You Want me to Pee in a Cup? Urinalysis, and Why it's Important

When you go to your annual well-woman examination, and you are asked to submit a urine sample, do you know why? What are they looking for, and is it really necessary? The answer to that question is a resounding, "YES!" Urinalysis is important for detecting infections in the bladder and urinary tract, but it can also save lives by detecting symptoms of serious, life-threatening conditions like cancer.

An immediate urine test can be performed with a strip of specially treated paper to check for white cells (often present if there is an infection), red blood cells (RBC’s) (if blood is present in the urine, the medical term is hematuria), protein (if elevated, a sign of kidney or even systemic disease), glucose (present in urine if blood levels are high), ketones (elevated with kidney problems or dehydration), bilirubin (elevated in liver disease), and pH (acidity).

If a test is positive for RBC’s, doctors usually send the urine out for a complete urinalysis. The urine is spun down and the sediment is examined for the number of RBC’s, white cells, and/or bacteria. Often they also do a urine culture to rule out infection.

The two most frequent causes of microscopic hematuria in non-pregnant women (46% of women do have hematuria during their pregnancy) are cystitis (bladder infection) and kidney stones. Additionally, some women seem to shed RBC’s in their urine without any pathology. But the cause that should be ruled out, especially in women over 40, is cancer.

Bladder cancer is the 17th most common cancer in women worldwide. In the United States in 2008 there were 17,770 new cases of bladder cancer diagnosed and 4,270 deaths.

The risk factors for urologic cancers in women include age over 40, smoking, a history of exposure to chemicals or dyes, a history of visible blood in the urine, analgesic abuse, and a history of pelvic radiation. Up to 35% of female bladder cancer cases may be attributable to cigarette smoking.

Have you wondered about any other tests we do? Drs. Strebel and Grolle are always happy to answer your questions regarding any part of your examination or treatment.

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