How to correctly give an average portion of urine. Special urine samples. How to take a general urine test

For the purpose of primary diagnosis and prevention, a person is referred for a general urinalysis (UCA). Therefore, a common question among patients remains how to collect a general urine test.

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

Preparation for passing the OAM

24 hours before urine collection, you must follow several rules, compliance with which will eliminate many factors that affect the reliability of the results.

First of all, you should not 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 scanty drinking is not allowed.

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

In addition, in order for the results of the study to be as correct as possible, 24 hours before collecting biomaterial you cannot:

take medications - antibiotics, vitamin complexes, antipyretics, diuretics;
eat berries, fruits and vegetables of 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 strenuous physical exercise;
do hard physical work.

If the patient cannot stop taking certain medications, this should be discussed with a specialist to take into account the possibility of increased concentrations of certain substances in the urine.

During menstruation, it is better for a woman to notify the specialist and postpone the examination until the end.

Selection of containers for biomaterial

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

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

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

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

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

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

Video: How to correctly collect (collect) a urine test

How to properly collect urine?

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

Despite the fact that collecting biomaterial for OAM is a simple process, a certain algorithm of operations must be followed when collecting material for research.

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

It is required to follow the rules of urination before collecting urine. Men should fully retract their foreskin while urinating, and women should spread their labia. The best option for a woman is to use a tampon when collecting urine. This measure prevents microorganisms from entering the urine from the vagina.

Urine for analysis must be collected from the morning portion. A person needs to sit on the toilet, begin the act of urination, and after 2-3 seconds replace the container. When the container is 2/3 full, urine flow can continue into the toilet. Close the container tightly with a lid.

This algorithm involves collecting an average portion of urine. It is worth noting that to date, no unified scheme for collecting biomaterial for OAM has been developed.

However, most doctors approve of this particular technique.

Urine collection in children and bedridden patients

Adults do not have any particular problems collecting urine. This cannot be said about 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 from young children includes the following measures:

Wash the child's genitals with warm water and dry with a soft cloth.
First wash the pot with hot water and soda, rinse with running water and pour over boiling water.
Place your baby on the potty and then collect some of the urine in a sterile container.

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

The urine collection algorithm for bedridden patients includes the following measures:

wash the genitals with warm water using soap or a solution of potassium permanganate;
substitute a vessel that has been washed in advance in the same way as a child’s potty;
take a portion of urine and fill a special jar.

If you have had a recent cytoscopy (examination of the bladder with a probe), an OAM must be taken at least 1 week later.

Storage and delivery to the laboratory

It is important to collect the morning urine itself for two reasons. Firstly, the first portion of urine shows the presence of foci of inflammation in the urethra when leukocytes and red blood cells are found in it. Secondly, it shows the presence of diseases in the kidneys and ureter.

When a patient undergoes OAM in a hospital setting, he does not have to worry about delivering urine to the laboratory. This is done by medical personnel. 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 urine is stored for a long time at room temperature, this will entail a change in physical properties, the development of various microorganisms and cell destruction.

Urine, which is subject to general examination, can be stored in the refrigerator for no more than one to two hours after its collection. An acceptable way to store biomaterial is cooling, that is, it can be stored in the refrigerator, but in no case should it be frozen.

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

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

When receiving the research results, the patient is faced with the problem of deciphering them. First of all, you need to pay attention to the specific gravity and reaction of the environment. Normal relative density ranges from 1006 to 1026 g/l. Exceeding the indicator indicates the presence of liver pathology, toxicosis during pregnancy, diabetes mellitus, heart failure, nephrotic syndrome or decreased urine production.

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

The reaction rate of the medium is 5-7 units. Elevated levels may indicate a protein deficiency in food, while decreased levels may indicate a lack of plant foods in the diet.

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

Normally, it does not have a specific odor. If you smell ammonia, this indicates inflammation in the bladder. A sweetish odor may indicate hyperglycemia.

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

In addition, clinical, biochemical analysis of urine, Zimnitsky and Amburger tests, as well as bacteriological urine culture are distinguished.

