Page 211 - pathology_services_handbook_5th_edition_2018

2.10 Urine

A. Midstream urine

Male
i. Instruct patient to completely retract foreskin and cleanse penis with soapy MICROBIOLOGY
water and throughly rinse with water.
ii. While holding the foreskin retracted, begin voiding.
iii. Pass the first few milliliters of urine to flush out the bacteria from the urethra,
then collect the midstream portion in a sterile/boric acid container.
iv. Send to the laboratory immediately.

Female
i. Cleanse the periurethral area and perineum with soapy water and thoroughly
rinse with water.
ii. Hold the labia apart during voiding and pass the first few milliliters of urine.
iii. Collect the midstream portion in a sterile/boric acid container.
iv. Send to the laboratory immediately.

Note:
For urine specimen (<20ml), use sterile container and send immediately to he
laboratory. Urine specimen (≥ 20ml), use urine boric acid container, invert the
container to allow proper mixing.

B. Suprapubic aspirate (SPA)

i. Before SPA, the patient should force fluids until bladder is full.
ii. Shave if necessary and disinfect the suprapubic skin overlying the urinary
bladder with 2% chlorhexidine in 70% alcohol.
iii. Aspirate urine from the bladder by using a needle aspiration technique.
iv. Place sample in sterile container and send to the laboratory immediately.
v. Label sample as suprapubic aspirate (SPA).

Note :
SPA is useful in determining urinary infection in adults in which the results from
routine procedures are equivocal but the diagnosis is critical. Also useful for paediatric
when clean-catch urine is difficult to obtain.

201