How to pass urine samples. General urine analysis: collection rules, indicators and interpretation of results. Types of urine tests

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The diagnostic value of urine analysis allows the use of these methods to identify a large number of pathological conditions. In addition to general (clinical) and biochemical urine tests, for diagnostic purposes I use various special samples (for example, Zimnitsky, Nechiporenko) and bacteriological inoculation on the medium. Each sample contributes to an increase in diagnostic accuracy, and is characterized by certain rules for the preparation and collection of urine for analysis. Consider the diagnostic value, normal indicators and rules for collecting various urine samples.

Test of Nechiporenko

The Nechiporenko test is used to clarify the number of leukocytes, erythrocytes and casts in the urine. This sample is used in case of revealing a large amount of these blood elements in the general analysis of urine. If the result of the Nechiporenko test is within the normal range, then a "bad" result of a general urine test (for example, an increase in the number of erythrocytes, leukocytes or cylinders) is unreliable, that is, there is no disease. Monitoring the effectiveness of the therapy is also carried out using the Nechiporenko test. At the same time, in the case of healing and cessation of the inflammatory process, the indicators of the Nechiporenko sample are normalized.

Rules for collecting urine according to Nechiporenko
Urine for the Nechiporenko sample is collected as follows: in the morning it is necessary to wash the perineum and external genitals with warm water without the use of disinfectant solutions. Then sit comfortably over the bathtub or basin and release the first portion of your morning urine. Retain urination, and bring a sterile container to the urethra in which to collect a small amount of urine (25-30 ml is sufficient). Drain any remaining urine into a tub or basin. Thus, Nechiporenko's sample is collected, like urine for general analysis - the middle morning portion.

If it is necessary to obtain urine from the bladder without passing through the urethra, then resort to taking a sample using a catheter. The collected urine must be delivered to the laboratory as soon as possible, since the analysis must be carried out within 2 hours.

Sample rates of Nechiporenko
Next, the number of erythrocytes, leukocytes and cylinders in the Goryaev chamber is counted, and the result is expressed in units per 1 ml of urine. Normally, in a healthy person, the number of leukocytes does not exceed 2000 per 1 ml, erythrocytes - 1000 per 1 ml, and cylinders - 20 per 1 ml.

Interpretation of the results of the Nechiporenko test
An increase in the number of leukocytes, erythrocytes and cylinders in the Nechiporenko test usually indicates kidney pathology. The reasons for the high content of indicators in the Nechiporenko sample are presented in the table.

Sample rate Nechiporenko	Reasons for the increase in the indicator
Leukocytes (increase over 2000 in 1 ml)	Cystitis (inflammation of the bladder) Kidney infarction Inflammation of the prostate
Erythrocytes (increase over 1000 in 1 ml)	Glomerulonephritis (acute and chronic) Kidney stone disease Tumor pathologies localized in the kidneys and urinary structures
Cylinders (increase over 20 in 1 ml)	Glomerulonephritis Pyelonephritis Kidney damage from poisons (eg, phosphorus, lead compounds, phenols) Kidney amyloidosis Nephronecrosis Violation of blood circulation in the renal tubules with hypertension or renal artery thrombosis Nephronecrosis

Examples of normal Zimnitsky's test and a sample of a patient with renal failure
An example of a normal Zimnitsky test.

The daily volume of urine is 1480 ml, daytime - 980 ml, nighttime - 500 ml.

An example of Zimnitsky's test for renal failure.

The daily volume of urine is 1060 ml, the daytime is 450 ml, and the nighttime is 610 ml.

Sulkovich test

Sulkovich's test is an express test that detects the level of calcium in the urine. This method is used to correct and select dosages of vitamin D. The Sulkovich test is most often performed for children who receive vitamin D in order to track the level of calcium excretion and prevent an overdose.

The Sulkovich test is carried out as follows: urine is mixed with Sulkovich's reagent, as a result of which turbidity of varying severity can form. The recording of the results and the assessment of the degree of turbidity is based on a semi-quantitative method. Variants of the Sulkovich test result are shown in the table.