Video: General urine analysis. How to properly collect urine

To collect biomaterial, you must first purchase a special kit for collecting daily urine (a dark container with 3-liter graduations, a test tube with a beige cap, an adapter if necessary, and instructions for collecting daily urine).

It is preferable to use the morning portion of urine; If this is not possible, urine collection for research should be carried out no earlier than 4 hours after the last urination.
Women are not recommended to provide urine testing during menstruation unless there is an urgent clinical need. In this case, be sure to inform about the fact of bleeding.
Before collecting urine, it is necessary to thoroughly clean the external genitalia, washing them in the shower with soap so that discharge from them does not get into the urine. Dry the perineal area and external genitalia with a sterile cloth. After this preparation, collect an average portion of urine into a special sterile container (5–10 ml).

Attention! A urine container is a container for collecting urine only. For storage and transportation, a special tube with the necessary preservative* must be used.

Insert the vacuum urine tube into the built-in container holder.
Take the test tube with the stopper down, press the stopper onto the needle in the hole in the holder until it stops. Make sure that the needle pierces the rubber part of the tube cap. Urine will begin to flow into the test tube, compensating for the vacuum created in it. To ensure proper filling, hold the tube in the holder by pressing on the bottom with your thumb until urine stops flowing into the tube.
If urine does not flow into the test tube or the flow dries up before the test tube is filled to the mark, you must:

Press harder on the test tube to completely pierce the rubber part of its cap.
If urine still does not flow, replace the tube. Remove the test tube from the holder.

Thoroughly mix the contents of the tube immediately after removing it from the holder to mix the urine sample and preservative. Turn urine collection tubes 8-10 times 180°.

*Follow the detailed instructions included with the urine collection kit.

It is recommended to collect urine for general analysis only after a thorough toilet of the external genitalia. But no matter how well the external genitalia are treated, traces of soap and bacteria remain on the mucous membrane. When you start urinating, these foreign elements are washed away with urine, and if you start collecting it from the beginning of urination, all these inclusions will fall into the container and distort the result of the study. Thus, for analysis it is necessary to collect urine that is not in contact with the mucous membrane of the external genitalia.

When urinating, a woman should cover her vagina with a gauze pad to prevent natural secretions from getting into the urine collection container. Vaginal mucus has a protein nature, and urine normally lacks protein, so if female secretions enter, the results are also distorted. When urinating, a man must retract his foreskin, otherwise the secretions of the penis will get into the urine.

The anatomical structure provides for the connection of the ureter and seminal duct into a common urethra, therefore, with the first portion of urine, the remains of sperm are washed away from a man, and in the presence of prostatitis, bacteria. When collecting all urine for analysis, the presence of male secretions will distort the results of the study.

To collect an average portion of urine, the patient is advised to release the first portion into the toilet for 2-3 seconds, then collect the middle portion into a clean jar, and release the last portion into the toilet. The last part is not recommended to be collected due to the fact that it is more concentrated and contains a lot of salts, so the analysis result will be inaccurate.

Composition of urine

Normally, protein should not be present in the urine; if it is, it is recommended to retake the test, because the patient could violate the collection rules and collect the entire portion when urinating. The analysis should also contain no sugar; its presence indicates diabetes mellitus or that the collection container was improperly prepared (for example, a baby food jar was poorly washed).

The presence of epithelium, leukocytes and mucus in the urine indicates the presence of inflammation in the renal pelvis, bladder, or poor hygienic preparation for collecting the analysis. Therefore, if such elements are detected, the patient is assigned a retake.

The detection of bacteria in a urine test indicates the presence of infectious inflammation in the organs of the urinary system. However, bacteria can also be present in non-sterile containers, so it is recommended to collect urine in special disposable plastic containers.

Preparing to submit an average portion of urine

You can ask the laboratory for accessories intended for storing urine (sterile cups and vacuum tubes) or buy them at the pharmacy. Only these containers are permitted to be used.
Do not touch the inside of the container or place foreign objects inside.
Urine should be collected immediately into the designated container. Transferring urine from one container to another is not permitted.
Morning urine taken immediately after waking up is suitable for analysis.
At least 10-14 hours should pass between the last meal and urine collection. If necessary, you can drink no more than one glass of water without any additives.
Before collection, urine should remain in the bladder for 4-6 hours, i.e. at least 4-6 hours should pass from the last urination to the time of collection.

