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Urinary Incontinence in Women

Table of Contents

Urinary Incontinence in Women

How Urinary Incontinence (UI) Affects Women

Urinary incontinence (UI) is the loss of bladder control, or leaking urine. Women are twice as likely as men to experience UI. UI is also more common among older women, although it is not a normal part of the aging process. Learn why UI affects women more frequently and how to lower your risk.

Urinary system - Bladder

Image by SMART-Servier Medical Art

What Is

Urinary Incontinence

Image by Hellerhoff

Urinary Incontinence

CT scan in the sagittal plane which reveals a greatly enlarged urinary bladder caused by urinary retention, a condition which often leads to overflow incontinence.

Image by Hellerhoff

What Is Urinary Incontinence?

Urinary incontinence is the loss of bladder control. The two most common types of urinary incontinence that affect women are stress incontinence and urge incontinence, also called overactive bladder. Incontinence affects twice as many women as men. This may be because pregnancy, childbirth, and menopause may make urinary incontinence more likely. Urinary incontinence is not a normal part of aging, and it can be treated.

Urine is made by the kidneys and stored in the bladder. The bladder has muscles that tighten when you need to urinate. When the bladder muscles tighten, urine is forced out of your bladder through a tube called the urethra. At the same time, sphincter muscles around the urethra relax to let the urine out of your body.

Incontinence can happen when the bladder muscles suddenly tighten and the sphincter muscles are not strong enough to pinch the urethra shut. This causes a sudden, strong urge to urinate that you may not be able to control. Pressure caused by laughing, sneezing, or exercising can cause you to leak urine. Urinary incontinence may also happen if there is a problem with the nerves that control the bladder muscles and urethra. Urinary incontinence can mean you leak a small amount of urine or release a lot of urine all at once.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (22)

Stress Urinary Incontinence in Women, Animation

Video by Alila Medical Media/YouTube

Stress Urinary Incontinence

Video by Covenant Health/YouTube

The Facts On Urinary Incontinence - Nebraska Medicine

Video by Nebraska Medicine Nebraska Medical Center/YouTube

Urinary Stress Incontinence in Women (Q&A)

Video by Howard County General Hospital/YouTube

Urinary Urge Incontinence in Women (Q&A)

Video by Howard County General Hospital/YouTube

Urinary Incontinence

Video by Mercyhealth/YouTube

Treating Female Incontinence

Video by Lee Health/YouTube

Urinary incontinence - an Osmosis preview

Video by Osmosis/YouTube

Urinary Incontinence in Women Video – Brigham and Women’s Hospital

Video by Brigham And Women's Hospital/YouTube

Urinary Incontinence

Video by CanadaQBank/YouTube

How to Do Kegel Exercises for Bladder Control - Urinary Incontinence Treatment

Video by WaysAndHow/YouTube

Urinary Incontinence Surgery in Women: Invasive Tests to Avoid

Video by UC San Diego Health/YouTube

Bertha Chen, MD, Discusses Female Urinary Incontinence

Video by Stanford Health Care/YouTube

Urinary Incontinence

Video by Mayo Clinic/YouTube

Treatment for stress urinary incontinence in women: Mayo Clinic Radio

Video by Mayo Clinic/YouTube

Mayo Clinic Minute: Treatment options for stress urinary incontinence

Video by Mayo Clinic/YouTube

When should I see a doctor about urinary incontinence or pelvic organ prolapse?

Video by Michigan Medicine/YouTube

What is urinary incontinence? Causes, symptoms and treatment explained

Video by Top Doctors UK/YouTube

What causes urinary incontinence?

