Urinalysis
Urine appearance and color; Routine urine test; Cystitis - urinalysis; Bladder infection - urinalysis; UTI - urinalysis; Urinary tract infection - urinalysis; Hematuria - urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds that pass through the urine.
The female and male urinary tracts are relatively the same except for the length of the urethra.
The male and female urinary tracts are relatively the same except for the length of the urethra.
Using the bathroom is usually a no-brainer. You go, you flush, you wash. But sometimes, you can have a condition that makes it painful or difficult to go. If you're feeling pain or burning when you urinate, or you feel like you need to go all the time, the problem could be a urinary tract infection. Most often, you get a urinary tract infections when bacteria make their way into your bladder, kidneys, ureters, those tubes that carry urine from the kidneys to the bladder, or the urethra, the tube that carries urine to the outside of your body. Unfortunately for women, they're more likely to get a urinary tract infection than men because they have a much shorter urethra. Bacteria can more easily slip into a woman's body after they have sex or use the bathroom. Certain conditions can also increase your risk of a urinary tract infection, including diabetes, pregnancy, kidney stones, an enlarged prostate in men, as well as urinary tract surgery. You can often tell you may have a urinary tract infection by the pain and burning whenever you urinate, and the constant urge to go. Your urine may look cloudy or bloody, and it might give off a bad smell. Your doctor can diagnose an infection by taking a urine sample and checking for bacteria. Occasionally different scans, including a CT and kidney scan, may be done to rule out other urinary problems. If you do have a urinary tract infection, you'll probably be prescribed antibiotics, drugs that kill bacteria. Also drink a lot of water and other fluids to help flush out the bacteria. Usually, antibiotics can knock out a urinary tract infection in a day or two. But like the unwelcome visitors they are, sometimes these infections keep coming back. You may need to keep taking antibiotics for a longer period of time. There are ways to help prevent getting urinary tract infections, like drinking a lot of fluids, perhaps including cranberry juice. Probiotics, beneficial bacteria may also help prevent urinary tract infections. Women should be careful about their hygiene. Always wipe from front to back after using the bathroom, urinate before and after sexual activity, and keep your genital area clean. If you use a diaphragm with spermicide, consider changing contraceptives. For post menopausal women, topical estrogen greatly reduces urinary tract infections. Recurrent, uncomplicated urinary tract infections are very common in non pregnant, healthy young women. Thankfully, they are easy to treat and are unlikely to lead to other health problems.
How the Test is Performed
A urine sample is needed. Your health care provider will tell you what type of urine sample is needed. Two common methods of collecting urine are 24-hour urine collection and clean catch urine specimen.
The sample is sent to a lab, where it is examined for the following:
PHYSICAL COLOR AND APPEARANCE
How the urine sample looks to the naked eye:
- Is it clear or cloudy?
- Is it pale, or dark yellow, or another color?
MICROSCOPIC APPEARANCE
The urine sample is examined under a microscope to:
- Check if there are any cells, urine crystals, urinary casts, mucus, and other substances.
- Identify any bacteria or other germs.
CHEMICAL TESTS (urine chemistry)
- A special strip (dipstick) is used to test for substances in the urine sample. The strip has pads of chemicals that change color when they come in contact with substances of interest.
Examples of specific urinalysis tests that may be done to check for problems include:
How to Prepare for the Test
Certain medicines change the color of urine, but this is not a sign of disease. Your provider may tell you to stop taking any medicines that can affect test results.
Medicines that can change your urine color include:
- Chloroquine
- Iron supplements
- Levodopa
- Nitrofurantoin
- Phenazopyridine
- Phenothiazine
- Phenytoin
- Riboflavin
- Triamterene
How the Test will Feel
The test involves only normal urination, and there is no discomfort.
Why the Test is Performed
A urinalysis may be done:
- As part of a routine medical exam to screen for early signs of disease
- If you have signs of diabetes or kidney disease, or to monitor you if you are being treated for these conditions
- To check for blood in the urine
- To diagnose a urinary tract infection
Normal Results
Normal urine varies in color from almost colorless to dark yellow. Some foods, such as beets and blackberries, may turn urine red.
Usually, glucose, ketones, protein, and bilirubin are not detectable in urine. The following are not normally found in urine:
- Hemoglobin
- Nitrites
- Red blood cells
- White blood cells
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.
What Abnormal Results Mean
Abnormal results may mean you have an illness, such as:
- Kidney disease
- Urinary tract infection
- Kidney stones
- Poorly controlled diabetes
- Bladder or kidney cancer
Your provider can discuss the results with you.
Risks
There are no risks with this test.
Considerations
If a home test is used, the person reading the results must be able to tell the difference between colors, because the results are interpreted using a color chart.
References
Riley RS, McPherson RA. Basic examination of urine. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 29.
Sobel JD, Brown P. Urinary tract infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 72.
Version Info
Last reviewed on: 2/2/2023
Reviewed by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
