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Urinalysis
A urinalysis is a set of tests on your pee (urine). You provide a urine sample, either in a cup or with a catheter. Then your provider sends it to a lab for a visual exam, dipstick test and microscopic exam. You might need a urinalysis as part of a routine screening or if you have symptoms of an infection, diabetes, or kidney or liver issues.
Overview
A urinalysis is a set of tests that looks at the appearance of your pee (urine) and checks for blood cells, proteins and other substances in it. You provider might use it as a routine screening test or to look for signs of infection, kidney or liver disease, diabetes or other health conditions.
A lot of people know a urinalysis as simply “the test where you pee in a cup.” And usually, that’s all you need to do for your part. Then your provider sends your sample to a lab, where they note its appearance, test it for certain substances (urine dipstick) and look at it under a microscope. Often, providers can do a simple urine dipstick test in their office and get the results right away.
What does a urinalysis test for?
A urinalysis can include a description of the sample’s appearance (visual exam), a dipstick test and microscopic exam. Your provider won’t necessarily order all the tests listed. Which tests the lab performs depend on what your provider is looking for.
Visual exam
A healthcare professional looks at the color, clarity and anything else they see with the naked eye in a visual exam. The description might include:
- Color. Normal pee color is usually some shade of yellow and can range from colorless or pale yellow to deep amber. This can depend on how concentrated or diluted (watery) your pee is.
- Clarity. They’ll note if your pee is clear or cloudy. They may also describe it as turbid (thick with suspended substances).
Dipstick test
Dipsticks are plastic strips with patches of chemicals that change color when they touch certain substances. Dipstick urinalysis tests might include:
- Acidity (urine pH). This measures the acid-base (pH) level in your pee. Kidney issues and urinary tract infections (UTI) can cause high urine pH. Diabetes-related ketoacidosis and diarrhea can cause low urine pH.
- Bilirubin. Liver or bile duct issues can lead to bilirubin in your pee.
- Blood (hemoglobin). Infections, damage in your urinary tract, high blood pressure and cancer can cause blood in your pee (hematuria).
- Glucose. A glucose urine test measures the amount of sugar (glucose) in your urine. Diabetes or gestational diabetes can cause glucose in your pee.
- Ketones. Healthcare providers most often use ketone urine tests to check for diabetes-related ketoacidosis.
- Leukocyte esterase. Leukocyte esterase is an enzyme that helps you fight infections. If a leukocyte esterase test is positive, you might have inflammation in your urinary tract, most often caused by a UTI.
- Nitrites. Bacteria in your urinary tract can create nitrites. A positive nitrite test result can mean you have a UTI.
- Protein. This measures the presence of proteins, like albumin, in your pee. Heart failure, kidney damage (often from high blood pressure or diabetes), overexertion and dehydration can lead to elevated protein levels.
- Urine specific gravity test. A specific gravity test shows the concentration of all chemical particles in your pee. Many conditions can cause abnormal results.
Microscopic exam
Some substances in your pee can only be seen with a microscope. A microscopic exam can look for:
- Crystals. Certain types of crystals in your pee can be a sign of kidney stones.
- Epithelial cells. Your pee typically contains some epithelial cells from your urinary tract. These can be listed as transitional epithelial cells, renal tubular cells or squamous epithelial cells. Infection, inflammation or cancer in your urinary tract can cause high numbers of epithelial cells in your pee. If your results list squamous epithelial cells, it probably means your sample was contaminated from another part of your body.
- Bacteria, yeast and parasites (infections). Signs of infection in your pee can mean you have a UTI, yeast infection or a sexually transmitted infection (STI). Bacteria and yeast from outside of your urinary tract can also contaminate the sample, especially for people with a vagina.
- Red blood cells (RBC). An elevated number of RBCs means there’s blood in your pee — that you might not be able to see just by looking at it. In some cases, higher-than-normal levels of red blood cells in your urine may indicate bladder, kidney or urinary tract issues.
- Urinary casts: Your pee can sometimes contain tiny, tube-like particles (casts), made from protein released by your kidney cells. Certain types of casts may indicate kidney issues, while others are completely normal.
- White blood cells (WBC): An increased number of WBCs might mean there’s an infection or inflammation somewhere in your urinary tract.
Why do I need urinalysis?
Your provider may order a urinalysis:
- As part of a routine medical exam to screen for certain health conditions.
- If you’re experiencing symptoms of an infection, kidney disease or diabetes.
- To monitor certain health conditions.
- During pregnancy.
- If you’ve been admitted to a hospital.
- In preparation for surgery.
How do I prepare for a urinalysis?
Usually, you don’t have to do anything to prepare for a urinalysis. You may need to drink an extra glass of water if you don’t feel like you’ll be able to pee for the test. But drinking too much extra water can give inaccurate results.
Let your provider know:
- If you’re currently getting your period (menstruating). Menstrual blood and vaginal discharge can interfere with certain urinalysis test results.
- If you have trouble peeing away from home, or shy bladder syndrome. They can give you options for providing a sample that’ll be comfortable for you.
In certain circumstances, your provider might ask you to:
- Get the sample from your first pee in the morning.
- Avoid certain foods before the test.
- Stop taking certain medications that can affect the results. Only stop taking medications if your provider tells you to.
What happens during a urinalysis?
In most cases, you’ll provide a pee sample at your healthcare provider’s office or at a laboratory using the “clean catch” method. You or your healthcare provider can also collect a urine sample using a catheter (thin tube).
For the clean catch method, your provider will give you a specimen cup, sterile wipes and specific instructions for collecting your urine sample. Your provider will tell you what to do with your sample after you’ve collected it. It’s important to wash your hands with soap and water before you collect the sample.
Collecting a clean catch urine sample if you have labia
If you have labia, collect your pee with the following steps:
- Start by sitting on the toilet with your legs spread apart.
- Using two fingers, spread your labia open. Use one sterile wipe to clean the inner folds of your labia, wiping from front to back.
- Use another sterile wipe to clean the opening to your urethra, where pee flows out of your body.
- Pee a small amount into the toilet.
- Stop the flow of pee and hold the specimen cup a few inches away from your urethra.
- Pee into the cup until it’s about halfway full or to the amount your provider recommends. It’s OK if you can’t fill it quite to halfway.
- Finish peeing into the toilet (if you need to).
Collecting a clean catch urine sample if you have a penis
If you have a penis, collect your pee with the following steps:
- Use a sterile wipe to clean the head of your penis. If your penis is uncircumcised, first pull back your foreskin to ensure a thorough cleaning.
- Pee a small amount into the toilet.
- Stop the flow of pee and hold the specimen cup below your penis.
- Pee into the cup until it’s about halfway full or to the amount your provider recommends. It’s OK if you can’t fill it quite to halfway.
- Finish peeing into the toilet (if you need to).
Collecting a urine sample with a catheter
A healthcare provider can also collect a urine sample with a catheter. They’ll clean the area around the opening of your urethra with a germ-killing (antiseptic) solution and insert a catheter into your urethra. Your pee will drain into a sterile container and your provider will remove the catheter.
What happens after a urinalysis?
Your healthcare provider will send your sample to a lab for the urinalysis. In some cases, your provider may examine the sample and run dipstick tests on it immediately in their office.