Let's learn everything about your urine test (urinalysis) in a simple way.

Hello! You've probably heard the doctor ask you to 'give a urine sample' when you go to see a doctor, right? You might be thinking, "Do I need to do this again?" Most of the time, all we have to do is give a little urine in a small cup. But with this simple test, called a ``Urinalysis'', the doctor can find out a lot about our body. Today, let's talk about this ``Urinalysis'', what it looks for, and why it's important.

What is a urine test (urinalysis)? Simply put...

Simply put, a urinalysis is a series of tests that take your urine (also called urine ) and look at what it looks like, whether it contains blood cells, protein, or other abnormalities. A doctor may use this as part of a routine screening test, or to check if you have an infection, kidney problems, liver disease, or a condition like diabetes mellitus.

Many people know this as the " pee- in-a-cup test." Yes, that's all you have to do. The doctor then sends the sample to a lab. There, they first look at it, then they put a small strip in it to look for certain chemicals (this is called a ``urine dipstick test''), and finally they look at it under a ``microscope'' to look for other subtle things. Sometimes, the doctor can do the ``dipstick test'' in his or her own room and give you the results quickly.

What exactly does a urinalysis test look for?

There are three main parts to a urinalysis: a visual inspection of the urine sample (visual inspection), a dipstick test, and a microscopic examination. However, doctors don't always order all of these. The lab tests they perform depend on what they're looking for.

Things to look at first (Visual Exam)

Someone in the lab will first note the visible characteristics of your urine sample, such as its color and clarity.

• Color: Normally, healthy urine can come in a variety of shades of yellow. It can be colorless, light yellow, or dark amber. This depends on how much water you have drunk, which means how concentrated or diluted your urine is.
• Clarity: The urine is also checked to see if it is clear or cloudy. Sometimes, if it is turbid, meaning that something seems to be floating around, that is also noted.

What is a dipstick test?

This is what I was talking about earlier, the test where you put a small plastic strip in your urine. There are little squares on the strip, and chemicals are applied to them. If there is something special in your urine, those squares will change color. This can help you quickly check for many things.

• Acidity (Urine pH):This measures the acid-base balance of your urine. Things like kidney problems and urinary tract infections (UTIs) can cause the pH to increase (become more alkaline). Conditions like diabetes-related ketoacidosis and diarrhea can cause the pH to decrease (become more acidic).
• Bilirubin: If there is a problem with the liver or bile ducts, bilirubin may be present in the urine. Normally, these are not present in the urine.
• Blood (Hemoglobin): This test looks for blood in the urine. Infections, an injury somewhere in the urinary tract, high blood pressure, and some types of cancer can cause blood in the urine. Doctors also call this ``hematuria''.
• Glucose: This tests for sugar (glucose) in the urine. People with diabetes mellitus or gestational diabetes may have glucose in their urine. A healthy person's urine should not contain glucose.
• Ketones: A dangerous condition that can occur in people with diabetes is called ``Diabetes-related ketoacidosis.`` This test checks for ketones in the urine.
• Leukocyte esterase: This is an enzyme. It helps our body fight infections. If it is positive, meaning it is present in the urine, it may indicate inflammation somewhere in the urinary tract. This is often caused by a urinary tract infection (UTI).
• Nitrites: When there is a bacterial infection in the urinary tract, the bacteria produce something called nitrites. So if nitrites are ``positive``, it can be a sign of a urinary tract infection.
• Protein: The urine is checked for the presence of proteins such as `(Albumin).` Normally, there should be very little, if any, present. Protein levels in the urine can increase due to factors such as heart disease, kidney damage (especially damage caused by high blood pressure or diabetes), excessive exercise, and dehydration.
• Urine specific gravity: This measures the concentration of all the chemical particles dissolved in the urine. It is a measure of how thick the urine is. This value can be abnormal due to many diseases.

What is a Microscopic Exam?

