Cancer Diagnosis Program | Biorepositories and Biospecimen Research Branch

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Collection of urine specimens in general practice: to clean or not to clean?

Author(s): Bradbury SM

Publication: J R Coll Gen Pract, 1988, Vol. 38, Page 363-5

PubMed ID: 3256648 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   This study investigated the effects of vulval cleaning on bacterial growth and epithelial cell contamination of urine specimens from 158 women with symptoms of cystitis and 158 asymptomatic women. Pregnant women, women with vaginitis, women who had taken antibiotics recently (timeframe not specified), or urological abnormalities were excluded. Women were randomly assigned to one of the two collection methods. Women assigned to the cleaning group were instructed to wash their hands, part the labia, wipe front to back with three cottonwool swabs dampened with soap and water, and then to collect urine while keeping the labia parted. Women in the non-cleaning group were told to pass some urine and then collect mid-stream urine. All specimens were collected into sterile containers with boric acid. Specimens were transported at the end of the morning or refrigerated for transport the next day if collected in the evening. Once in the laboratory, specimens were examined microscopically and cultured overnight. Infections were classified as definite when they had >10⁸ organisms/L in the urine with >10⁴ white blood cells/L and equivocal when they contained 3 x 10⁷-1 x 10⁸ organisms/L with >10⁴ white blood cells/L or in the presence of mixed growth. Specimens were considered contaminated with the presence of epithelial cells.

   Summary of Findings:

   For the symptomatic group, specimens collected after vulval cleaning rather than without cleaning were just as likely to be classified as definite (23 versus 16) or equivocal (5 for both). Similarly, for the control group, cleaning prior to collection did not impact the number of specimens classified as definite (2 versus 1) or equivocal (0 for both). Further, cleaning did not change the number of specimens that had white blood cells but no organismal growth in symptomatic (26 versus 21) or control (8 versus 12) women or organisms in the absence of white blood cells in symptomatic (2 versus 0) or control (0 versus 1) women. Finally, cleaning did not reduce the incidence of epithelial cell contamination of urine in symptomatic (8 versus 6) or control (3 versus 11) women.

   Biospecimens

   • Bodily Fluid - Urine

   Preservative Types

   • Other Preservative

   Diagnoses:

   • Other diagnoses
   • Not specified

   Platform:

   Analyte	Technology Platform
   Cell count/volume	Light microscopy
   Cell count/volume	Microbiological assay

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Acquisition	Method of fluid acquisition	Different urine collection procedures compared Voided urine (spot collection) Collection site preparation methods compared
   Preaquisition	Diagnosis/ patient condition	Symptoms of cystitis No symptoms of cystitis

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