As can be seen from the table, the Sulkovich test can only act as an approximate analysis, the result of which does not provide accurate data on the calcium concentration. Therefore, when a strong turbidity is detected in Sulkovich's sample, it is necessary to pass a biochemical urine test to determine the calcium concentration using modern and accurate methods.

The Sulkovich test rate for children is "+" (slight turbidity) or "++" (moderate turbidity). The absence of turbidity in the urine sample ("-") indicates a possible lack of vitamin D or a malfunction of the parathyroid glands. Severe opacity ("+++") and very severe opacities ("++++") can be detected with increased function of the parathyroid glands or with an overdose of vitamin D.

For the Sulkovich test, you need to collect the baby's morning urine before you start feeding him. Since it is quite difficult to collect daily urine from a child, it is morning urine that is used for Sulkovich's test.

Bacteriological examination of urine for sterility

If bacteriuria (bacteria in the urine) is detected, which is not accompanied by clinical symptoms, or in case of unsuccessful attempts to establish an infectious focus, they resort to bacteriological examination of urine.

Bacteriological testing can be done to assess urine sterility, or to identify a specific pathogen and its sensitivity to antibiotics.

Normal urine is sterile, but when it passes through the urethra, it washes away microorganisms living on the walls of the urethra and becomes "contaminated". Together with normal flora, urine can be "contaminated" with pathogenic microbes, which are the cause of the infectious and inflammatory process in the organs of the urinary system. A bacteriological study for sterility allows you to establish the degree of contamination of urine by microbes, by the level of which one can judge the presence or absence of pathogenic microorganisms that cause infectious inflammation.

Rules for collecting urine for bacteriological culture for sterility
For bacteriological examination of urine for sterility, only 5-7 ml of an average portion of morning urine collected on an empty stomach after thorough washing of the perineum with warm water is sufficient. Urine is inoculated on special nutrient media using the sector method, which makes it possible to distinguish between contamination by the normal flora of the urethra from an infectious disease in the organs of the urinary system. The result of the analysis evaluates the number of grown colony-forming elements (CFE) of microorganisms. The table shows variants of the result of bacteriological examination of urine for sterility.

Deciphering the results of bacteriological culture of urine for sterility

The detection of a large number of CFUs of the same microorganism indicates an acute course of the infectious and inflammatory process. If a large number of CFU is formed by different microbes, then the infectious disease is chronic.

In case of detection of chronic infectious inflammation, a bacteriological examination of urine is used in order to find out the specific type of microorganism that caused the pathological process. In this case, urine is sown on special media, conditions for growth are created for the pathogen, and then it is identified. Duration diagnostics it pays off completely with the subsequent targeted precision of antibiotic therapy, which will completely cure a chronic infectious disease.

Today, there are many research methods, but you should not neglect the reliable and well-proven samples, which can reduce examination time and costs. Urine samples have a high diagnostic value, but are not completely universal, therefore, their results should be interpreted taking into account the clinical picture and objective data. However, the simplicity and efficiency of conducting urine analyzes allows them to be used very widely, including for screening examinations of large groups of people.

Blood is taken strictly on an empty stomach, before taking and administering drugs and before X-ray, endoscopic and ultrasound examinations. At least 8 hours and not more than 14 hours of hunger, water - as usual, avoid food overload the day before, infants should not eat 3-4 hours before blood sampling.
Drugs that can significantly affect the results of the study should be canceled in advance, except in cases of control over treatment with this drug.
Blood for testing for substances, the concentration of which in the blood changes cyclically, must be taken in strict accordance with physiological cycles. For example, the concentration of FSH and LH is determined on the 5-7th day of the menstrual cycle.
Eliminate alcohol intake on the eve of the study.
No smoking at least 1 hour before the study.

Analysis of urine

General urine analysis

On the eve of the test, it is recommended not to eat vegetables and fruits that can change the color of urine (beets, carrots, etc.), do not take diuretics.
Before collecting urine, a thorough hygienic toilet of the genitals must be performed.
Women are advised not to have a urine test during their period.

Collect your morning urine in a container. For the correct study, during the first morning urination, a small amount of urine (the first 1 - 2 seconds) is released into the toilet, and then, without interrupting urination, substitute a container for collecting urine, in which to collect approximately 50-100 ml of urine. Close the container tightly with the screw cap.