Video by Premier Health/YouTube

Bladder Control for Women - Learning About Urinary Incontinence

Video by My Doctor - Kaiser Permanente/YouTube

Female Bladder Leakage: Solutions to Get Control‎ | Christopher Tarnay, MD | UCLAMDChat

Video by UCLA Health/YouTube

Bladder Health: What Every Woman Should Know About Stress Urinary Incontinence | UCLAMDChat

Video by UCLA Health/YouTube

2:05

Stress Urinary Incontinence in Women, Animation

Alila Medical Media/YouTube

3:09

Stress Urinary Incontinence

Covenant Health/YouTube

2:42

The Facts On Urinary Incontinence - Nebraska Medicine

Nebraska Medicine Nebraska Medical Center/YouTube

5:24

Urinary Stress Incontinence in Women (Q&A)

Howard County General Hospital/YouTube

5:31

Urinary Urge Incontinence in Women (Q&A)

Howard County General Hospital/YouTube

4:23

Urinary Incontinence

Mercyhealth/YouTube

1:36

Treating Female Incontinence

Lee Health/YouTube

0:47

Urinary incontinence - an Osmosis preview

Osmosis/YouTube

3:08

Urinary Incontinence in Women Video – Brigham and Women’s Hospital

Brigham And Women's Hospital/YouTube

15:13

Urinary Incontinence

CanadaQBank/YouTube

3:41

How to Do Kegel Exercises for Bladder Control - Urinary Incontinence Treatment

WaysAndHow/YouTube

2:11

Urinary Incontinence Surgery in Women: Invasive Tests to Avoid

UC San Diego Health/YouTube

1:00:40

Bertha Chen, MD, Discusses Female Urinary Incontinence

Stanford Health Care/YouTube

3:19

Urinary Incontinence

Mayo Clinic/YouTube

12:20

Treatment for stress urinary incontinence in women: Mayo Clinic Radio

Mayo Clinic/YouTube

1:00

Mayo Clinic Minute: Treatment options for stress urinary incontinence

Mayo Clinic/YouTube

1:35

When should I see a doctor about urinary incontinence or pelvic organ prolapse?

Michigan Medicine/YouTube

5:50

What is urinary incontinence? Causes, symptoms and treatment explained

Top Doctors UK/YouTube

0:44

What causes urinary incontinence?

Premier Health/YouTube

3:33

Bladder Control for Women - Learning About Urinary Incontinence

My Doctor - Kaiser Permanente/YouTube

32:17

Female Bladder Leakage: Solutions to Get Control‎ | Christopher Tarnay, MD | UCLAMDChat

UCLA Health/YouTube

27:43

Bladder Health: What Every Woman Should Know About Stress Urinary Incontinence | UCLAMDChat

UCLA Health/YouTube

Types

In stress urinary incontinence, weak muscles of the pelvis can release urine when a cough or other action presses on the bladder.

Image by NIDDK/NIH

In stress urinary incontinence, weak muscles of the pelvis can release urine when a cough or other action presses on the bladder.

Illustration of a woman coughing with the pelvic bone and exposed bladder. A box shows a bladder with a weak pelvis that allows the urine to escape.

Image by NIDDK/NIH

What Are the Types of Urinary Incontinence That Affect Women?

The two most common types of urinary incontinence in women are:

Stress incontinence. This is the most common type of incontinence. It is also the most common type of incontinence that affects younger women. Stress incontinence happens when there is stress or pressure on the bladder. Stress incontinence can happen when weak pelvic floor muscles put pressure on the bladder and urethra by making them work harder. With stress incontinence, everyday actions that use the pelvic floor muscles, such as coughing, sneezing, or laughing, can cause you to leak urine. Sudden movements and physical activity can also cause you to leak urine.
Urge incontinence. With urge incontinence, urine leakage usually happens after a strong, sudden urge to urinate and before you can get to a bathroom. Some women with urge incontinence are able to get to a bathroom in time but feel the urge to urinate more than eight times a day. They also do not urinate much once they get to the bathroom. Urge incontinence is sometimes called “overactive bladder.” Urge incontinence is more common in older women. It can happen when you don’t expect it, such as during sleep, after drinking water, or when you hear or touch running water.