There are some things that can't be seen by the naked eye or by that dipstick. To see them, you have to look through a microscope.

• Crystals: If there are certain types of crystals in the urine, it could be a sign that kidney stones are developing.
• Epithelial cells:These are the types of cells that come out of our urinary tract. They may be listed in the report as `(Transitional epithelial cells)`, `(Renal tubular cells)` or `(Squamous epithelial cells)`. Usually, having a little is not a problem. But if there are a lot of them, it can be a sign of a urinary tract infection, inflammation, or possibly cancer. If there are a lot of `(Squamous epithelial cells)`, it means that the sample was `(contaminated)` from the outside (for example, from the skin) when it was taken.
• Bacteria, yeast, parasites: If any of these are found in the urine, it could be a sign of a urinary tract infection (UTI), a yeast infection, or a sexually transmitted infection (STI). But sometimes, especially in women, these can get in from around the vagina when the sample is taken and become contaminated.
• Red blood cells (RBC): An excess of these means that there is blood in the urine, although it may not be visible to the naked eye. This can be caused by a problem in the bladder, kidneys, or elsewhere in the urinary tract.
• Urinary casts: These are small, tube-like particles made of protein produced by kidney cells. Some types of casts indicate a problem with the kidneys. Other types of casts are normal.
• White blood cells (WBC): An increase in these is a major sign that there is an infection or inflammation somewhere in the urinary tract.

Why do I need a urinalysis?

There are several reasons why a doctor might ask you to take a urine test:

• As part of your annual health checkup , identify some diseases early.
• If you have symptoms of a urinary tract infection, kidney disease, or diabetes (e.g., frequent urination , burning when urinating , fever, back pain).
• Monitor certain pre-existing medical conditions (e.g., check the condition of the kidneys in someone with diabetes).
• A mandatory test during pregnancy .
• If you are admitted to a hospital .
• Before any surgery .

How should I prepare for a urinalysis?

The good news is that most of the time, this doesn't require any special preparation . However, if your doctor or someone in the lab gives you special instructions, you should follow them exactly.

• If you are worried that you will not be able to urinate , drink an extra glass of water before giving the sample. However, keep in mind that if you drink too much water and dilute your urine, the results may be inaccurate.
• Tell the doctor these things in advance:
• If you are menstruatingSay that because menstrual blood and vaginal discharge can affect some test results.
• If you have difficulty urinating outside of the home, such as shy bladder syndrome, tell them about it. They will find an easier way for you.
• Sometimes the doctor may also say:
• The sample should be taken first thing in the morning, with the first urine you urinate upon waking .
• You should not eat certain foods before the test.
• Some medications may affect the results and you may be asked to stop taking them for a few days . But remember, you should only stop taking them if your doctor tells you to. Don't stop them on your own.

How to do a urine test (urinalysis) correctly?

Most of the time, you will have to go to a bathroom in your doctor's office or lab to give a urine sample. This is called the "clean catch" method. It means that you collect the sample cleanly, without contamination. For this, they will give you a small specimen cup and sterile wipes. Be sure to wash your hands thoroughly with soap and water before collecting the sample.

If you have a labia, you should provide the sample as follows:

1. First, sit on the toilet and spread your legs a little apart.

2. Use two of your fingers to hold the labia on either side.

3. Wipe the inside of the labia with the sterile wipe they gave you, from front to back . (Do not wipe from back to front, as this can bring germs from the anus forward).

4. Take another sterile wipe and wipe the urethra.

5. Then, first urinate a little into the toilet (this will remove some of the germs in the urethra).

6. Then, stop urinating for a while, hold the cup provided a little away from the urethra, and urinate into it. Urine until the cup is about half full, or as much as the doctor tells you. It doesn't matter if it's not completely half full.

7. Flush the rest (if any) back into the toilet.

If you have a penis, you should provide the sample as follows:

1. Clean the head of the penis thoroughly with the sterile wipe they provided. If you are uncircumcised, you should first clean the foreskin by pulling it back.