A specialized plastic container is the optimal means of collecting and transporting urine for laboratory research. Ask at pharmacies. The container is a 125 ml wide-mouth graduated translucent glass with a hermetically sealed screw cap. The container is sterile, does not require pre-treatment and is completely ready for use.

Test of Nechiporenko

For urine analysis according to the Nechiporenko method - collect the morning portion in the middle of urination ("middle portion"). 15-25 ml is enough.

24-hour urine collection

For laboratory tests, in the morning before collecting urine, it is necessary to conduct a toilet of the external genital organs.

The first morning urine is not collected, but the time of urination is noted. Subsequently, all urine excreted within 24 hours from the marked time of the first urination to the same hour every other day is collected.

It is optimal to collect daily urine in a specialized graduated plastic container for 2, 7 liters, which has a wide neck and a raised handle. The container is safe and easy to handle.

You should urinate directly into the container and screw the cap tightly after each urination. The urine should be stored in a closed container in the refrigerator on the bottom shelf, away from freezing.

At the end of the collection (the last urination is performed at the same time, which is marked as the time of the first urination, but in a day), urine can be taken to the laboratory: the daily volume of urine in a closed container is shaken, after which it is poured into a small container for clinical urine analysis for 125 ml a serving of 100 ml. You don't need to bring all the urine. In the medical center, report the daily amount of urine.

Collection of daily urine according to Zimnitsky

Urine is collected per day (8 servings in 8 containers, every 3 hours). The first morning urine sample is removed. All subsequent portions of urine excreted during the day, night and the morning portion of the next day are collected in different containers (50 ml) purchased at the pharmacy, each with a collection time signed.

After the completion of urine collection, accurately measure the contents of the container, be sure to mix and immediately pour into a container purchased at a pharmacy. Bring the container to the medical center for examination. You don't need to bring all the urine. In the medical center, report the daily amount of urine.

Urine for sugar

From the daily amount of urine, 50-100 ml of urine or 3 portions of urine collected per day with intervals of 8 hours are delivered to the laboratory:

1 serving - from 8 am to 4 pm

2 servings - from 16 to 24 hours

Serving 3 - from 24 to 8 am (as directed by your doctor).

Urine for PCR studies (tuberculosis, CMV, STI)

Before collecting urine, it is necessary to conduct a toilet of the external genital organs. Urine is collected in the morning on an empty stomach after sleep or no earlier than 2-3 hours after the last urination in a sterile plastic container. The minimum volume of urine required for the analysis is 20 ml.

Urine for bacteriological research

The urine sample is collected only in sterile containers.

Urine must be taken before starting antibacterial treatment or 3 days after therapy. If the patient is taking antibacterial drugs, then the issue of their temporary cancellation must be resolved.

After a thorough toilet of the external genital organs, flush the first portion of urine into the toilet, collect the middle portion in the amount of 3-5 ml in a sterile hermetically sealed container. The urine can be delivered to the laboratory within 1-2 hours, if this is not possible, then the urine sample can be stored in the refrigerator for no more than a day. When transporting the sample, care must be taken to ensure that the cork does not get wet.

Stool analysis

Stool studies should not be carried out earlier than 2 days after the enema, X-ray examination of the stomach and intestines, colonoscopy.
You can not take medicinal substances the day before, including: - laxatives; - Activated carbon; - preparations of iron, copper, bismuth; - use fat-based rectal suppositories.
Avoid contact with urine or water.
Conduct a study of feces in women during menstruation

Feces should be collected for research in the morning. If this is difficult, you can prepare a sample in advance, but no more than 8 hours before donating feces to the laboratory. In this case, keep the sample in the refrigerator (do not freeze).

Thorough toilet of the external genitals and anus. Pre-urinate. Defecate in a dry, clean container: a vessel or a night vase. Transfer a stool sample with a volume of 3-5 cubic meters. see in a pre-prepared, clean, dry container for storage and transport.

Feces for occult blood

The patient should not eat meat, fish, tomatoes 3-5 days before the examination (they can be replaced with milk and cereal dishes). The patient should not brush his teeth. The material is collected on the fourth day in a clean, dry container for storage and transport.