Many women with urinary incontinence have both stress and urge incontinence. This is called “mixed” incontinence.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (5)

Types of Female Incontinence

Video by Lee Health/YouTube

Urinary Stress Incontinence in Women (Q&A)

Video by Howard County General Hospital/YouTube

Stress Urinary Incontinence in Women, Animation

Video by Alila Medical Media/YouTube

Stress Urinary Incontinence

Video by Covenant Health/YouTube

Urinary Urge Incontinence in Women (Q&A)

Video by Howard County General Hospital/YouTube

1:41

Types of Female Incontinence

Lee Health/YouTube

5:24

Urinary Stress Incontinence in Women (Q&A)

Howard County General Hospital/YouTube

2:05

Stress Urinary Incontinence in Women, Animation

Alila Medical Media/YouTube

3:09

Stress Urinary Incontinence

Covenant Health/YouTube

5:31

Urinary Urge Incontinence in Women (Q&A)

Howard County General Hospital/YouTube

Risk Factors

Female Urinary System

Image by TheVisualMD

Female Urinary System

3D visualization reconstructed from scanned human data of the female urinary system revealing lateral view of the kidneys, ureters, bladder and urethra. The urinary system is responsible for fluid balance and waste excretion. Blood enters the kidneys where waste products are excreted to form a fluid called filtrate. Filtrate continues to collect additional waste products and minerals as it travels through the winding tubules of the kidney. Eventually the filtrate becomes urine as it is channeled out of the kidney, into the ureters, down to the bladder and eventually out through the urethra to the external body.

Image by TheVisualMD

Who Gets Urinary Incontinence?

Urinary incontinence affects twice as many women as men. This is because reproductive health events unique to women, like pregnancy, childbirth, and menopause, affect the bladder, urethra, and other muscles that support these organs.

Urinary incontinence can happen to women at any age, but it is more common in older women. This is probably because of hormonal changes during menopause. More than 4 in 10 women 65 and older have urinary incontinence.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (1)

Urinary Incontinence in Women

Twice as many women experience urinary incontinence (leaking urine) than men, and this has been linked to unique health challenges like pregnancy, childbirth, and menopause. Fortunately, most cases can be cured or controlled.

Image by StoryMD

Urinary Incontinence in Women

StoryMD

Why Women Are More Affected

Urinary System

Image by NIH Medical Arts

Urinary System

https://www.flickr.com/photos/nihgov/25137782099/

Image by NIH Medical Arts

Why Does Urinary Incontinence Affect More Women Than Men?

Women have unique health events, such as pregnancy, childbirth, and menopause, that may affect the urinary tract and the surrounding muscles. The pelvic floor muscles that support the bladder, urethra, uterus (womb), and bowels may become weaker or damaged. When the muscles that support the urinary tract are weak, the muscles in the urinary tract must work harder to hold urine until you are ready to urinate. This extra stress or pressure on the bladder and urethra can cause urinary incontinence or leakage.

Also, the female urethra is shorter than the male urethra. Any weakness or damage to the urethra in a woman is more likely to cause urinary incontinence. This is because there is less muscle keeping the urine in until you are ready to urinate.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (1)

Urinary Incontinence in Women Video – Brigham and Women’s Hospital

Video by Brigham And Women's Hospital/YouTube

3:08

Urinary Incontinence in Women Video – Brigham and Women’s Hospital

Brigham And Women's Hospital/YouTube

Causes

Sensitive content

This media may include sensitive content

Overweight Woman with Visible Internal Organ

Image by TheVisualMD

Sensitive content

This media may include sensitive content

Overweight Woman with Visible Internal Organ

Obesity and its health risks are a growing problem in the United States. It is estimated that more than two-thirds of adults are either overweight (10 to 30 pounds heavier than recommended) or obese (more than 30 pounds heavier than recommended). The number of overweight and obese school-age children is also on the rise. This is especially alarming given what is known about how obesity increases the risk of diabetes, high blood pressure, and cardiovascular disease. The Framingham Study found that regular exercise and maintaining a healthy weight are positive factors for cardiovascular health. Your heart is a muscle like any other in your body. Regular exercise strengthens muscles and improves the efficiency of circulation and nutrient and waste exchange. Little or no exercise means less muscle tone and can cause weight gain, which adds stress to the cardiovascular system and increases blood pressure. Weight gain - specifically the extra fat cells - also raise blood sugar and cholesterol levels. People who are overweight or obese are at a much higher risk of developing diabetes, which increases their risk of chronic kidney and heart disease. People who are obese also take a longer time to recover from surgical treatments and are more likely to develop complications from surgery.