2. Then first urinate a little into the toilet.

3. Pause while urinating , hold the cup provided below your penis, and urinate into it. Urine until the cup is about half full, or as much as your doctor tells you. It doesn't matter if it's not half full.

4. Flush the rest (if any) back into the toilet.

The most important thing is to not let the inside of the cup or the inside of the lid touch your body, clothes, or anywhere else. Doing so could contaminate the sample.

Taking a sample through a catheter

In some special cases, for example if you are unable to urinate on your own, a doctor or nurse may insert a small tube (catheter) into your urethra to collect a urine sample. Before doing this, they will clean the area around your urethra with an antiseptic solution. Then they will insert the catheter and collect the urine in a clean container. The catheter will then be removed.

What happens after a urinalysis?

After you provide the sample, it is sent to a lab for testing. As I mentioned earlier, sometimes the doctor can do a `dipstick` test right in their office and give you a quick result.

How do I read my urinalysis results?

Typically, your urine test report will show things like:

• The name of the test or what was tested (e.g. Glucose, Protein, RBC).
• Your result: This can be a number, either `positive` (yes) or `negative` (no), or a description (e.g. color - yellow, clarity - clear). If there are things that can be counted, such as red blood cells, white blood cells, or bacteria, the result may be ``few``, ``moderate``, or ``many``.
• The normal value or range for that test.
• A chart showing whether your results are within the normal range or not .

Depending on the tests your doctor ordered, your report may contain many or few results. These may appear as a list or a table.

What are the normal results of a urinalysis?

Normal values ​​can vary slightly from lab to lab, but in general, they should look something like this:

• Color: Light yellow to amber.
• Clarity: Clear.
• pH value: between 4.5 – 8.0.
• Specific Gravity: Between 1.005 – 1.030.
• Glucose: Negative.
• Ketones: Negative.
• Bilirubin: Negative.
• Nitrites: No `(Negative)`.
• Blood/Hemoglobin: Negative.
• Protein: None or very little (Negative or Trace).
• Leukocyte Esterase: Negative.
• White blood cells (WBC):Very low numbers when viewed under a microscope (e.g. 0-5 per HPF).
• Red blood cells (RBC): Very low numbers when viewed under a microscope (e.g. 0-2 per HPF).
• Bacteria, yeast, crystals, casts: none or very few.

What do urinalysis results mean?

Whether the results of a urine test are ``positive`` or outside the normal range, it means that you may have a health problem. But there is one thing to remember. Doctors rarely make a diagnosis based on the results of a urine test alone. If the results are abnormal, the doctor may order further tests to find the cause.

How long does it take to know the results?

In most cases, you will get the results of your urine test within one or two business days . Your doctor will tell you about it, or you may be able to look it up yourself in your electronic health record.

Should I be worried if I get an abnormal result?

No, just because one test result is abnormal doesn't mean it's a serious condition. It doesn't mean you have something serious. Your doctor will look at the result and tell you if it's really a problem or if you need more tests. He or she will take into account your past medical conditions, your current symptoms, and the medications you're taking.

Sometimes the following things can affect urine test results:

• Some medications and supplements you take, such as metronidazole and vitamin C supplements.
• Contamination can occur when the sample is collected, either from germs or other things (e.g. vaginal discharge, menstrual blood) .

When should I call the doctor?

If you notice any new changes in your urine (e.g., persistent color change, strange odor, or change in consistency), or if you have any questions about your urine test results, be sure to talk to your doctor.

Finally, remember (Take-Home Message)

Yes, urinating into a cup can be a bit awkward and embarrassing. But this `Urinalysis` is a `noninvasive` test that provides the doctor with a lot of valuable information about your health without causing any harm or pain to our body.

This simple test can help your doctor quickly identify a condition or decide if you need further testing. So, don't be afraid to ask your doctor about why you need this test and what the results mean. The most important thing is to be informed about your health!

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