Semen (spermogram)

Requires complete sexual abstinence for 3-5 days before the study, but no more than 7 days. In the direction it is necessary to indicate the currently taken medications (medications). Do not collect material from a condom. Collecting material is best done in the morning.

Bacteriological research

Detachable from the eyes

The material is taken from the affected areas in the midst of the inflammatory process in compliance with the rules of asepsis. At least 5-6 hours before the study, all medications and procedures are canceled. The sample is taken by the doctor with a separate swab for each eye.

Conjunctiva

In the presence of abundant purulent discharge with a sterile dry cotton swab, take pus from the inner surface of the lower eyelid by moving to the inner corner of the palpebral fissure. It is necessary to ensure that the eyelashes do not touch the tampon (hold the eyelids with your hands).

Edge of the century

Pus crusts are removed with tweezers. Material is taken from the ulcer at the base of the eyelashes.

Cornea

Material for research is taken after anesthesia with a sterile dry cotton swab.

Discharge from the nose

Material from the nasal cavity is taken with a dry sterile cotton swab, which is inserted deep into the nasal cavity. A separate swab is used for each nasal passage.

Discharge of the nasopharynx

Material from the nasopharynx is taken with a sterile posterior pharyngeal cotton swab, which is inserted through the nasal opening into the nasopharynx. If a cough begins, the tampon is not removed until it is finished. For tests for diphtheria, films and mucus from the nose and throat are examined simultaneously.

Oral material

Material from the oral cavity is taken on an empty stomach or 2 hours after a meal with a sterile cotton swab from the mucous membrane or its affected areas at the exits of the salivary gland ducts, the surface of the tongue, from the ulcers. If there is a film, the latter is removed with sterile tweezers.

Ear material

The material for inflammation of the middle ear is taken by the doctor. The skin of the adjacent areas is treated with an antiseptic solution.

1. Various microorganisms have their own peculiarities of localization, ways of spreading and excretion, which should be taken into account when choosing a place for taking biomaterial.

2. Taking biomaterial, if possible, should be carried out during the period of exacerbation of the infection. A few days before the study, it is necessary to stop taking chemotherapy drugs. Monitoring the effectiveness of treatment should be carried out no earlier than 3-4 weeks after the end of therapy.

3. The volume of the sampled biomaterial should not be excessive, since together with the pathogen, substances that can inhibit PCR or contribute to DNA degradation during storage and transportation get into the sample. When taking smears and scrapings, it is enough to obtain material in the volume of a "match head".

4. For sampling, use only a disposable instrument and sterile plastic containers (or test tubes with a transport medium) with a tight-fitting lid.

Recommendations for women on preparation for taking a smear for PCR, RIF, culture for flora, mycoplasma, Trichomonas, fungal infection.

Such studies should not be carried out while taking any antibacterial drugs.
These studies are not submitted during menstruation and within 1-2 days after its end.
2-3 days before the visit to the clinic, you should stop using any vaginal pills, balls, suppositories - both medicinal and contraceptive (Pharmatex, Panteks-Oval, Klion D, Polygynax and others).
The night before and in the morning on the day of taking a smear, you should not wash and douche.
IMPORTANT! You can not take smears for PCR after colposcopic tests.

Material from the urethra

Before taking the material, the patient is advised to refrain from urinating for 1.5-2 hours. Immediately before taking the material, the external opening of the urethra must be treated with a swab moistened with sterile saline. In the presence of purulent discharge, scraping is recommended to be taken after 15-20 minutes. after urination, in the absence of discharge, it is necessary to massage the urethra with a probe to take material. In women, before the introduction of the probe into the urethra, it is massaged on the pubic joint. In women, the probe is inserted into the urethra to a depth of 1.0-1.5 cm, in men - 3-4 cm, and then several careful rotational movements are made. In children, material for research is taken only from the external opening of the urethra. After taking the material, the probe is transferred to the package of the probe, or it is placed in a test tube with a transport medium and thoroughly washed, the test tube is closed and marked, after which the material is delivered to the laboratory.

