Routine urinalysis (UA) is one of the most frequently requested laboratory procedures at Main Line Health Laboratories (MLHL) because it can provide a useful indication of body health. It can be performed on a "first morning" or random urine specimen. Various diseases and disorders can be detected through a routine UA.

Below is a summary of urine specimen types, their diagnostic uses and physician instructions.


Random Urine

Description: This type of specimen is most convenient to obtain.
Uses: Routine urinalysis
Physician Instructions: Patient may void at any time of the day or night.
  1. Obtain an appropriate specimen container from MLHL.
  2. Collect the specimen in a clean, dry urine container. Appropriate containers include plastic disposable cups or bags (for infants) with a capacity of 50 ml.
  3. Label the container with the patient's full name exactly as it appears on the test requisition.
  4. Ensure that the specimen container is tightly closed to prevent leakage during transport.
  5. Transport the container to the laboratory within two hours. If transportation or analysis cannot occur within this time period, refrigerate the urine.
< h3> First Urine of the Morning
Description: This urine excretion is the most concentrated.
Uses: Protein, nitrite, microscopic analysis and routine urinalysis.
Physician Instructions:

Instruct the patient to void before retiring at night and discard specimen. On arising the next morning the patient should void and collect the urine specimen. Have the patient deliver the specimen to your office for transport to MLHL or bring the specimen to an MLHL collection facility. If using an MLHL collection site, please instruct the patient to bring a completed test requisition and to indicate that the specimen is a "first morning" specimen.

  1. Obtain an appropriate specimen container from MLHL.
  2. Collect the specimen in a clean, dry urine container. Appropriate containers include plastic disposable cups or bags (for infants) with a capacity of 50 ml.
  3. Label the container with the patient's full name exactly as it appears on the test requisition.
  4. Ensure that the specimen container is tightly closed to prevent leakage during transport.
  5. Transport the container to the laboratory within two hours. If transportation or analysis cannot occur within this time period, refrigerate the urine.

Fasting

Description and Uses: Used when metabolic abnormalities are suspected and for glucose-level determinations for diabetes mellitus testing.

Clean-Catch Mid-stream Urine

Description: The specimen is free of contamination.
Uses: Routine urinalysis. Culture for bacteria and/or microscopic analysis.
Physician Instructions: Many physicians prefer that urine specimens submitted for routine urinalysis be collected as the "first morning" specimen and/or a "clean catch" specimen. Specific instructions concerning urine cultures are provided in the Directory of Services under the culture section.

Explain to the patient that this type of specimen involves first voiding approximately one half of the urine into the toilet, then collecting a portion of "mid-stream" urine in a sterile urine container, and finally allowing the rest to pass into the toilet. Explain that this type of specimen is used to detect the presence or absence of infecting organisms and, therefore, must be free of contaminating matter that may be present on the external genital areas.

Obtain the correct collection kit from MLHL and instruct the patient as follows:

Female Patient:

  1. Wash hands with soap and water.
  2. Remove towelettes from urine collection kit. Cleanse perineal area with towelettes.
  3. Separate folds of urinary opening with thumb and forefinger and clean inside with towelettes, using downward strokes only; keep labia separated during urination.
  4. Remove jar from kit. Do not touch inside of jar. Hold jar by the handle. Begin urination into toilet. As urination continues, bring jar into stream. Fill jar hallway. Twist off plastic handle-ring and discard.
  5. Do not touch inside of cap. Screw cap tightly on jar.

Male Patient:

  1. Wash hands with soap and water.
  2. Remove towelettes from urine collection kit. Completely retract foreskin and cleanse penis with towelettes.
  3. Remove jar from kit. Do not touch inside of jar. Hold jar by the handle.
  4. Begin urination into toilet. As urination continues, bring jar into stream. Fill jar hallway. Twist off the plastic handle-ring and discard.
  5. Do not touch inside of cap. Screw cap tightly on jar.

Timed Urine Specimens (e.g., 2-hour, 4-hour, 24-hour)

Description: The excretion rate of the analyte can be determined.
Uses: Creatinine clearance test, urobilinogen determinations, hormone studies.
Physician Instructions: 

For many urine chemistry procedures the specimen of choice is 24-hour urine. In some instances special preservatives or dietary restrictions are required. Prior to collection you should consult the specific test ordered in the Directory of Services. Proper specimen collection is critical to obtaining accurate results. MLHL can provide you with patient instruction sheets for collecting 24-hour urine specimens.

General instructions for collection of 24-hour urine specimens:

  1. Obtain the correct collection container from MLHL. Specific chemical preservatives are required for certain tests, and generally, these preservatives contain strong acid. Instruct the patient to use caution when adding specimen to the container. Precautionary labels describing the preservatives are present on the outside of the collection container. Instruct the patient not to void directly into the container.
  2. At the beginning of the collection period, empty the bladder and discard the urine. The patient should write their full name, the date and time the collection period started on the label and attach it to the collection container.
  3. The patient should collect all urine voided for the next 24-hours and add it to the collection container. It is essential that all urine voided be collected in order to obtain accurate, useful results.
  4. Instruct the patient to drink adequate fluids during the collection period.
  5. Instruct the patient to keep the collection container refrigerated or on ice during the collection period.
  6. Instruct the patient to empty the bladder at the end of the 24-hour period and add the urine to the collection container. Instruct the patient to write the ending date and time on the label attached to the collection container.
  7. Instruct the patient to continue to keep the collection container refrigerated or on ice until delivery to your office.
  8. Instruct the patient to return to your office with the completed collection as soon as possible. The client should follow the instructions for processing a 24-hour urine specimen. Refer the specimen to MLHL.

For example: Begin collecting the 24-hour urine specimen by voiding at 7:00 am and discarding the urine. Collect all urine voided during the next 24 hours. At 7:00 am the next morning, void and add the urine to the collection container. Label the container and deliver to the office or MLHL collection facility for processing and referral to MLHL.

Please refer any questions to the Main Line Health Laboratories Client Service Center during normal business hours at 484.580.4200.