Image by TheVisualMD

What Causes Urinary Incontinence?

Urinary incontinence is usually caused by problems with the muscles and nerves that help the bladder hold or pass urine. Certain health events unique to women, such as pregnancy, childbirth, and menopause, can cause problems with these muscles and nerves.

Other causes of urinary incontinence include:

Overweight. Having overweight puts pressure on the bladder, which can weaken the muscles over time. A weak bladder cannot hold as much urine.
Constipation. Problems with bladder control can happen to people with long-term (chronic) constipation. Constipation, or straining to have a bowel movement, can put stress or pressure on the bladder and pelvic floor muscles. This weakens the muscles and can cause urinary incontinence or leaking.
Nerve damage. Damaged nerves may send signals to the bladder at the wrong time or not at all. Childbirth and health problems such as diabetes and multiple sclerosis can cause nerve damage in the bladder, urethra, or pelvic floor muscles.
Surgery. Any surgery that involves a woman’s reproductive organs, such as a hysterectomy, can damage the supporting pelvic floor muscles, especially if the uterus is removed. If the pelvic floor muscles are damaged, a woman’s bladder muscles may not work like they should. This can cause urinary incontinence.

Sometimes urinary incontinence lasts only for a short time and happens because of other reasons, including:

Certain medicines. Urinary incontinence may be a side effect of medicines such as diuretics (“water pills” used to treat heart failure, liver cirrhosis, hypertension, and certain kidney diseases). The incontinence often goes away when you stop taking the medicine.
Caffeine. Drinks with caffeine can cause the bladder to fill quickly, which can cause you to leak urine. Studies suggest that women who drink more than two cups of drinks with caffeine per day may be more likely to have problems with incontinence. Limiting caffeine may help with incontinence because there is less strain on your bladder.
Infection. Infections of the urinary tract and bladder may cause incontinence for a short time. Bladder control often returns when the infection goes away.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Pregnancy

Uterus Size through Pregnancy

Image by TheVisualMD

Uterus Size through Pregnancy

The uterus is a thick-walled, elastic, muscular organ and enlarges greatly during pregnancy.

Image by TheVisualMD

How Does Pregnancy Cause Urinary Incontinence?

As many as 4 in 10 women get urinary incontinence during pregnancy. During pregnancy, as your unborn baby grows, he or she pushes down on your bladder, urethra, and pelvic floor muscles. Over time, this pressure may weaken the pelvic floor muscles and lead to leaks or problems passing urine.

Most problems with bladder control during pregnancy go away after childbirth when the muscles have had some time to heal. If you’re still having bladder problems 6 weeks after childbirth, talk to your doctor, nurse, or midwife.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (1)

Incontinence after Pregnancy & Childbirth: is it normal and how to fix it

Video by Orchard Clinic/YouTube

1:59

Incontinence after Pregnancy & Childbirth: is it normal and how to fix it

Orchard Clinic/YouTube

Childbirth

Delivery of baby - Childbirth

Image by Delivery of baby - Birth

Delivery of baby - Childbirth

TheVisualMD

Image by Delivery of baby - Birth

How Does Childbirth Cause Urinary Incontinence?