Material from the cervical canal

Before taking the material, it is necessary to remove mucus with a cotton swab and then treat the cervix with sterile saline. The probe is inserted into the cervical canal to a depth of 0.5-1.5 cm, the material is collected with gentle rotational movements. In the presence of erosion of the cervical canal, it is necessary to treat them with sterile saline, the material should be taken at the border of healthy and altered tissue. When removing the probe, it is necessary to completely exclude its contact with the walls of the vagina. After taking the material, the probe is transferred to the package of the probe, or it is placed in a test tube with a transport medium and thoroughly washed, the test tube is closed and marked, after which the material is delivered to the laboratory.

Vaginal material

The material should be taken prior to manual examination. Before manipulation, the mirror can be moistened with hot water; the use of antiseptics for processing the mirror is contraindicated. In case of excess mucus or heavy discharge, remove it with a sterile cotton swab. Vaginal discharge is collected with a sterile disposable probe from the posterior lower fornix or from pathologically altered areas of the mucosa. In girls, the material must be taken from the mucous membrane of the vestibule of the vagina, in some cases - from the posterior fornix of the vagina through the hymenal rings. After taking the material, the probe is transferred to the package of the probe, or it is placed in a test tube with a transport medium and thoroughly washed, the test tube is closed and marked, after which the material is delivered to the laboratory.

Prostate secretion

Before taking the secretion of the prostate, the head of the penis is treated with a sterile cotton swab moistened with saline. After preliminary massage of the prostate through the rectum, the doctor performs a pressure massage with several vigorous movements from the base to the top of the penis. Then 0.5-1 ml of prostatic secretion is squeezed out of the cavernous part, which is collected in a dry sterile container. The material should be delivered to the laboratory within 1-3 hours; transportation should be made only in a cooler bag.

Material from the conjunctiva of the eye

In the presence of abundant purulent discharge, it is removed with a sterile cotton swab moistened with saline. Scraping is taken from the inner surface of the lower eyelid by moving to the inner corner of the palpebral fissure. When taking a scraping, it is necessary to hold the eyelid with your hands so that when blinking the eyelashes do not touch the probe. After taking the material, the probe is transferred to the probe package, or the probe is placed in a test tube with a transport medium and thoroughly washed, the tube is closed, marked and delivered to the laboratory.

Material from the back of the pharynx

The material is taken on an empty stomach or not earlier than 2-4 hours after a meal. A disposable probe is inserted behind the soft palate into the nasopharynx and passed along the back of the pharynx. If the aim of the study is the tonsils, the probe is inserted into the lacunae of the tonsils and rotated there. After taking the material, the probe is transferred to the probe package, or introduced into a test tube with a transport medium and washed thoroughly. The tube is closed, labeled and delivered to the laboratory.

Material from the nasopharynx

The material is taken on an empty stomach or not earlier than 2-4 hours after a meal. When taking the material, good lighting is needed, the patient sits against the light source, the root of the tongue is pressed with a spatula, the material is taken with a sterile probe, without touching the tongue, cheek mucosa and teeth. After taking the material, the probe is transferred to the probe package, or introduced into a test tube with a transport medium and thoroughly washed, the tube is closed, marked and delivered to the laboratory.

Material from periodontal pockets

Pouch smears are collected in a sterile test tube (Eppendorf type) with saline. In this case, test tubes can be stored in a refrigerator (+4 ... 6 ° С) for no more than 12 hours, and they are transported in a refrigerator bag. You can take swabs and rigid urethral tubes. In this case, the probe, after taking the material, is placed in its disposable package, and in this form is delivered to the laboratory.

Saliva

12 hours before taking (collecting) saliva, food, alcohol and drugs are excluded. Immediately before collecting saliva, it is necessary to exclude the use of toothpaste and remove the dentures. Before collecting saliva, you need to brush your teeth without toothpaste, then rinse your mouth well without using irritants. Saliva is spit out or aspirated from the bottom of the mouth with a disposable syringe and transferred into a test tube (eppendorf type). Saliva can be stored in a refrigerator (+4 ... 6 ° C) for no more than 12 hours, transportation is carried out without refrigeration.

