Urine tests are used to help diagnose many different conditions, including gynecological conditions and disorders. Urinalysis is a physical, chemical and microscopic examination of urine using a battery of tests. It is commonly used to evaluate substances that are eliminated in the urine and can help identify a number of conditions, disorders or diseases. 

Patients can collect a sample of urine either at home, at a physician’s office or at a clinic. The procedure for obtaining the sample is easy and painless. The sample is then sent to a laboratory for analysis by a pathologist. In some physician offices and facilities, simple urinalysis can be completed on site. For more complex analysis, such as for tumor markers for cancer, the sample may need to go to a specified laboratory. 

In terms of a woman’s gynecological health, urine tests are most frequently used to diagnose urinary disorders, especially urinary tract infections. Blood cells or bacteria in a urine sample often indicate this condition. Some sexually transmitted diseases such as chlamydia can also be detected with urinalysis.

Urine tests are also frequently used to diagnose pregnancy and pregnancy-related conditions. All home pregnancy tests measure the level of a hormone called human chorionic gonadotropin (HCG) in urine. These tests can usually detect pregnancy about two weeks after conception. Urine tests can also detect conditions related to pregnancy, such as gestational diabetes or preeclampsia.

Urine tests are used to detect a variety of illnesses or conditions including gynecological disorders. Analysis from urine tests can detect various substances that are eliminated in the urine, including bacteria, protein and blood cells.

Depending on the type of test, they may be conducted at home, in a physician’s office or at a clinic. For urinalysis, patients obtain their own sample of urine in a provided container and give it to a physician or other healthcare worker. It is then analyzed either on site or sent to a laboratory for analysis. Other tests, such as glucose testing or home pregnancy tests, can be conducted at home by the patient. 

Urine tests may be used to diagnose gynecological conditions and disorders such as:

• Urinary disorders. Urine samples can be tested for blood cells and abnormal substances such as protein, glucose or bacteria. If a urinary tract infection is suspected, the urine will be sent for a culture to test for white blood cells. If red blood cells are detected in a urinalysis, the urine sample will be sent for a urine cytology. This test can help detect cancer of the urinary tract by revealing malignant cells that have been passed into the urine.
  
  
• Sexually transmitted diseases. Sexually transmitted diseases such as gonorrhea and chlamydia can be detected through urine tests.
  
  
• Menopause. The Food and Drug Administration (FDA) has approved a home urine test kit that measures follicle stimulating hormone (FSH) in a woman’s urine. This may indicate that the woman is in menopause or the period leading up to menopause, known as perimenopause.
  
  
• Pregnancy and related conditions. All home pregnancy tests measure the level of a hormone called human chorionic gonadotropin (HCG) in urine. These tests can usually detect pregnancy about two weeks after conception. There are three different types of home pregnancy tests:
  
• • Dipstick test
  • Collection cup test
  • Chemical mixing test
    
    
  Urine tests are also frequently used during prenatal care to diagnose conditions related to pregnancy. These include:
  
• • Preeclampsia. Sometimes called “toxemia” and “pregnancy-induced hypertension,” it is a potentially serious condition that affects all bodily organs and often can be detected by the presence of excess protein in the urine.
    
    
  • Gestational diabetes. A type of diabetes that occurs only in pregnant women with no previous history of diabetes. Urine tests can be used to detect high levels of blood sugar (glucose), which are characteristic of diabetes.

Samples of urine may be taken in several ways:

• Spot sample (also called dipstick method). A single urine sample.
  
  
• 24-hour urine sample. A collection of all urine for a 24-hour period.
  
  
• Overnight urine sample. A collection of all urine voided between going to bed in the evening and rising in the morning.
  
  
• Timed urine sample. A collection of all urine voided in a specific period (e.g., four hours).

Spot samples provided in a physician’s office should be tested within 15 minutes of collection. Immediately after the sample is taken, the cup is labeled with the date and the patient’s name. Twenty-four-hour samples need to be refrigerated throughout the day and are tested once given to the physician’s office or lab.

Different urine tests may require different methods of analysis. Urinalysis may include:

• Visual examination. The technician visually examines the color and clearness of the urine sample. Blood may make the urine appear red or brown. An infection may cause the sample to appear cloudy.
  
  
• Test strip examination. The examiner uses a chemically coated test strip to measure the amount of certain substances in the urine including blood, glucose, creatinine, protein, pH, nitrite, ketones and bilirubin. The test strip is dipped in the urine sample. A chemically coated test pad on the strip will react with the urine and change color accordingly. The test pad is then compared to a color chart of possible results. Test times vary, but most test strips provide results in under a minute.
  
  
• Microscopic examination. A pathologist examines a small amount of urine under a microscope. Cells, bacteria, casts (protein substances that can indicate kidney disorders), crystals and other matter are counted and reported as either the number observed or as estimates (e.g., few, moderate or many).
  
  
• Culture. When the presence of bacteria is suspected in the urine, a urine culture may be ordered. A sample of urine is streaked across the surface of one or more lab dishes (Petri dish). The sample is then placed in an incubator that keeps the urine at body temperature. Bacteria will be allowed to grow in the dish so the type of bacteria can be determined. If there is no growth on the dish at the end of 24 hours, the test is considered negative for infection. If yeast or bacteria is present, the organisms are identified and counted. Further testing may be done to determine which antibiotics are likely to be effective in treating the infection.

