Urinalysis, or OAM, is a typical laboratory test. The patient receives a referral to him during inpatient or outpatient treatment, as well as during a routine medical examination. The correct interpretation of the indicators helps the doctor in the diagnosis. A general analysis of urine allows you to evaluate how physiological processes occur in the body, detect inflammatory processes in the ureter, kidneys, and also make a diagnosis and prescribe the necessary therapeutic treatment.
Preparatory Activities
Careful preparation will determine the results, based on which, if necessary, the doctor will prescribe appropriate therapy.
Each patient should know how to pass a general urine test. To obtain reliable results, you need to prepare for it:
- one day before the collection of urine, switch to dietary food;
- do not drink alcohol;
- if possible, refuse to take medications and vitamin complexes;
- exclude foods that affect the color of urine from the diet;
- reduce physical activity;
- refuse procedures that lead to dehydration of the body (visiting a bath and sauna).
It is not recommended to take tests during menstruation, since red blood cell counts may be overestimated.
Before the urine collection procedure, it is very important for both women and men to thoroughly wash their genitals. Otherwise, mucus can enter the container, and the accuracy of the analysis results will be impaired. Of detergents, it is advisable to use only baby soap. Women should be washed from front to back.
Urinalysis: how to collect?
The biomaterial is collected immediately after sleep, in the morning, since at this time urine contains all the substances that the body secreted during the night. The results obtained in this case will most fully reflect the patient’s state of health. On the eve of the pharmacy institution, you need to purchase a special jar for collecting urine, pour over it with boiling water. For analysis, take an average portion of the allocated urine. Do not immediately collect urine in a container. The first few seconds, urination should be done in the toilet, then in the jar and the rest again in the toilet.
For research you will need no more than 100 ml of urine. Close the jar with a lid and refrigerate. After collection within 1-2 hours, it must be taken to the laboratory. It is not recommended to freeze it, it is necessary to transport it at plus temperature, without shaking. Violation of recommendations can lead to erroneous results.
What can not be done when collecting urine?
When collecting a general urine test in adults, it is not recommended:
- Collect urine in unprocessed containers: pot, plastic bag.
- Hand over urine to the laboratory, which has been stored for more than three hours.
- Use a catheter to collect analysis when not necessary. Its use is possible in bedridden patients, as well as patients with some oncological diseases. All these cases are agreed with the attending physician.
- Take an analysis during inflammation of the genitourinary system, vagina and dermis near the urethra.
- Collect urine immediately after defecation, sexual intercourse, during menstruation.
Indications for analysis
A general urine test in adults and children is a standard procedure for diagnosing and checking health status. It is carried out in the following cases:
- annual medical examination;
- with poor functioning of the urinary system and kidneys;
- doctor visits with diseases of the internal organs;
- research before any operation;
- diagnosis of prostate diseases;
- after suffering a sore throat and scarlet fever;
- examinations to monitor ongoing therapy.
By decoding the general analysis of urine, the doctor can diagnose diseases of the bladder, various kidney diseases, diseases with the prostate gland, pathology of the internal organs, when there are no obvious symptoms of the disease.
OAM Physical Indicators
These include:
- Density. It is determined using a special device called a urometer. It is placed in a container with urine and indicators are determined on a scale. For adults (men and women), the rate of specific gravity is 1010-1025 g / l. A density higher than normal is possible when a large amount of sugar, protein, salts and bacteria is found in urine. Low rates are characteristic when taking fluid in large volumes during the day.
- Color. His laboratory assistant determines by eye. The use of some products changes the color of urine, but this phenomenon is not considered a pathology. Urine can be light yellow, pink, red, brown, straw yellow.Normally, it is light yellow. Colorless urine indicates dehydration, dark tones of urine indicate severe damage to the urinary system. It can be pyelonephritis, kidney stones or oncology. The color of the meat slops indicates jade, and the milky color is a violation of the outflow of lymph. With hepatitis, a malfunction in the exchange of bilirubin occurs, and the urine becomes dark in color.
