Urine Specimens

(See specific Microbiology Specimens sections for other instructions.)

Note: Please examine specimen collection and transportation supplies to be sure they do not include expired containers.

Urine Specimen Collection Products

Urinalysis and Culture and Susceptibility

Submit a urinalysis preservative tube and culture and susceptibility preservative tube. Label both filled tubes with the patient's first and last name and second identifier. Include the date and time of specimen collection on each specimen container.

Urinalysis Only

Submit a urinalysis preservative tube. Label filled tube with the patient's first and last name and second identifier. Include the date and time of specimen collection on each specimen container.

Culture and Susceptibility Only

Submit a culture and susceptibility preservative tube. Label the filled tube with the patient's first and last name and second identifier. Include the date and time of specimen collection on each specimen container.

Frozen Gel Packs. To ensure specimen integrity during warm weather, follow these Instructions for Use of frozen gel packs and specimen lockboxes.

Random Urine Collection for Routine Analysis

Patients should be provided with both written and spoken “clean-catch” instructions. When a clean-catch urine specimen is required, follow the directions given under Urine for Culture in the Microbiology Specimens: Bacteriology and Mycobacteriology Specimens section. The collected urine should be added to the appropriate urine preservative tube or refrigerated immediately to retard growth of bacteria until the test is performed.

Urine values vary considerably during a 24-hour period, and most test methods are based on normal values for first morning samples. The first urine voided in the morning is preferred because it has a more uniform volume and concentration and a lower pH, which helps preserve the formed elements. If it is not possible to obtain a first morning sample, the time of the sample should be noted on the test request form and in the patient's records.

Instructions for Use: Urine Monovette® With pH Stabilizer

Caution: The urine Monovette® contains a corrosive liquid that may cause severe burns to all areas of contact. Inhalation can cause irritation and burns, and it may be fatal if swallowed.

1. Friction fit the yellow suction tip securely onto the Luer end of the multi-adapter.

2. Connect the multi-adapter to the urine Monovette® membrane cap via the three-pin locking mechanism. Guide the pins on the cap straight into the grooves of the adapter, then secure by twisting slightly clockwise.

3. Place the suction tip down into the urine specimen and pull the urine Monovette® plunger to the black base fill line, drawing urine into the tube. The base fill line is located on the label near the bottom of the urine Monovette®.

4. Hold the urine Monovette® upright, and fully extend the plunger to draw the remaining urine out of the yellow straw.

5. Break off the plunger and place it in the proper receptacle.

6. Remove the straw from the Luer adapter and place it in the proper receptacle.

7. Disconnect the multi-adapter from the urine Monovette® membrane cap by twisting slightly counterclockwise, and dispose of the adapter in the proper sharps container.

8. Label and submit the specimen according to Labcorp's procedures.

Routine 24-hour Urine Collection

For many urine chemistry tests, it is necessary to analyze a sample taken from an entire 24-hour excretion. Incorrect collection and preservation of 24-hour urine collections are two of the most frequent lapses in urine collections.

The 24-hour urine specimen should be submitted in a chemically clean, properly labeled urine container provided by Labcorp. (Patients should not be allowed to submit urine specimens in their own “clean” jars.) The laboratory supplies the proper preservative with the container.

Written instructions should clearly explain the following points.

1. The collection of the 24-hour urine starts with the patient voiding (completely emptying bladder) and discarding the first urine passed in the morning.

2. Except for this first discarded urine, all of the urine passed during that day and night, up to and including the first voiding of the following day, must be collected. Urine passed during bowel movements must also be collected.

3. The entire specimen should be refrigerated at 2°C to 8°C during collection, or kept in a cool place, to maintain the integrity of the sample.

4. The 24-hour urine container may contain a preservative of acetic acid, boric acid, or hydrochloric acid, which may cause burns if touched. If ingested, a physician should be contacted immediately. The patient should be informed of the following recommended collection requirements:

1. A normal intake of fluids during the collection period is desirable unless otherwise indicated by the physician or test specimen requirements.
2. In some cases, it may be advisable for patients to discontinue taking all medications for an interval of at least 12 hours (preferably 48 to 72 hours) preceding the urine collection period. This is done as a precaution against interference in the chemical assays of various hormones. (See the specimen collection instructions for the test(s) ordered.)
3. In certain complex chemical analyses, the metabolic products of certain foods and supplements (such as vitamins and minerals) may also cause misleading results. (See the specimen collection information for the test(s) ordered.)

