How to collect urine sample from male,female,Infants and children

Urine container MLTGEEKS

Urine is one of  the most frequently specimen submitted for culture in microbiology. Therefore the urine collection, transport, culture techniques, and interpretation of results is very important in order to obtain accurate and reliable result. As with any other specimen submitted to the laboratory, the more comprehensive the information provided by the submitting physician the more able the laboratory will provide reliable culture data.

The most common sites of urinary tract infection (UTI) are the urethra and  urinary bladder (cystitis). From these sites, the infection may ascend into the ureters causing urethritis and subsequently involving  the kidney(pyelonephritis).

There is no obvious doubt that females are more prone to Urinary tract  infections than are males and they also present the greater problem proper collection of urine specimens.

Stage of urinary tract infections in both males and females,  may start from asymptomatic, acute, to chronic.Asymptomatic infection can be diagnosed by culturing the urine specimen. As for  acute UTI,it is more frequently seen in females of all ages; these patients are usually treated on an outpatient basis and are rarely admitted to hospital.

A Chronic urinary tract infection in both males and females is usually associated with an underlying disease such as pyelonephritis, prostatic disease, or congenital anomaly of the genitourinary tract) and these  often result to hospitalization of these patients. Asymptomatic,acute, and chronic  urinary tract infection are three distinct entities and the laboratory results often require different interpretation.

In female, asymptomatic pyelonephritis may remain undetected for a long period of time, and is often only diagnosed by carefully performed quantitative urine culture. Chronic prostatitis is common and difficult to cure, and is often responsible for recurring  urinary tract infection. In most urinary tract infection, irrespective of type, enteric bacteria are the etiological agents such as Escherichia coli,Proteus species and sometimes even protozoans and fungi are incriminated.

Also read  Normal range ,Critical and Reference values in Medical Laboratory

In about 10% of patients with  urinary tract infection, two organisms may be present and both may contribute to the disease process.The presence of three or more different organisms in a urine culture is a strong presumptive evidence of improper collection or handling of the urine specimen. However, multiple organisms are often seen in  urinary tract infection in patients with indwelling bladder catheters.Therefore Urine specimen collection is very important for accurate result and the culture media of choice for urine culture is Cysteine Lactose Electrolyte deficient Agar abbreviated CLED Agar while the best urine specimen for urine culture is the early morning mid stream urine as explain below

Urine specimen collection

The importance of the method of collection of urine specimens, their transport to the laboratory, and the initial efforts by the laboratory to screen and culture the urine cannot be overemphasized.

ideal urine container

should be sterile

  • wide-mouthed, glass or plastic jars, beakers, or other suitable receptacles.
  • It should have tight-fittinglids or be covered with aluminium foil prior to sterilization by dry heat or autoclaving.
Urine container
Urine container

Urine specimens may have to be collected by a surgical procedure, like

  • the supra-pubic aspiration
  • Cystoscopy,
  • catheterization.

If not, the laboratory must insist on a clean-catch midstream urine specimen, particularly in females and children. Since urine itself is a good culture medium, therefore ,all urine specimens should be processed by the laboratory within 2 hours of collection, or be kept refrigerated at 4°C until delivery to the laboratory and processed no longer than 18 hours after collection.

Whenever possible, urine specimens for culture should be collected in the morning. It is advisable to ask the patient the night before to refrain from urinating until the specimen is to be collected.

Also read  Clinical Significance of Various Crystals Found In Urine

How to Collect Urine specimen from Female (Midstream Urine)

Urine collection female
Urine collection female
  • Wash her hands thoroughly with soap and water and dry them with a clean towel.
  • Spread the labia, and cleanse the vulva and labia thoroughly using sterile cotton gauze pads and warm soapy water, wiping from front to rear. Don’t use disinfectant to clean the vulva
  • Rinse the vulva and labia thoroughly with warm water and dry with a sterile gauze pad. During the entire process the patient should keep the labia separated and should not touch the cleansed area with the fingers.
  • Now pass a small amount of urine (Midstream).This help to clear out any possible bacteria or particle found at the mouth of the urethra
  • The patient should collect most of the remaining urine in a sterile container, closing the lid as soon as the urine has been collected. This is a midstream urine specimen.
  • Hand the closed container to the nursing personnel for prompt delivery to the laboratory or directly to the laboratory

How to Collect Urine specimen from Male

Urine collection male
Urine collection male
  • Wash his hands thoroughly with soap and water and dry them with a clean towel
  • Pull back the foreskin (if not circumcised) and wash the glans thoroughly using sterile cotton gauze pads and warm soapy water.Disinfectants should not be used for this process.
  • Rinse the glans thoroughly with warm water and dry with a sterile gauze pad.
  • During the entire procedure the patient should not touch the cleansed area with the fingers.
  • Pull back the foreskin and pass a small amount of urine. Still holding back the foreskin, the patient should pass most of the remaining urine into a sterile container, closing the lid as soon as the urine has been collected.This is also a midstream urine specimen.
  • Hand the closed container to the to the laboratory.
Also read  comprehensive stool analysis (Macroscopic,Microscopic and Concentration techniques)

For bedridden patients, the same procedure is followed, except that a nurse must assist the patient or, if necessary, do the entire cleansing procedure before requesting the patient to pass urine.In both situations every effort must be made to collect a clean-catch urine specimen in a sterile container and to ensure that it is delivered promptly to the laboratory together with information on the patient, the clinical diagnosis, and the requested procedures.

Infants and children

Urine collection infant
Urine collection infant

Collection of a clean-catch urine specimen from infants and children who are ill in bed or uncooperative can be a serious problem.

  • Start by giving the child water or other liquid to drink.
  • Clean the external genitalia. The child can be seated on the lap of the mother, nurse, or ward attendant, who should then encourage the child to urinate and collect as much urine as possible in a sterile container.
  • The container should then be covered and delivered to the laboratory for immediate processing.

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About the Author: Arthur Westmann

DEFFE ARTHUR (AMOEBAMANN) is the founder and author of MLTGEEKS and MLTEXPO.He’s from Cameroon and is currently a Final year State Medical Laboratory Technician (MLT MA). Beyond lab works, he’s a passionate internet user with a keen interest in web design and blogging. Furthermore He likes traveling, hanging around with friends and social networking to do in his spare time.

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