Before urinating, the patient should wash the external genitalia with warm running water. Detergents (soap, washcloth, etc.) cannot be used. It is important to wash the external opening of the urethra. To do this, in women you need to spread the labia with your fingers, in men you need to move the foreskin back.
Gently dry the external genitalia with a paper towel.
When urinating, you must ensure that the external opening of the urethra is exposed.
If women have menstrual or any other discharge at the time of urine collection for analysis, then it is necessary to use a vaginal tampon.
To collect urine, remove the lid from the cup and place it next to it with the label facing down. NB!Do not peel off the sticker from the cup lid!
Before collection, a few milliliters of urine must be flushed down the toilet, then, without interrupting the flow, it should be directed into a container, filling three-quarters full. Then finish urinating into the toilet.
After collecting urine, close the container tightly with a lid.
Within 15 minutes after collecting the urine, pour the urine from the cup into the test tubes.
- NB!Do not remove the stoppers from the test tubes!
- If you need to fill several test tubes, first fill the test tube with the green stopper, then the test tube with the beige stopper.
- For transferring urine into test tubes:
  - Partially remove the sticker from the lid (do not throw it away). In the hole you will see a latex-covered needle.
  - Insert the test tube into the hole in the glass with the lid facing forward and press until it stops. Hold the test tube until the stream stops flowing into the test tube. Remove the tube from the hole and, if necessary, fill the next one. Once the tubes are full, cover the hole with the sticker again.
  - Turn the test tube upside down and back again with smooth movements so that the preservative in the test tube dissolves.
Label the tube(s): Write a name on the side of the tube or label the side of the tube vertically from top to bottom, as straight and smooth as possible. Also write the date and time of urine collection.
Used cup:
- Make sure the hole in the cup lid is sealed tightly with the sticker.
- Pour the remaining urine in the glass into the toilet.
- Dispose of the cup in a household waste container.
Samples must be taken to the laboratory on the same day.
Before taking samples to the laboratory, store them in the refrigerator at a temperature of +2...+8°C.

General rules:

ATTENTION! On the eve of the study, consumables (container with adapter and test tube) must be obtained in advance from any laboratory department
10-12 hours before the test it is not recommended to consume: alcohol, spicy and salty foods, as well as foods that change the color of urine (beets, carrots)
If possible, avoid taking diuretics
After cystoscopy, a urine test can be prescribed no earlier than 5-7 days later.
Women are not recommended to take a urine test during menstruation
The patient collects urine independently (with the exception of children and seriously ill patients)
Before taking the test, perform a thorough toileting of the external genitalia:

in women, use a cotton swab moistened with warm soapy water to clean the external genitalia (treating the labia by moving the swab in front and downwards); dried with a clean cloth, previously ironed with a hot iron.
in men - the external opening of the urethra is toileted with warm water and soap, then washed with warm water and dried with a clean napkin, previously ironed with a hot iron.

General urine analysis

On the eve of the test, receive a disposable special sterile container with a device for transferring urine into a test tube from any Hemotest laboratory department.

For general analysis, use the first morning portion of urine (the previous urination should be no later than 2 am)
Before collecting urine, perform a thorough toilet of the external genitalia. For men, when urinating, completely pull back the skin fold and release the external opening of the urethra. For women, spread the labia. Unscrew the lid of the container and place it with the urine transfer device facing up
Flush the first small amount of urine into the toilet, and then collect the middle amount of urine in a container
The container should be filled no more than ¾ of its volume. Minimum - 30 ml, maximum - 80 ml
. Deliver the test tube with urine to the laboratory department on the day of taking the biomaterial

24-hour urine collection

Collect urine for 24 hours with normal drinking regimen (1.5 - 2 liters per day):

At 6-8 o'clock in the morning, empty the bladder (pour out this portion of urine)