There are many different types of urine tests, including:

• Home pregnancy tests. These tests search for the presence of human chorionic gonadotropin (HCG) in the urine. They can usually detect pregnancy about two weeks after conception. For the most reliable results, a woman should not take a home pregnancy test until seven to 10 days after she has missed her period. Urine tests can detect HCG levels above 25 to 50 milli-international units per milliliter (mIU/mL). There are three types of home pregnancy tests:
  
• • Dipstick test. The woman places the end of the dipstick in her urine stream during urination or immerses the dipstick in a container of collected urine for five to 10 seconds.
    
    
  • Collection cup test. A sample of urine is collected midstream in a cup.
    
    
  • Chemical mixing test. A small amount of urine is placed in a test tube with a liquid or powder chemical mixture.
    
    
  Blood tests that are conducted in a physician’s office or clinic can also be used to diagnose pregnancy. Obstetrician-Gynecologists (ObGyns) typically perform a blood test to confirm an at-home urine pregnancy test.
  
  
• Ovulation predictor test. This urine test analyzes the level of luteinizing hormone (LH) to determine the time of ovulation in women. It also may be used by physicians to monitor and adjust the dose of certain medications. There are several types of home ovulation predictor tests on the market.
  
  
• Menopause test. The Food and Drug Administration (FDA) has approved a home urine test kit that measures follicle stimulating hormone (FSH) in a woman’s urine. This may help indicate if the woman is in menopause or perimenopause (the period leading up to menopause).
  
  
• Nitrite test. Nitrite is normally not detectable in the urine. Nitrite is formed when bacteria changes nitrate in the urine into nitrite. The presence of nitrite in the urine (nitrituria) is often a sign of a urinary tract infection.
  
  
• Urine cytology. Examination of the cells can reveal blood in the urine, hormones and other substances that may indicate cancer of the urinary tract. Cytology can also be used to detect tumor markers, substances released in the urine, blood or body tissues in response to cancer cells. Research continues to examine which cancers can be detected and monitored with tumor markers found in the urine.
  
  
• White blood cell test. Checks urine for the presence of white blood cells. The main infection-fighting cells in the body, white blood cells are not normally detectable in the urine. The presence of white blood cells in the urine may indicate a urinary tract infection. 
  
  
• Drug testing. Urine samples may be collected and tested for a variety of illegal and prescription drugs. There are a number of home urine testing kits available to detect the presence of recreational drugs (e.g., marijuana, cocaine, amphetamines). Home test results may require laboratory verification for accurate results.

Most urine tests require little or no preparation. The physician may instruct the patient to restrict exercise and to reduce or stop taking certain medications or vitamins at some point prior to the test. Infection, fever, dehydration and other physical stress can cause inaccurate results. Patients should notify their physician of these conditions when scheduled for a urine test. Menstruation, too much fluid intake and failure to fully empty the bladder on the previous trip to the bathroom can also interfere with test results.

Urine tests can be performed at home, in a physician’s office or in a clinic. Patients conducting at-home urine tests, such as pregnancy tests, should refer to package instructions about factors that can alter test results and positive results should always be confirmed by a physician.

Generally, urine tests take only minutes to complete. Many involve only a spot (single) sample in which one to two ounces (30 to 60 milliliters) of urine are collected in a cup. The urine sample should not be brought from home because the urine needs to be as fresh as possible. The sample should be a midstream, or clean catch sample. To collect a clean catch sample, the patient should:

1. Clean the exit area. Women should wash the area between the lips of the vagina with soap and water and rinse well. Cleansing wipes may be provided.
   
   
2. Allow a small amount of urine to fall into the toilet bowl. This will clear the urethra of contaminants.
   
   
3. Catch the required amount of urine in the provided collection cup.
   
   
4. Remove the cup from the urine stream and place the provided lid firmly on the cup. Caution should be made not to contaminate the inside of the container before it is capped.
   
   
5. Return the sample to the physician or physician assistant with the correct name and date on the container.

Patients should not use the first urine sample upon awakening. Rather they should wait a minimum of three hours after the previous void before collecting a urine sample.  

Some urine tests require a 24-hour sample rather than a spot sample. To collect a 24-hour urine sample the patient should:

1. Get up in the morning of the first day of the test and empty the bladder.
   
   
2. Collect all subsequent urine in the provided container for the next 24 hours.
   
   
3. Cap the container and keep it in a refrigerator or cool place during the collection period.
   
   
4. Get up in the morning of the second day of the test and urinate into the container.
   
   
5. Return the container with appropriate labeling to the physician’s office or a laboratory for analysis.

It typically takes two or three days for a laboratory to complete a urinalysis. A pathologist will use a microscope to examine the sample for signs of disease, such as abnormal epithelial cells (which may indicate cancer), excessive numbers of red blood cells, white blood cells or other abnormal cells. Treatment depends on the condition that is diagnosed.

Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions related to urine tests:

1. Why do you need a urine sample from me?
   
   
2. Should I obtain the sample at home or in your office?
   
   
3. Do you need one sample or several ones?
   
   
4. When is the best time to obtain the sample?
   
   
5. Do I need to fast or adjust any of my medications?
   
   
6. What should I do to ensure accurate results?
   
   
7. Who will analyze the urine sample?
   
   
8. How long will it take to get the results of my urine test?
   
   
9. Can I test my urine with a home test kit?
   
   
10. What will I learn from the urine test?
    
    
11. Will I need any follow-up tests?
    
    
12. What is the recommended treatment for my condition?