- Smell. It is determined by the organs of smell and should be unsharp. With various diseases, the smell of urine changes. It smells like ammonia in diabetes, and in bladder cancer it is foul meat.
- Transparency. It is determined visually. Normally, urine is transparent and retains this property for several hours after collection. It forms a precipitate only during prolonged storage, which makes it difficult to determine the result. Urine becomes cloudy if it contains mucus, salts, white blood cells, bacteria, or a large amount of epithelium. The transparency of the biomaterial largely depends on how the urine was collected for general analysis and how it was stored.
- Acidity. To determine its use indicator paper. It is lowered into a test tube and the resulting color is compared with the standard. Norm for urine is an acid reaction. Reduced acidity occurs in people who consume large amounts of plant foods, as well as in certain diseases of the kidneys, hormonal imbalance and lack of trace elements. Increased acidity is present with dehydration, diabetes, fasting, urinary tract infections, debilitating diets.
Each indicator is entered by the laboratory assistant in the research form.
Deciphering the results
Deciphering the results of a general analysis of urine in adults, is carried out according to the content of organic substances in the test material.
Most often, urine is checked for its protein and glucose content. Sometimes the doctor prescribes an extended analysis, which requires you to indicate the presence of ketone bodies, bile pigments and bilirubin. The listed substances are not present in the urine of a healthy person.
- Protein. Its appearance in urine in the form of traces is normal. This may be a consequence of eating salty or spicy foods before taking the test. Protein in the urine appears after physical or emotional stress.
- Glucose - an increased content indicates a large consumption of carbohydrates on the eve of the biomaterial or acute pancreatitis, diabetes mellitus, pheochromocytoma, and nephrotic syndrome. Normally, she should not be present.
- Urobilin - is a consequence of liver failure, sepsis, intestinal inflammation.
- Ketone bodies - their detection in urine indicates a violation of metabolic processes in the body: thyrotoxicosis, diabetes, alcohol intoxication.
- Bilirubin - appears as a result of liver damage, severe toxic poisoning, hemolytic disease.
- Hemoglobin - indicates a significant destruction of red blood cells. In the urine, it is detected with myocardial infarction, injuries of the kidneys, malaria, burns, intravenous blood infusions.
- White blood cells - with inflammation of the urethra, leukocyturia is observed.
- Red blood cells - a large level indicates bleeding. In addition, the cause may be chronic glomerulonephritis, cystitis, urolithiasis. An increased level of red blood cells is also detected when a general urine test is taken during menstruation.
Urinary sediment
Urine is centrifuged to detect sediment. It is placed on a glass slide and examined under a microscope. For standard analysis, the number of the following inclusions is determined and counted:
- Epithelium. It is flat, renal and transient. Flat epithelium should not exceed 3-5 pieces. A large number of it is observed in women who neglect the toilet of the genitals. In this case, the analysis has to be retaken. The presence of renal epithelium signals a pathology of the kidneys, and a transitional epithelium in the urine is the norm.
- Mucus - it should not be present in urine.
- Bacteria - their presence indicates abnormalities in the body: infection of the urinary tract.
- Salt crystals - for a healthy person, the content of oxalates, urates and tripelphosphates is considered normal.
- White blood cells - for men, the maximum number should not exceed three cells, and for women - five. If, when decoding the general analysis of urine, the indicators are more than normal, then this is a sign of an inflammatory process in the kidneys, bladder, prostate or urethra. Often, an increased content of mucus and leukocytes occurs due to a poorly conducted toilet, before collecting urine, genitals.
- Red blood cells - a high level in the urine indicates a pathology of the urinary system and kidneys, possibly bleeding. In men, they should be in a single amount, and in women - no more than three.
- Cylinders - their presence occurs in renal pathology. At high pressure, pyelonephritis, hyaline cylinders may be present. The presence in the urine of granular, waxy, erythrocyte, epithelial cylinders indicate pathological changes in the body.