Within 24 hours, collect urine in a clean container with a capacity of at least 2 liters. During collection, the container with urine must be stored in a cool place (optimally in the refrigerator on the bottom shelf at +4° +8°C), preventing it from freezing
Collect the last portion of urine at exactly the same time the next day when collection began the day before.
Measure the amount of urine and pour 50-100 ml into a special sterile container. Be sure to write on the container the volume of urine collected per day (daily diuresis)

Urinalysis according to Nechiporenko

Collect urine in the morning (immediately after sleep) using the 3-glass sample method: start urinating in the toilet, collect the middle portion in a special sterile container, finish in the toilet

The second portion of urine should prevail in volume. Deliver a medium portion of urine to the laboratory in a urine tube. Report the time of urine collection to the registrar. It is allowed to store urine in the refrigerator (at t +2° +4°), but not more than 1.5 hours.

Urine analysis according to Zimnitsky

Urine for research is collected throughout the day (24 hours), including at night.

1 serving: from 6-00 to 9-00 am
2 servings: from 9-00 to 12-00
3 serving: from 12-00 to 15-00
4 servings: from 15-00 to 18-00
5th portion: from 18-00 to 21-00
6th portion: from 21-00 to 24-00
7th portion: from 24-00 to 3-00
8 portion: from 3-00 to 6-00

In the morning at 6-00 (on the first day of collection), you should empty your bladder, and this first morning portion of urine is not collected for research, but poured out.

In the future, during the day it is necessary to consistently collect 8 portions of urine. During each of eight 3-hour periods of time, the patient urinates one or more times (depending on the frequency of urination) into a container with a volume of at least 1 liter. The volume of urine in each of the 8 portions is measured and recorded. Each portion of urine is mixed and 30-60 ml is taken into a separate special sterile container. If the patient has no urge to urinate within three hours, the container is left empty. Urine collection is completed at 6 a.m. the next day. All 8 containers are delivered to the laboratory, on each of which it is necessary to indicate the portion number, the volume of urine excreted and the time interval for urine collection.

Report the amount of liquid you drink per day to the receptionist.

Functional tests

Rehberg test (blood creatinine, 24-hour urine creatinine)
Before carrying out the test, it is necessary to avoid physical activity, exclude strong tea, coffee, and alcohol.
Urine is collected throughout the day: the first morning portion of urine is poured into the toilet, all subsequent portions of urine excreted during the day, night and the morning portion of the next day are collected in one container, which is stored in the refrigerator (t +4° +8° C) in during the entire collection period (this is a necessary condition).
After completing urine collection, measure the contents of the container, be sure to mix it and immediately pour it into a special container, which must be delivered to the laboratory.
Report the volume of daily urine to the treatment nurse.
After this, blood is taken from a vein to determine creatinine.

Biochemistry of urine

When preparing for a biochemical urine test, pay attention to what kind of urine needs to be collected (one-time or daily) for each type of analysis.

Urine collection for oxalate determination
The material for the study is only single urine.
Sulkowicz test (urine calcium, qualitative test)
- Immediately after sleep on an empty stomach, collect the entire morning portion of urine in a dry, clean container.
- Mix all collected urine. Pour 40-50 milliliters of the total volume of urine into a special sterile container and close the lid tightly. You cannot take urine from a vessel or potty.
- Urine in a container is delivered to the laboratory

Urine tests for hormones

Urinalysis for catecholamines, namely:
- Adrenaline+Norepinephrine
- Adrenaline+Norepinephrine+Dopamine
- Comprehensive study of catecholamines, serotonin and their metabolites
- Urine analysis for the content of intermediate metabolites of catecholamines: metanephrine, normetanephrine

