservoir to PREVENT Specimen ADULTERATION