5. Finally, in preparing and submitting the specimen, you should always adhere to the following critical points:

1. Measure the entire 24-hour volume and record the total amount in milliliters (mL) to the nearest volume marking found on the side of the jug on the test request form for laboratory use. For example, if volume marking is in 25 mL increments, record the total volume to the nearest 25 mL. The specimen must be well mixed prior to pouring off an aliquot of the sample into an appropriately labeled transport container and submitting it to the laboratory.
2. When aliquots are required with preservatives, use only the preservative requested. One preservative must not be substituted for another. 
3. Even in the healthy individual, the total daily urine volume may be highly variable depending upon water intake, diet, activity and environmental factors. Be sure to provide the patient with a container of adequate size.
4. If a single 24 hour collection requires an additional container, the tow containers must be will mixed and the total volume in milliliters (mLs) of the two containers added together must be recorded on the requisition before making a separate aliquot.

Recommended Patient Instructions for 24-hour Urine Collections

This section includes written instructions to be provided to the patient with the specified laboratory collection container. Supplement these instructions by discussing them with the patient and explaining why the test and collection procedures are necessary. Collection containers that include acids should be clearly marked.

To the Physician: You may wish to photocopy these pages so that you can provide your patients with written instructions.

To the Patient: Follow these instructions in collecting your 24-hour urine specimen.

Void (urinate) into the smaller container provided and transfer the urine into the larger collection container. Do not add anything but urine to the container and do not discard any liquid, tablets, or powder that may already be in the larger collection container. These substances may cause burns if touched. The collection container should be kept tightly closed and refrigerated (or kept in a cool place) throughout the collection period.

1. Upon rising in the morning, urinate into the toilet, emptying your bladder completely. Do not collect this sample. Note the exact time and print it on the container label.

2. Collect all urine voided for 24 hours after this time in the container provided by the physician or patient service center. All urine passed during the 24-hour time period (day or night) must be saved. Urine passed during bowel movements must also be collected.

3. Refrigerate the collected urine between all voidings at 2°C to 8°C or keep it in a cool place.

4. At exactly the same time the following morning, void completely again (first time after awakening), and add this sample to the collection container. This completes your 24-hour collection.

5. Take the 24-hour specimen to the physician's office or patient service center as soon as possible, maintaining the cool temperature in transit by placing the specimen in a portable cooler or insulated bag.

Two Consecutive 24-hour Urine Collections: Patient Instructions

To the Physician: You may wish to photocopy these pages so that you can provide your patients with written instructions.

Follow the directions below to collect urine for analysis by your physician. Remember to store all urine in the refrigerator or in a cool place from the time collection begins until you take the containers to your physician. Important: Do not allow the urine from one container to mix with the urine in the other container. The urine container may contain a preservative of acetic acid, boric acid, or hydrochloric acid, which may cause burns if touched. If ingested, a physician should be contacted immediately.

First 24-hour Urine Collection (Hydrochloric Acid “HCl” Preservative)

1. Urinate in the usual manner on awakening, making sure to empty your bladder completely. Do not save this urine, but you must record the date and time of this first urination. Example: 03/13/01, 7:30 AM.

2. All urine passed during the remaining 24-hour period must be collected in this first container, labeled “HCl Preservative.” Urine passed during bowel movements must also be collected.

3. Urine may be collected in another clean container and then carefully poured into the first 24-hour collection container.

4. The next morning, urinate on awakening, but this time include the urine in the HCl preservative container. Record the date and time of this urination. Example: 03/14/01, 7:30 AM. This is the last sample to be included in the container marked “HCl Preservative.”

5. Refrigerate the collected urine at 2ºC to 8ºC or keep it in a cool place.

Second 24-hour Urine Collection (No Preservative)

1. Record the date and time of the first urine of the day. The time is the same as the last entry of the HCl preservative container. (See number 4 above.)

2. From now on, all urine passed for the next 24-hour period must be included in the second container, labeled “No Preservative.” Urine passed during bowel movements must also be collected.

3. Urine may be collected in another clean container and then carefully poured into the second container.

4. On the following morning, the first urine of the day must be included in this second container. Record the date and time of this urination. Example: 03/15/01, 7:30 AM. This is the last sample to be included in the container labeled “No Preservative.”

5. Take both collections to the physician's office or patient service center as soon as possible, maintaining the cool temperature in transit by placing the specimen in a portable cooler or insulated bag. If collections cannot be performed consecutively, submit each collection separately as soon as the collection is complete.