Collection
A midstream urine specimen should be collected in a clean container. The container does not have
to be sterile. Discarding the first 200 mL of early morning voided urine is recommended. Women
should clean the external genitalia (cleansing front to back) before voiding to avoid contamination
with secretions. These directions help ensure a "clean catch" specimen.
No special preparations before collection are necessary, medications and treatments need not be
stopped prior to collection
For accurate results, the urine specimen must be analyzed within 30-60 minutes after the patient
voids. Analysis of the urine specimen can be divided into 3 parts.
First, a gross visual inspection of the urine determines color and clarity/turbidity.
Second, the urine specimen undergoes chemical analysis by urine dipstick. This is typically
performed on the uncentrifuged urine specimen; however, it can also be performed after
centrifugation on the supernatant (after centrifugation, it is poured into a separate test tube for
analysis). Reagent test strips are dipped into the urine, compared with controls, and then analyzed
to determine urine pH, specific gravity, blood, protein, glucose, ketones, nitrites, leukocyte esterase,
bilirubin, and urobilirubin
Third, the urine should undergo microscopic evaluation. If it was not already done, the urine is
centrifuged at 3000 rpm for 3-5 minutes and the supernatant is poured off. The remaining pellet is
resuspended and a small amount of the sediment is poured onto the microscope slide. The urine
sediment is then examined under the microscope for elements such as cells, casts, crystals,
bacteria, and yeast. These elements from the urine sediment are typically reported as the number
observed per high- or low-power field
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