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Urinalysis

A test of a urine sample that can reveal many problems of the urinary tract and other body systems. The sample may be observed for color, cloudiness, concentration; signs of drug use; chemical composition, including glucose; the presence of protein, blood cells, or germs; or other signs of disease.

PubMed Health Glossary
(Source: NIH - National Institute of Diabetes and Digestive and Kidney Diseases)

About Urinalysis

What is urinalysis?

Urinalysis can be part of a routine examination and is frequently performed upon admission to the hospital and before surgery. The test can also follow a preliminary rapid urine test that produced abnormal results, so that urinalysis can be used to check those results. Complete urinalysis is done in a laboratory. It is usually made up of 3 parts:

  • Assessment of the color, clarity and concentration of the urine
  • Examination of the chemical composition of the urine with a test strip
  • Examination of the urine using a microscope to identify bacteria, cells and cell parts

Microscopic examination of the solid parts of urine: the picture shows red blood cells (above), white blood cells (middle) and a cast of clumped-together white blood cells (below).

Urinalysis is used to find the cause of or monitor urinary tract infections, bleeding in the urinary system, or kidney or liver disease... Read more about Urinalysis

What works? Research summarized

Evidence reviews

Preoperative Tests (Update): Routine Preoperative Tests for Elective Surgery

In 2003, NICE first issued guidance on the use of routine preoperative tests for elective surgery (NICE CG3). The guideline evaluated the practice of routinely performing preoperative diagnostic tests for elective surgery in healthy and comorbid populations.

Hypertension in Pregnancy: The Management of Hypertensive Disorders During Pregnancy

This clinical guideline concerns the management of hypertensive disorders in pregnancy and their complications from preconception to the postnatal period. For the purpose of this guideline, ‘pregnancy’ includes the antenatal, intrapartum and postpartum (6 weeks after birth) periods. The guideline has been developed with the aim of providing guidance in the following areas: information and advice for women who have chronic hypertension and are pregnant or planning to become pregnant; information and advice for women who are pregnant and at increased risk of developing hypertensive disorders of pregnancy; management of pregnancy with chronic hypertension; management of pregnancy in women with gestational hypertension; management of pregnancy for women with pre-eclampsia before admission to critical care level 2 setting; management of pre-eclampsia and its complications in a critical care setting; information, advice and support for women and healthcare professionals after discharge to primary care following a pregnancy complicated by hypertension; care of the fetus during pregnancy complicated by a hypertensive disorder.

Urinary biomarkers for the non‐invasive diagnosis of endometriosis

Women with endometriosis have endometrial tissue (the tissue that lines the womb and is shed during menstruation) growing outside the womb within the pelvic cavity. This tissue responds to reproductive hormones causing painful periods, chronic lower abdominal pain and difficulty conceiving. Currently, the only reliable way of diagnosing endometriosis is to perform laparoscopic surgery and visualise the endometrial deposits inside the abdomen. Because surgery is risky and expensive, urine tests have been evaluated for their ability to detect endometriosis non‐invasively. An accurate urine test could lead to the diagnosis of endometriosis without the need for surgery; or it could reduce the need for diagnostic surgery, so only women who were most likely to have endometriosis would require it. Other non‐invasive ways of diagnosing endometriosis using blood, imaging, endometrial and combination tests are evaluated in separate Cochrane reviews from this series.

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Summaries for consumers

Urinary biomarkers for the non‐invasive diagnosis of endometriosis

Women with endometriosis have endometrial tissue (the tissue that lines the womb and is shed during menstruation) growing outside the womb within the pelvic cavity. This tissue responds to reproductive hormones causing painful periods, chronic lower abdominal pain and difficulty conceiving. Currently, the only reliable way of diagnosing endometriosis is to perform laparoscopic surgery and visualise the endometrial deposits inside the abdomen. Because surgery is risky and expensive, urine tests have been evaluated for their ability to detect endometriosis non‐invasively. An accurate urine test could lead to the diagnosis of endometriosis without the need for surgery; or it could reduce the need for diagnostic surgery, so only women who were most likely to have endometriosis would require it. Other non‐invasive ways of diagnosing endometriosis using blood, imaging, endometrial and combination tests are evaluated in separate Cochrane reviews from this series.

Pregnancy and birth: What are the benefits of routinely screening for bacteria in the urine of pregnant women?

It’s not clear whether it’s a good idea to routinely screen for bacteria in the urine of pregnant women (bacteriuria screening). It’s also not possible to say whether antibiotics should be used if high levels of bacteria are detected in the urine but there are no noticeable urinary tract problems.

Blood and urine tests for the diagnosis of acute pancreatitis (sudden inflammation of pancreas)

The pancreas is an organ in the abdomen (tummy) that secretes several digestive enzymes (substances that break down the food we eat) into the pancreatic ductal system, which empties into the small bowel. The pancreas also contains the islets of Langerhans, which secrete several hormones such as insulin (which helps regulate blood sugar). Acute pancreatitis is sudden inflammation of the pancreas, which can lead to damage of the heart, lungs, and kidneys and cause them to fail. Acute pancreatitis usually manifests as upper abdominal pain radiating to the back. However, there are several potential causes of upper abdominal pain. It is important to determine if someone with abdominal pain has acute pancreatitis or another illness in order to start appropriate treatment. Blood tests such as serum amylase and serum lipase, as well as urine tests such as urinary trypsinogen‐2 and urinary amylase, can be used to determine if someone with abdominal pain has acute pancreatitis. It is usually the case that a patient is considered to have acute pancreatitis only when amylase or lipase levels are three times the upper limit of normal. With regard to urinary trypsinogen‐2, a level of more than 50 ng/mL of trypsinogen‐2 in the urine is considered an indication of acute pancreatitis. With regard to urinary amylase, there is no clear‐cut level beyond which someone with abdominal pain is considered to have acute pancreatitis. At present it is unclear whether these tests are equally effective or if one of the tests is better than the other in the diagnosis of acute pancreatitis in people with sudden‐onset abdominal pain. We determined to resolve this question by performing a literature search for studies reporting the accuracy of the above mentioned blood and urine tests. We included studies reported until 20 March 2017.

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More about Urinalysis

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Other terms to know:
Hypercalciuria

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