What happens during my urine test?

PHOTO: What happens during my urine test?

They look at it with the naked eye first. Then they put a strip of test paper into it. They could also do other things to it. This is all standard procedure for a urine test.

I AM now looking at the results of my urine test and cannot make head or tail of it.

Why did the nurse ask me to collect a mid-stream urine sample rather than the whole thing?

A urine test is also known as a urinalysis. The nurse asks you to collect your mid-stream urine. This means that you allow the first initial drops to come out first, before you put the plastic container to your urethra – because it is preferred that the urine sample be clean.

This is especially important if the test is looking for bacteria. Labs prefer their urine samples to be free of bacteria when they run their analysis. (Meaning, they prefer the urine to be as sterile as possible, direct from your bladder.)

If you collect your urine at the initial phase of your urination, there may be impurities that come from the skin around your urethra – such as the aforementioned bacteria, some white blood cells from your vaginal passage or urethral passage, and even some dead skin cells. The urine at mid-stream is more clean and pure.

OK. I have given my urine sample. The nurse mentioned my urine looks a little cloudy. Is that a reason for me to be alarmed?

The lab actually performs what we call a macroscopic analysis first – they look at the appearance of the urine.

Normal urine is light yellow in colour. It is clear and not supposed to be cloudy.

Cloudy urine may possibly mean an infection, because then your urine may contain pus.

Foamy urine that has plenty of froth may suggest large amounts of protein present, such as in the disease condition called nephrotic syndrome, which signifies kidney disease.

If your urine is very dark in colour, it may mean that you are dehydrated, because the urine would then be concentrated.

If your urine is red in colour, this would mean it contains blood. (This is known as haematuria – haema is blood, while uria means urine.)

If your urine is the colour of tea, this may suggest a liver disease involving the metabolism of a substance known as bilirubin, which is a breakdown of your bile.

If you have orange urine, this may suggest massive breakdown of creatinine from your muscles.

Certain medicines may also change the colour of your urine.

Once I gave my urine sample, the doctor then put a urine dipstick inside it. The dipstick had a lot of different coloured pads on it that changed colour as soon as it was immersed in my urine. What does that mean?

Those squares that have different colours on a urine dipstick actually represent different components of the test that form part of your urinalysis. It’s a quick method that is used to tell you what’s wrong at a glance, but not in any way as sensitive or accurate as a full urinalysis performed in a lab.

The colours on those squares don’t always change immediately. Sometimes, it takes a few minutes to observe a change.

The altered dipstick, when drenched with your urine, is compared to a colour chart at the side of the dipstick bottle. Some colour changes are normal and to be expected. Others signify abnormalities.

Basically, the squares denote:

  • Urine specific gravity – your urine concentration (looking out for dehydration).
  • pH or acidity
  • Protein, because protein in the urine suggests a leakage through your kidney tubules that should not be there.
  • Glucose (suggesting diabetes)
  • Ketones – this is a by-product of fat metabolism, suggesting that your body is using a lot of fat instead of sugar to metabolise for energy. This happens during severe illness, diabetes crisis, or starvation/severe fasting.
  • Red blood cells and white blood cells. The white cells suggest infection.
  • Bilirubin, which suggests liver disease.

I have heard that they can detect drugs in a urine sample. Is this true? Does this come with my test?

The urinalysis offered by GPs, hospitals or labs that come in a package with your blood tests usually do not go as far as to include these special tests.

Other special tests involving your urine include:

  • Urine pregnancy test.
  • Urine drug screen – to look for amphetamines, cocaine, marijuana, opiates, etc.
  • Urine creatinine (for kidney disease).
  • 24-hour urine protein (if massive amounts of protein is detected, this warrants further investigation).
  • 24-hour urine catecholamines (for assessing adrenal gland disease).