Before collecting the analysis, the patient needs to familiarize himself with how to take a general urine test. Obtaining false results may depend on the violation of storage of the container with the collected material. It must be remembered that room temperature contributes to the development of microorganisms, you can not put a jar in the sunlight.
OAM during pregnancy
At OAM, chemical and physical properties are examined and microscopic studies are performed. The first include:
- acidity;
- bilirubin;
- protein;
- glucose;
- urobilinogen;
- ketone bodies.
The study of physical properties:
- transparency
- density;
- colors.
Microscopic examination:
- red blood cells;
- white blood cells;
- salts;
- epithelium;
- mushrooms;
- cylinders;
- bacteria.
Before each visit to the doctor of the antenatal clinic, the woman carrying the child passes a general urine test:
- in the first three months - once every four weeks;
- in the second and at the beginning of the third trimester - once every two weeks;
- starting from week 35 - every seven days.
In order for the doctor not to make mistakes when diagnosing, the procedure must be treated responsibly. Every pregnant woman should be given a diet before taking biomaterial. Refuse fatty and sweet foods, as well as products that can change the color of urine. How to pass a general urinalysis, the attending doctor will tell.
Purpose of the study
During pregnancy, the kidney has a double load. They remove metabolic products not only of the mother, but also of the fetus. An ever-expanding uterus presses on all the organs of the abdominal cavity, and the kidneys and bladder are no exception. This can cause stagnation of urine, swelling of the kidneys, the appearance of infection. In connection with the restructuring of the body, the woman’s immunity is significantly weakened, which can also provoke an infectious process in the bladder and kidneys or cause an exacerbation of chronic pathologies of the urinary system.
In addition, a general urine test helps the doctor not to miss a disease such as gestosis. It is very dangerous for the fetus and mother. OAM is often prescribed to women in an interesting position in connection with:
- early diagnosis of pathological changes in the urinary system and other internal organs;
- observation in dynamics of the state of health of the woman in labor;
- monitoring the course of an existing disease and evaluating the effectiveness of the treatment.
In deciphering the results of a general analysis of urine, a pregnant woman should not have:
- Protein - proteinuria. Its identification can be caused by stress, physical activity, the use of protein foods. Pathological proteinuria signals the occurring gestosis.
- Ketone bodies. Their identification indicates anemia, early toxicosis or diabetes mellitus.
- Glucose - Glucosuria is possible with gestational diabetes.
- Bilirubin, the detection of which indicates the presence of obstructive jaundice or hepatitis of viral origin.
- Mushrooms, bacteria. Bacteriuria signals pyelonephritis or lack of intimate hygiene.
- Cylinders, their detection indicates a kidney disease. All other indicators should fall within the acceptable range. If any abnormalities are found, treatment in a hospital or additional examinations are recommended.
Change Results
Distortion of the results of a general analysis of urine is observed with violations committed in the preparation and collection of biomaterial:
- Mucus and leukocytes, found to be super-acceptable, indicate poorly washed external genitalia in both men and women, before collecting urine.
- A large number of microorganisms is associated with errors in nutrition or the use of a non-sterile container for collecting urine, storing it at room temperature, which provokes the active reproduction of bacteria, as well as the lack of hygiene procedures.
- In the absence of signs of bleeding, an elevated level of red blood cells indicates that urine was collected during menstruation.
In addition, the decoding of the general analysis of urine in adults and children will be unreliable if the storage conditions for containers with biomaterial are violated. For example, ultraviolet rays have a destructive effect on bilirubin. Unsuitable for research will be urine, which underwent long-term storage (more than two hours).
It is important to remember that the assessment of the work of organs and systems, the detection of infectious or inflammatory processes depends on the accuracy of determining certain indicators, for example, color, density, reaction. And in order for the doctor not to make a mistake in the diagnosis, based on the results of laboratory tests, the individual needs to know how to properly pass a general urine test. This will serve as an additional guarantee against an incorrect diagnosis, and, accordingly, treatment.