Collection And Preservation Of Urine Specimen

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METHODS OF URINE COLLECTION

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-Bottle method-Gauze-pad method-Catheterization-SPA-Mid-stream catch method/ Clean catch method

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TYPES OF URINE SPECIMEN

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-Random -Cytology studies-FAS-Timed

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Urine specimen must be evaluated in terms of its _________________ before performing any examination.

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acceptability and integrity

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is essential to prevent microbiologic decomposition and inherent chemical changes.

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Preservation of Urine Specimen

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When a specimen is to be transported over a long distance and refrigeration is impossible, ______________________ may be added.

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chemical preservatives

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glass, plastic wide mouth container

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Bottle method

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use for infants

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Gauze-pad method

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catheter is inserted in the urethra & urine is obtained from the bladder.

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Urethral catheter

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urine may be collected by external introduction of needle through the abdomen into the bladder.

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SPA (Suprapubic Aspiration)

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Because the bladder is sterile under normal conditions, SPA provides a sample for

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Bacterial culture

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Can be used for cytologic examination. It involves putting a needle through the skin just above the pubic bone into the bladder.

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SPA

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It is typically used as a method to collect urine in children less than 2 years of age who is not yet toilet trained in an effort to diagnose a urinary tract infection.

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SPA

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Collecting urine in the middle part of urination. Free from contamination.

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Mid-stream catch method/ Clean catch method

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Urine collected at any timeUSES: Routine screening

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Ramdom

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with prior hydrationYou may need to hold your first morning urine in your bladder for a few hours prior to a cystoscopy.

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Cytology studies

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First urine voided after sleep (= 6 to 8 hours). Most concentrated urine.

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FIRST MORNING/FIRST AVAILABLE SPECIMEN (FAS)

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USES: Routine screening; good recovery of cells and casts to confirm postural or orthostatic proteinuria

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FIRST MORNING/FIRST AVAILABLE SPECIMEN (FAS)

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Collect all urine during a specific timed interval.

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TIMED

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USES: Quantitative chemical analysis, Clearance tests, Cytology studies, Evaluation of fistula

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Timed

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Will prevent bacterial growth, instability of urinary solutes, and degradation of organized sediments.

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Preservation

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_________is converted to ammonium carbonate (alkaline fermentation) by _________splitting organisms, thus urine becomes alkaline.

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Urea

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False positive albumin test due to the presence of

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Bacterial protein

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Diacetic acid is converted to __________

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Acetone

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Bilirubin is oxidized to _______________

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Biliverdin.

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Urobilinogen is oxidized to______________

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Urobilin

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Two methods of urine preservation

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-Refridgeration

-Chemical preservatives

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most commonly used and precipitates amorphous phosphates & urates

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Refrigeration

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Preserves glucose & sediments well

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Thymol

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Preserves protein & formed elements well. Does not interfere with routine analyses other than pH

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Boric acid

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Does not interfere with routine tests

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Phenol

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Acts as reducing agent interfering with chemical tests for glucose, blood, leukocyte esterase, & copper reduction

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Formalin

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Does not interfere with routine tests

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Toluene

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Prevents glycolysis. Good preservative for drug analyses

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Sodium Fluoride

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Convenient when refrigeration not possible. Have controlled concentration to minimize interference

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Commercial preservative tablets

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inhibits bacterial growth, Aldosterone. Causes change in the characteristics of the cellular sediments.

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Chloroform

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prevents bacterial growth & useful as a glucose preservative.

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Chlorhexidine

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for Vanil Mandelic Acid/VMA

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6N hydrochloric acid

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for Cathecholamines

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Sulfuric acid

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Sample stable at RT for 48 hrs. Preserves bacteria. Decreases pH.

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Uses of Gray C&S tube

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Use on Automated instruments. Refrigerate w/in 2 hours.

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Uses of yellow plain tube

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Stable for 72 hours at RT. Preservative is sodium propionate.

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Uses of cherry red tube

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A 75-year-old bedridden patient has an acute urinary retention.

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Type of Urine: Random

Method: Catheterization/Midstream clean catch

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A 6-month-old febrile patient with a bladder outlet obstruction and urethral catheterization is not possible.

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Type of urine: random

Method: SPA

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A 24-year-old male patient is having recurrent UTI, the doctor requested for a urine culture and routine urinalysis

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Type of urine:Random/First morning

Method: mid-stream clean catch

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One year old patient is suspected of UTI, the doctor requested for a routine urinalysis.

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Type of Urine Specimen: Random or First MorningCollection Technique: Gauze Pad Method

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A 30 year old female came in the laboratory at noon time and have a request for routine urinalysis for her annual physical exam

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Type of Urine Specimen: RandomCollection Technique: Midstream Clean Catch

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Modified/Darkened- color

Increased- Odor, pH, Nitrite, Bacteria

The rest decreased

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