Problems during labor and childbirth, especially vaginal birth, can weaken pelvic floor muscles and damage the nerves that control the bladder. Most problems with bladder control that happen as a result of labor and delivery go away after the muscles have had some time to heal. If you’re still having bladder problems 6 weeks after childbirth, talk to your doctor, nurse, or midwife.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (1)

Incontinence Following Childbirth with Dr Emmanuel Karantanis

Video by Ramsay Health Care/YouTube

1:59

Incontinence Following Childbirth with Dr Emmanuel Karantanis

Ramsay Health Care/YouTube

Menopause

Vaginal Canal Normal vs. Menopause

Image by BruceBlaus

Vaginal Canal Normal vs. Menopause

Vaginal Canal Normal vs. Menopause

Image by BruceBlaus

How Does Menopause Cause Urinary Incontinence?

Some women have bladder control problems after they stop having periods. Researchers think having low levels of the hormone estrogen after menopause may weaken the urethra. The urethra helps keep urine in the bladder until you are ready to urinate.

Also, like all muscles, the bladder and urethra muscles lose some of their strength as you get older. This means you may not be able to hold as much urine as you get older.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (1)

Incontinence at menopause – urinary changes and why they happen

Video by Health & Her/YouTube

5:17

Incontinence at menopause – urinary changes and why they happen

Health & Her/YouTube

Symptoms

Drawing of female figure showing pelvic bone, bladder, and brain. Arrows outside the figure indicate the general direction of nerve signals from the brain to the bladder and from the bladder to the brain

Image by NIDDK Image Library

Drawing of female figure showing pelvic bone, bladder, and brain. Arrows outside the figure indicate the general direction of nerve signals from the brain to the bladder and from the bladder to the brain

Parts of the bladder control system: nerves and brain.

Image by NIDDK Image Library

What Are the Symptoms of Urinary Incontinence?

Urinary incontinence is not a disease by itself. Urinary incontinence is a symptom of another health problem, usually weak pelvic floor muscles. In addition to urinary incontinence, some women have other urinary symptoms:

Pressure or spasms in the pelvic area that causes a strong urge to urinate
Going to the bathroom more than usual (more than eight times a day or more than twice at night)
Urinating while sleeping (bedwetting)

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Diagnosis

X-ray of urinary bladder filled with contrast media.

Image by Lucien Monfils

X-ray of urinary bladder filled with contrast media.

Image by Lucien Monfils

How Is Urinary Incontinence Diagnosed?

Your doctor or nurse will ask you about your symptoms and your medical history, including:

How often you empty your bladder
How and when you leak urine
How much urine you leak
When your symptoms started
What medicines you take
If you have ever been pregnant and what your labor and delivery experience was like

Your doctor or nurse will do a physical exam to look for signs of health problems that can cause incontinence.

Your doctor or nurse also may do other tests such as:

Urine test. After you urinate into a cup, the doctor or nurse will send your urine to a lab. At the lab, your urine will be checked for infection or other causes of incontinence.
Ultrasound. Your doctor will use an ultrasound wand on the outside of your abdomen to take pictures of the kidneys, bladder, and urethra. Your doctor will look for anything unusual that may be causing urinary incontinence.
Bladder stress test. During this test, you will cough or bear down as if pushing during childbirth as your doctor watches for loss of urine.
Cystoscopy. Your doctor inserts a thin tube with a tiny camera into your urethra and bladder to look for damaged tissue. Depending on the type of cystoscopy you need, your doctor may use medicine to numb your skin and urinary organs while you are still awake, or you may be fully sedated.
Urodynamics. Your doctor inserts a thin tube into your bladder and fills your bladder with water. This allows your doctor to measure the pressure in your bladder to see how much fluid your bladder can hold.

Your doctor or nurse may ask you to keep a diary for 2 to 3 days to track when you empty your bladder or leak urine. The diary may help your doctor or nurse see patterns in the incontinence that give clues about the possible cause and treatments that might work for you.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (1)

Cystoscopy

A diagram of the catheters used in cytometry

Image by The National Institute of Diabetes and Digestive and Kidney Diseases,

Cystoscopy

The National Institute of Diabetes and Digestive and Kidney Diseases,

Urine Test

Urinalysis Test

Also called: Urine Test

A urine test is used to help diagnose a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. It evaluates many characteristics, macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye). It is a routine exam for your health check-up, before surgery, or when pregnant.