Rectal swabs for the intestinal group

A sterile disposable probe is inserted into the rectum, the material is collected by rotating movements, the probe is removed and placed in a sterile test tube, which is delivered to the laboratory.

Sputum

After a thorough toilet of the oral cavity (brushing the teeth and rinsing with boiled water), the morning sputum is collected in a sterile dish. The diagnostic value is mucous or mucopurulent sputum, as well as sputum containing dense whitish inclusions, and sputum colored yellowish, gray or brown. A sufficient volume of sputum for research is 3-5 ml. To increase the information content, a repeated (up to 3 times) examination of sputum is possible, which makes it possible to increase the number of positive findings.

If sputum is produced irregularly or in scanty amounts, expectorant drugs or irritating inhalation should be used the night before and early in the morning on the day of sputum collection. Preparation of smears from material obtained in this way should be performed on the day of collection. In the absence of sputum, the impossibility of aerosol inhalation or its failure, the bronchial or gastric washings should be examined for mycobacterium research.

Stomach washings

They are investigated mainly in young children, poorly coughing up phlegm and often swallowing it. To avoid mixing swallowed sputum with food, gastric lavage should be taken on an empty stomach. The last meal should be at least 12 hours before taking gastric washings. Before taking material to neutralize the contents of the stomach, the patient drinks 100-150 ml of baking soda solution (1 teaspoon per 1 glass of water) in sterile distilled water, after which a sterile gastric tube is inserted into the stomach and the contents of the stomach are collected in a sterile bottle. The material is immediately delivered to the laboratory and processed, which excludes the possible destructive effect of gastric enzymes on the pathogen.

Each person has taken urine tests many times, especially if you have kidney problems, this is a very common occurrence, but did you do it right? Someone does not think about it, someone just hesitates to ask the doctors, but they themselves, when prescribing tests, for some reason do not specify this.

From the very beginning, it is important to understand that you do not need to change your usual drinking regimen before taking tests, everything should be natural, if, of course, you need an adequate result.

The first and second steps will be the same for any urine collection option.

So, the first step is to prepare the container for the fence. Better to cook it in the evening. It needs to be washed well. It is necessary. A dirty container interferes with the correct assessment of the result, and some specialists will not check the analysis at all, referring to foreign impurities in the material. And here they are right. Indeed, in the analysis they can find something that a person does not really have, impurities that have come from the outside. And nothing can be argued here, you have to take the test again. Or even worse, no one knows what to be treated for.

The second stage is the cleansing of the external genital organs. An important step for the same reasons is that nothing foreign from the surface of the skin gets into the urine.

General urine analysis

To pass a general analysis, you will need the entire morning urine sample... It is important here! Not the average portion, as many believe, but the whole portion. This means that you should urinate in a prepared container from beginning to end. If you get a lot of urine, then you can not take it all, you can pour it into another clean container, since about 150 grams will be enough for analysis. But first it should be mixed well, for example, with a clean stick, and then cast.

You should try to bring only collected urine to the laboratory. If it doesn't work out at all, then you can store the urine in the refrigerator for 2-4 hours, but you can't just leave it on the table.

Urine according to Nechiporenko

But with this type of study, it is necessary to collect just the middle part of the morning urine. This is easy to do. You need to start urinating in the toilet, wait a few seconds, then substitute the prepared container and urinate into it for a few seconds, but not until the bladder is completely empty. Then the last portion of urine goes down the toilet again.

Urine collection for general analysis and analysis according to Nechiporenko is very often confused not only by ordinary patients, but also by doctors who are not related to the intricacies of laboratory work, they do not attach importance to the collection features. But this is very important. The general analysis should include urine from all parts of the urinary tract, so it does not need to be drained.

Urine collection according to Zimnitsky

This study at home is rarely prescribed, since it has limited indications. The night before, you should prepare not one, but 8 jars. Each should be signed with a period of time with an interval of 3 hours, during which urine will be collected in it, for example, 6-9, 9-12, 12-15 hours and so on. As you can see, urine must be collected both at night and during the day, therefore this analysis is considered very responsible, it requires attentiveness and precise execution.