IMPORTANT! To study 24-hour urine, a preservative is required - 15 g of citric acid (the powder must be obtained on the eve of the study in the Laboratory office along with a container for urine).
Before routine urine collection to determine catecholamines, preparations containing rauwolfia, theophylline, nitroglycerin, caffeine, and ethanol should not be used for 3 days. If possible, do not take other medications, as well as foods containing serotonin (chocolate, cheeses and other dairy products, bananas), and do not drink alcohol. Avoid physical activity, stress, smoking, pain, which causes a physiological rise in catecholamines.
First, a preservative - powder (citric acid) obtained in the laboratory - is poured into the bottom of a clean large container into which urine will be collected. The first portion of urine is poured into the toilet, the time is noted and the urine is collected in a container with a preservative exactly during the day, the last urination into the container should be 24 hours from the time recorded (for example, from 8.00 am to 8.00 am the next day).
As an exception, you can collect urine for 12, 6, 3 hours, or use a single portion of urine collected during the daytime for analysis. At the end of the collection period, measure the total volume of urine excreted per day, mix it, pour some into a specially provided container and immediately bring it for examination. When submitting the material, be sure to note the time of collection and the total volume of urine.

Definitions of DPID in urine
Collect urine before 10 am. Collect and deliver the 1st or 2nd morning urine sample to the laboratory

Collection of urine for microbiological studies

Urine culture (with antibiotic sensitivity testing)
Urine collection must be carried out before the start of drug treatment and no earlier than 10-14 days after the course of treatment. Collect urine in a special sterile container: DRAIN THE FIRST 15 ml OF URINE INTO THE TOILET. Collect the next 3-10 ml in a special sterile container and screw the lid on tightly. Deliver the biomaterial to the laboratory within 1.5-2 hours after collection. It is allowed to store the biomaterial in the refrigerator (at t +2° +4° C) for no more than 3-4 hours. If delivered to the laboratory later than the specified time, the results of urine culture may be unreliable.

Urine collection for determination of UBC (bladder cancer antigen)

It is recommended to collect a morning urine sample. An arbitrary portion of urine that has been in the bladder for 3 hours or more is subject to examination. The biomaterial is delivered to the laboratory within 3 hours after collection in a special container.

2 glass sample:

For the study, a full portion of urine is collected, which has been in the bladder for at least 4-5 hours; it is preferable to collect the first morning urine
The patient begins urinating into the first container and finishes into the second, it is important that the second portion of urine is larger in volume
Attention! Do not touch the sterile straw or the inside of the cap with your hands.
Each container should be filled to no more than ¾ of its capacity. Minimum - 30 ml, maximum - 80 ml
Screw the lid on tightly, carefully holding the edges. Stir the contents of the container 3-5 times, carefully turning it 180°
Label the tubes with patient information. Enter Last Name I.O. Attention! Block letters
Carefully peel back the sticker on the tube cap, but do not tear it off completely!
Place the test tube, cap down, into the recess on the container lid. Press down on the bottom of the tube and push the cap through. After filling the test tube with urine, remove it from the container
Mix the contents of the test tube 8-10 times, carefully turning it 180°
Both tubes of urine are delivered to the laboratory, and the portion number must be indicated on each tube. Storage in the refrigerator is allowed (+2…+4), but no more than 1.5 hours

3 glass sample:

For the study, a full portion of urine is collected, which has been in the bladder for at least 4-5 hours; it is preferable to collect the first morning urine.
The patient begins to urinate into the first container, continues into the second and finishes into the third, it is important that the second portion of urine is larger in volume (about 80% of all urine).
Attention! Do not touch the sterile straw or the inside of the cap with your hands.
Each container should be filled to no more than ¾ of its capacity. Minimum - 30 ml, maximum - 80 ml.
Screw the lid on tightly, carefully holding the edges. Stir the contents of the container 3-5 times, carefully turning it 180°
Label the tubes with patient information. Enter Last Name I.O. Attention! Block letters
Carefully peel back the sticker on the tube cap, but do not tear it off completely!
Place the test tube, cap down, into the recess on the container lid. Press down on the bottom of the tube and push the cap through. After filling the tube with urine, remove it from the container.
Mix the contents of the test tube 8-10 times, carefully turning it 180°
All three tubes of urine are delivered to the laboratory, and the portion number must be indicated on each tube. Storage in the refrigerator is allowed (+2…+4), but no more than 1.5 hours.

Cytological examination of urine:

It is necessary to collect urine after morning urination
Urine collected during morning urination is not used for this study. Cells left overnight in the bladder may be destroyed
Mix all collected urine. Pour 40-50 ml into a special sterile container and deliver to the laboratory department