Urinalysis Test

Also called: Urine Test

A urine test is used to help diagnose a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. It evaluates many characteristics, macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye). It is a routine exam for your health check-up, before surgery, or when pregnant.

A urinalysis test consists in the evaluation of the macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye, can be seen through a microscope) characteristics of a urine sample to detect and measure various substances and compounds that the body filter through the kidneys.
Usually, these characteristics are done as a single panel and are not done separately as it had been before. This test can be used to make an overall health evaluation of the urinary tract, but it also helps diagnose and monitor many other conditions.
The structure of the test includes:
- Macroscopic aspects:
  Color
  Appearance
  Odor
- Chemical examination:
  pH
  Density
  Proteins
  Glucose
  Urobilinogen
  Bilirubin
  Leucocytes
  Nitrites
  Blood
  Ketones
- Microscopic aspects include:
  Blood cells (white and red cells)
  Epithelial cells
  Bacteria
  Crystals or casts
The most common uses of the urine test are:
- Overall check up
- To monitor pregnant women
- If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
- To monitor a medical condition, such as diabetes or kidney disease
- Drug screening
You will need to give a clean catch urine sample.
This requires following these simple steps;
1. Clean your genitals
2. Start to urinate in the toilet
3. Stop halfway through
4. Collect about two ounces of midstream urine in the container
5. Stop again and close the container
6. Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
Macroscopic findings
- Appearance (Clarity): normal urine is typically clear. If the urine seems to be cloudy or with floating particles, it may be indicative of urinary tract infection.
- Color: most often shades of yellow. Unusual colors might be because of certain foods, medications or a specific condition.
- Odor: normally it is relatively mild and not too noticeable.
Chemical examination
- pH: this measures the acidity. Under normal conditions, the urine is acidic with pH levels that range from 4.5 to 8.0
- Density (specific gravity): this measures how diluted or concentrated is your urine. Normal urine density is usually from 1.003 to 1.035.
- Proteins: urine can have small amounts of proteins; however, finding high protein levels may indicate kidney disease or diabetes mellitus.
- Glucose: no glucose should be found in the urine of a healthy individual.
- Urobilinogen: normal results range from 0.1 to 1.0 mg/dL.
- Bilirubin: no bilirubin should be found in the urine of a healthy individual. Positive findings may suggest liver disease.
- Nitrite: no nitrites should be found in the urine of a healthy individual. When positive is highly indicative of urinary tract infection.
- Ketones: normally is not found. However, it can be positive if you have been fasting for long periods of time, or if you have diabetes mellitus.
Microscopic aspects
- Red blood cells (RBC’s): is not unusual to find RBCs in a urine sample; however, 3 or more red blood cells are regarded as a sign of hematuria (blood loss through urine).
- White blood cells (WBC’s): under normal conditions, this parameter should be negative. A positive result is suggestive of urinary tract infection.
- Epithelial cells: from 1 to 5 squamous/hpf is considered to be normal. Higher results may indicate contamination of the urine sample by improper collection methods.
- Bacteria: it is normal to find up to 1+ bacteria; more than this is abnormal and should be analyzed to discern whether is caused by an infection or by improper sample storage.
- Crystals or casts: no crystals or casts should be found in the urine of healthy individuals. When present, it may be indicative of kidney disease or kidney stones.
1. Mayo Clinic: Urinalysis [accessed on Aug 19, 2018]
2. Urinalysis: A Comprehensive Review; Am Fam Physician. 2005 Mar 15;71(6):1153-1162. [accessed on Aug 19, 2018]
3. University of Utah: Urinalysis [accessed on Aug 19, 2018]

Additional Materials (22)

Urine Hydration chart

Image by Aishik Rehman/Wikimedia

Test Tube Containing Urine

Visualization of a test tube containing urine. Urine comprises mainly of water - 96% and the remaining 4% is urea and sodium.

