Urine testing

A urinalysis is a common urine test that's done for several reasons:

• To check your overall health. Your doctor may recommend a urinalysis as part of a routine medical exam, pregnancy check-up, pre-surgery preparation or when you are admitted to hospital. This is to screen for a range of conditions, such as diabetes, kidney disease, liver disease and bladder cancer.
• To diagnose a medical condition. Your doctor may suggest a urinalysis if you're having symptoms such as abdominal (tummy) pain, back pain, peeing often or having pain when you pee, blood in your pee or other urinary problems. A urinalysis may help diagnose the cause of these symptoms.
• To monitor a medical condition. If you've been diagnosed with a medical condition, such as kidney disease or a urinary tract disease, your doctor may recommend a urinalysis on a regular basis to monitor your condition and treatment.

Other tests, such as pregnancy testing and drug screenings, also may rely on a urine sample, but these tests look for substances that aren't included in a typical urinalysis. For example, pregnancy testing measures specific hormones and drug screenings detect specific drugs.

Common urine tests include a midstream urine test and a 24-hour urine test.

Midstream urine test

A midstream urine test is the most common urine test and is used when a culture is needed to look for urinary infections. This means the middle part of the urinary flow is collected into a clean container for testing. The collection centre will give you instructions of how this needs to be done.

24-hour urine testing

Sometimes a 24-hour urine test is done, eg, to help assess whether you have kidney disease, or if you are already diagnosed with kidney disease, to see how well it is being managed. With this test, all the urine you produce throughout a 24-hour period is collected into a container provided by your doctor. This is then sent to the lab for analysis. The collection centre will give you instructions of how this needs to be done.

There are several steps in analysing urine.

1. Visual examination. Looking at the colour, clarity (cloudy or clear) and concentration provides some information, 
2. Chemical examination. Dip sticks containing small squares of reactants test for glucose, ketones, drugs, protein, red blood cells and more.
3. Microscopic examination. By looking at the urine under a microscope, you can count the type of cells, look for casts, crystals, bacteria, mucus and cancer cells.
4. Culture. If the dip stick test suggests infection is possible, the urine is cultured to see if any bacteria grow.

All steps provide some information about your health. The first two phases are often completed in a doctor or nurse's office when you present with symptoms of possible urine infection, kidney problems or as part of a routine check-up. If these phases show any positive results, then a sample is sent to the laboratory for culture and/or microscopy. 

Video: Urine Analysis

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(Ilearnthisway, 2009)

A urinalysis alone usually doesn't provide a definite diagnosis. Depending on the reason your doctor recommended this test, abnormal results may or may not require follow-up. Your doctor will consider the results along with the results of any other tests to work out the next steps.

If you are otherwise healthy and have no signs or symptoms of illness, results slightly above normal on a urinalysis may not be a cause for concern and follow-up may not be needed. However, if you've been diagnosed with a kidney or urinary tract disease, elevated levels may indicate a need to change your treatment plan.

For specifics about what your urinalysis results mean, talk with your doctor.