The collection of the analysis begins at 6 o'clock in the morning, the entire nightly portion of urine is emptied into the toilet, and from that moment, each urination until 6 o'clock the next morning should be carried out in an appropriate container. In the first container, urine will be emptied, which was formed from 6 to 9 o'clock and further in sequence.

Important note! In the morning, at 9 o'clock, you should definitely urinate in jar No. 1, even if there is no strong urge to urinate, because from 9 o'clock the collection will begin in the next container. If one allocated container was not enough for the collection, then you should take another one and sign it as an additional one, but you cannot pour urine into the toilet! If, at some interval, urine was not discharged at all, then the corresponding jar must be left empty, but it must be handed over, noting that there was no urine on it, so that the laboratory would correctly evaluate these data. For night time, you will most likely have to set an alarm.

The collection of urine according to Zimnitsky is a little difficult to implement for the patient, but if a reliable result is needed, then the collection should be carried out properly. And there is no time for laziness! It is necessary to remember that it is important for the laboratory to know: how much urine was excreted and at what time!

Daily urine

This type of analysis is even less often prescribed at home, but you should still know about it. The collection of urine begins in the morning at 6:00 and continues until 6:00 the next morning. You need to urinate in one container for a whole day, more often they use a three-liter jar. And then all of it is handed over to the laboratory. You need to store urine in the refrigerator, but since this analysis is prescribed more often in a hospital setting, the laboratory issues a special preservative that allows you to store the jar at room temperature.

For the purpose of primary diagnosis and prevention, a person is sent for a general urine analysis (OAM). Therefore, a frequent question among patients remains how to collect a general urine test.

The study helps not only to find out abnormalities in the functioning of the organs of the genitourinary system, but also other diseases. How to properly prepare for the analysis and prepare the biomaterial is described in the article.

Preparation for passing the OAM

24 hours before urine collection, several rules must be followed, the observance of which will exclude many factors that affect the reliability of the results.

First of all, it is impossible to violate the drinking regime, because this leads to a change in the relative density of urine, which negatively affects the interpretation of the results. That is, excessively abundant or poor drinking is not allowed.

Drinking mineral water can affect the acidity of urine. Therefore, the day before the test is done, it is better to completely abandon it.

In addition, in order for the results of the study to be as correct as possible, 24 hours before the sampling of the biomaterial, it is impossible:

take medications - antibiotics, vitamin complexes, antipyretics, diuretics;
eat berries, fruits and vegetables of a bright color (blueberries, cherries, sour apples, lemon, orange, tangerine, beets, carrots);
eat smoked and spicy foods;
eat a lot of sweets;
drink alcoholic beverages;
have sexual intercourse;
engage in exhausting physical exercise;
do hard physical work.

If the patient cannot refuse to take certain medications, this should be discussed with a specialist in order to take into account the likelihood of an increase in the concentration of certain substances in urine.

During menstruation, it is better for a woman to warn a specialist and postpone the study until they are over.

Selection of containers for biomaterial

Urine is collected in a dry, clean container. If in Soviet times, jars of mayonnaise or saline solution were used to collect biomaterials, now in any pharmacy you can purchase a disposable special container.

If a person does not have the opportunity to buy a sterile jar for delivery of OAM, he will have to prepare the container himself in the evening.

The container for the biomaterial must be thoroughly washed with hot water and soda. Then the jar must be rinsed under running water.

100 ml of water is poured into the bottom of the container, placed in the microwave, setting the highest power and 1 minute of time. This process is sterilization. Pour the boiling water out, and place the jar in a plastic sealed bag.

The lid of the container must be thoroughly washed with soda, then with cold water, and at the end, pour over with boiling water. The lid should be kept in the bag until morning.

Failure to comply with such rules will distort the results of the study. Therefore, the best option is to purchase a sterile jar for collecting biomaterial at the pharmacy.

Video: How to properly collect (collect) urine analysis

How to collect urine correctly?

It is important to know how to do it correctly, because the correctness of the results will depend on it.

Despite the fact that the collection of biomaterial for OAM is a simple process, it is necessary to follow a certain algorithm of operations when collecting material for research.

It is necessary to wash the external genitals well. Such an event will prevent bacteria, mucus and other substances from entering the urine. The genitals are washed under the shower using soap. The use of a solution of potassium permanganate (0.02-0.1%) is also allowed.