Image by TheVisualMD

Urine in Vial

Urine is tested for a variety of reasons and can reveal a wealth of information about the source individual. More than 100 different tests can be done on urine. In addition to visual characteristics, for example color and clarity, urine may be examined for the presence of glucose, nitrites, or ketones. Microscopic examination may reveal the presence of red or white blood cells, or bacteria, yeast cells, or parasites. Urine samples may contain tumor markers, which can suggest cancer.

Image by TheVisualMD

White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)

White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)

Image by Bobjgalindo

Abundant uric acid crystals in a human urine sample

Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.

Image by Doruk Salancı

Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample

Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.

Image by Doruk Salancı

Struvite crystals (urine)

Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.

Image by Doruk Salancı

Uric acid crystals (urine)

Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.

Image by Doruk Salancı

Urine samples

Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Urine samples are evaluated visually, for color, clarity and concentration; chemically, for various substances, such as glucose and proteins, in solution; and microscopically, for signs of bacteria, crystals and other contaminants.

Image by TheVisualMD

Male Figure with Urinary System

Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.

Image by TheVisualMD

Urine collection container

Image by frolicsomepl/Pixabay

Cancer screening

Screening for Cancer: Urine Tests : Urine samples may contain tumor markers, which can suggest cancer. Urinalysis is commonly a part of routine health screening. It is simply an analysis of the urine that can be performed in many healthcare settings including doctors' offices, urgent care facilities, laboratories, and hospitals. Urinalysis can disclose evidence of diseases, even some that have not caused significant signs or symptoms.

Image by TheVisualMD

Sensitive content

This media may include sensitive content

Male Urinary System

Image of a male showing his urinary system. The urinary system, also known as the excretory system, produces, stores, and eliminates urine. It also helps to maintain the fluid balance in humans. The male urinary system consists of two kidneys, ureters, a urinary bladder, prostate, and urethra.

Image by TheVisualMD

Nephron of Kidney

The nephron is composed of looping and folding tubules that at first glance look like an impossibly tangled knot of highways, side roads and interchanges. But in fact, the nephron directs the traffic flow effortlessly. When stretched out, a nephron would be almost a couple of feet in length and there are about a million nephrons in each kidney. A nephron is composed of two basic parts: the glomerulus and the tubule. The glomerulus, part of the vascular system, is a tuft of capillaries that filters the wastes and fluid from the blood. The tubules then catch, concentrate and excrete the waste into the urine. The walls of the tubules are made of specialized cells, which serve as \"check points\" for the waste flowing by them. Hormonal sensors in these cells determine which substances should be excreted as waste and which substances will be reabsorbed into the blood to nourish the body's cells. The specific materials the cells are assigned to reabsorb or secrete include water and essential nutrients, salts and minerals, depending on where in the tubules the cells are located. From the glomerulus until the collecting duct, intricate and minute calculations are at constant play within the nephron. The production of urine does not just result in a waste product but also protects the fine balance of substances required to keep the body healthy.

Image by TheVisualMD

Fluid Filtration

Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of waste, which is then eliminated as urine. The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli. The kidneys also play a key role in maintaining the body's fluid balance within a very narrow range. Even a 1% increase in blood sodium, for example, will make a person thirsty enough to take a drink in order to return the fluid balance to normal.

Image by TheVisualMD

Ammonia, Urine

Ammonia is a waste product generated by intestinal bacteria during the digestion of protein. From the intestine, ammonia is transported to the liver, where it is converted into urea, which is then excreted in the urine by the kidneys. The conversion and elimination of ammonia can be impaired by liver disease or kidney damage, which can result in a dangerous build up of ammonia.

Image by TheVisualMD

Pyuria

Urine may contain pus (a condition known as pyuria) as seen from a person with sepsis due to a urinary tract infection.

