When cystitis flares up, it is important to get your urine tested for bacteria as this helps you to determine a) if it is really bacterial cystitis you’re suffering from and b) what type of bacteria are present. In this article I’m going to describe how to collect a urine sample.

I am a big fan of testing. Knowing what’s going on with your bladder will help you to decide on a suitable course of action.

Things you’ll need

If you suffer from cystitis frequently you want to have the following items at hand so you can quickly collect urine when symptoms appear.

• Sample bottle: these should be individually packed and sterile. Don’t open until you need them as this could contaminate the bottle.
• Pyrex jar or urine collection device: these can help to collect the urine. The pyrex jar should be sterilized with boiling water before using it. The urine collection device should be packaged until use and then discarded.
• Urine testing strips: You can quickly check for an infection at home with testing strips. You can buy Multistix here.
• Cotton balls: ideally you want to clean the bladder opening before taking a sample.

How to collect a urine sample and get it tested

For the most accurate results you need to take a mid-stream urine sample (MSU) into the sterile sample bottle as soon as the symptoms start to appear. Do this before drinking anything or taking supplements and/or medication for cystitis.

1. First, clean you urethral and vaginal openings with a wet cotton-ball. Your goal is to catch a bit of uncontaminated urine that comes directly from your bladder.
2. Urinate for a bit, then place the sample bottle or pyrex jar (or the urine collection device with the sample bottle) under the stream to catch the ‘mid-stream’ urine.
3. If you’ve collected the urine into the pyrex jar, pour it into the sample bottle.
4. Label the sample bottle with your name, address, date and time and your doctor’s name.

After you’ve followed these steps your sample is ready to be tested:

1. If you have urine testing strips (Multistix) at hand, you can quickly check if an infection is present. You could also get your doctor to do that for you. If positive, this does not show you which type of bacteria are present, so a sample should still be cultured at the lab.
2. If your GP practice is open, you can take the sample straight in to be sent to the lab. If it is closed, refrigerate your sample and take it in ASAP.
3. Wait for your results (it shouldn’t take too long).

How to test your urine at home

As I’ve mentioned before, it is a good idea to keep Multistix at hand if you’re prone to cystitis. Touching the strips can make them inaccurate so always keep them closed until you need them. They keep for about a year, so check the ‘use by’ date.

Before use, check that all the colours correspond with the chart.

Have the colour chart and a watch ready – you need to follow the times on the chart closely.

• Dip the strip into the urine sample and hold for a few seconds. Remove it and shake off any drops of urine.
• The markers you want to pay close attention to are nitrites, blood and leukocytes.
• Nitrites are produced when bacteria convert urea in the urine – a sign that bacteria are present.
• Blood can be a sign of infection or a more serious condition. It should always be investigated by your GP.
• Leukocytes are white blood cells usually present at a sight of infection.

If both markers are present, infection is very likely. If only one is present there is still a chance and you should still get a lab culture.

Most of the other markers can also give you clues towards any other potential problems:

• Glucose: if glucose is secreted in urine it means that the body has an excess of sugar. This can be a marker of diabetes and should be investigated by your GP.
• Ketones: if your body burns fat for fuel, ketones will be present in the urine. This can be a sign of low food or low carbohydrate intake.
• Specific gravity: this tells you how concentrated your urine is. It could be a good marker to check for dehydration (if it is concentrated, you may not be drinking enough fluids).
• pH: this tells you how acid or alkaline your urine is. High acidity can cause a burning sensation and may be present with an infection.
• Protein: high protein in the urine can be a sign of kidney malfunction and should be investigated by your GP.

If any of the markers show up positive, you should investigate further and get your urine sample cultured via your GP.

If the only marker that is showing up is specific gravity showing your urine is concentrated your symptoms may just be due to dehydration. Drink plenty of water and monitor your symptoms. If there is no improvement investigate further.

Note that any test can have false positives or negatives:

• The test is very sensitive to blood. If you’re menstruating you may get a false positive.
• If the urine has not been in the bladder long, bacteria may not have had time to convert urea to nitrites
• Some drugs may interfere with the tested reactions
• Large doses of Vitamin C prevent glucose from sticking to the test strips

 What’s your experience with urine testing? Have you got any more questions? Let me know in the comments!

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Sources

Kilmartin, Angela The Patient’s Encyclopaedia of Cystitis, Sexual Cystitis, Interstitial Cystitis (London: Angela Kilmartin, 2002), p. 14-15

Myhill, Sarah Urine MULTISTIX analysis interpretation Doctor Myhill March 2016 http://drmyhill.co.uk/wiki/Urine_MULTISTIX_analysis_interpretation

 

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