It is required to follow the rules of urination before urine collection. Men should completely pull back the foreskin during urination, and women should push the labia apart. The best option for a woman is to use a tampon while collecting urine. This measure prevents microorganisms from entering the urine from the vagina.

For analysis, urine must be collected from the morning portion. A person needs to sit on the toilet, start urinating, and after 2-3 seconds, substitute the container. When the container is 2/3 full, urination can be continued down the toilet. Close the container tightly with a lid.

This algorithm involves the collection of the middle portion of urine. It should be noted that to date, a unified scheme for collecting biomaterial for OAM has not been developed.

However, most doctors approve of this particular technique.

Collection of urine from children and bedridden patients

In adults, there are no particular problems with collecting urine. The same cannot be said for small children and bedridden patients.

The question of how a general urine test is collected in such cases remains quite relevant.

When collecting material for research in these categories of patients, the recommended algorithm of actions should be followed.

The algorithm for collecting urine in young children includes the following measures:

Wash the baby's genitals with warm water and dry with a soft cloth.
Pre-wash the pot with hot water and soda, rinse with running water and rinse with boiling water.
Place the baby in a pot, and then collect some of the urine in a sterile container.

To collect urine from newborns and infants, you will need to use a urine collection bag. It is put on instead of a diaper, after filling, the liquid is poured into a sterile container.

The algorithm for collecting urine from bedridden patients includes the following measures:

wash the genitals with warm water using soap or potassium permanganate solution;
substitute a vessel previously washed in the same way as a pot for a child;
take a portion of urine and fill a special jar.

In the case of a recent cytoscopy procedure (examination of the bladder with a probe), OAM must be taken after at least 1 week.

Storage and delivery to the laboratory

Collecting your morning urine is important for two reasons. Firstly, the first portion of urine shows the presence of foci of inflammation in the urethra when leukocytes and erythrocytes are found in it. Secondly, it shows the presence of diseases in the kidneys and ureter.

When a patient takes OAM in a hospital setting, he should not worry about the delivery of urine to the laboratory. This is done by the medical staff. But when collecting at home, you need to worry about its delivery.

After collecting biological material, you need to quickly deliver it to the laboratory. If you store urine for a long time at the temperature of the room, this will entail a change in physical properties, the development of various microorganisms and the destruction of cells.

Urine, which is subject to general research, can be stored in the refrigerator for no more than one to two hours after collection. An acceptable way of storing biomaterial is refrigeration, that is, it can be stored in a refrigerator, but under no circumstances can it be frozen.

Cooling does not affect the structure of urine, does not destroy the formed elements. However, there is always the possibility of a change in relative density.

If the doctor suspects the patient has diabetes mellitus, infectious diseases, cystitis and other diseases of the genitourinary system, metabolic disorders, he prescribes a referral for the delivery of OAM.

When receiving the results of the study, the patient is faced with the problem of decoding them. First of all, you need to pay attention to the specific gravity and reaction of the medium. Normal relative density ranges from 1006 to 1026 g / l. An excess of the indicator indicates the presence of hepatic pathology, toxicosis when carrying a child, diabetes mellitus, heart failure, nephrotic syndrome or reduced urine production.

An underestimated value indicates renal failure, type 2 diabetes, and renal tubular damage.

The medium reaction rate is 5-7 units. Increased indicators may indicate a deficiency of proteins in food, decreased ones - evidence of a lack of plant foods in the diet.

The urine should be light yellow in color without blood impurities, a change in its color indicates the development of any disease. The presence of sediment is a consequence of inflammatory processes and urolithiasis.

Normally, it does not have a specific odor. If there is a smell of ammonia, it indicates the presence of inflammation in the bladder. A sweetish odor may indicate hyperglycemia.

Elements such as proteins, glucose, hemoglobin, ketones, nitrites and urobilinogen may be present in urine, which is a bad sign. In a healthy person, urine should not contain such substances.

In addition, a clinical, biochemical analysis of urine, a sample of Zimnitsky, and Amburzhe, as well as a bacteriological culture of urine, are isolated.

Video: General urine analysis. How to properly collect urine