Image by James Heilman, MD

Urine

Sample of human urine

Image by Markhamilton

Interpretation of the Urinalysis (Part 1) - Introduction and Inspection

Video by Strong Medicine/YouTube

Interpretation of the Urinalysis (Part 2) - The Dipstick

Video by Strong Medicine/YouTube

How to collect a mid-stream urine sample for a urinary tract infection test

Video by Pathology Tests Explained/YouTube

How to collect a first-void or first-pass urine sample

Video by Pathology Tests Explained/YouTube

Urine Hydration chart

Aishik Rehman/Wikimedia

Test Tube Containing Urine

TheVisualMD

Urine in Vial

TheVisualMD

White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)

Bobjgalindo

Abundant uric acid crystals in a human urine sample

Doruk Salancı

Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample

Doruk Salancı

Struvite crystals (urine)

Doruk Salancı

Uric acid crystals (urine)

Doruk Salancı

Urine samples

TheVisualMD

Male Figure with Urinary System

TheVisualMD

Urine collection container

frolicsomepl/Pixabay

Cancer screening

TheVisualMD

Sensitive content

This media may include sensitive content

Male Urinary System

TheVisualMD

Nephron of Kidney

TheVisualMD

Fluid Filtration

TheVisualMD

Ammonia, Urine

TheVisualMD

Pyuria

James Heilman, MD

Urine

Markhamilton

6:10

Interpretation of the Urinalysis (Part 1) - Introduction and Inspection

Strong Medicine/YouTube

16:36

Interpretation of the Urinalysis (Part 2) - The Dipstick

Strong Medicine/YouTube

1:03

How to collect a mid-stream urine sample for a urinary tract infection test

Pathology Tests Explained/YouTube

1:06

How to collect a first-void or first-pass urine sample

Pathology Tests Explained/YouTube

Glucose in Urine Test

Glucose in Urine Test

Also called: Urine sugar test, Urine glucose test, Glucosuria test, Glucose urine dipstick

A glucose in urine test measures the amount of glucose (sugar) in your urine. The test is used to monitor both type 1 and type 2 diabetes.

Glucose in Urine Test

Also called: Urine sugar test, Urine glucose test, Glucosuria test, Glucose urine dipstick

A glucose in urine test measures the amount of glucose (sugar) in your urine. The test is used to monitor both type 1 and type 2 diabetes.

{"label":"Glucose in Urine Reference Range","scale":"lin","step":0.1,"hideunits":false,"units":[{"printSymbol":"mg\/dL","code":"mg\/dL","name":"milligram per deciliter"}],"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":15},"text":"Glucose is not usually found in urine. If it is, further testing is needed. ","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":15,"max":40},"text":"If high levels of glucose in urine are found in pregnant women, it may indicate\u00a0gestational diabetes. A urine glucose test is only a screening test. If glucose is found in your urine, your provider will order a blood glucose test to help make a diagnosis.","conditions":["Diabetes","Pregnancy","Renal glycosuria"]}],"value":7.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your health.
mg/dL
15
Your result is Negative.
Glucose is not usually found in urine. If it is, further testing is needed.
Related conditions
You may get a glucose in urine test as part of your regular checkup or if you have symptoms of diabetes and cannot take a blood glucose test. Symptoms of diabetes include:
- Increased thirst
- More frequent urination
- Blurred vision
- Fatigue
You may also need a urinalysis, which includes a glucose in urine test, if you are pregnant. If high levels of glucose in urine are found, it may indicate gestational diabetes. Gestational diabetes is form of diabetes that happens only during pregnancy. Blood glucose testing can be used to confirm a diagnosis of gestational diabetes. Most pregnant women are tested for gestational diabetes with a blood glucose test, between their 24th and 28th weeks of pregnancy.
If your urine glucose test is part of a urinalysis, you will need to provide a sample of your urine. During your office visit, you will receive a container in which to collect the urine and special instructions to ensure the sample is sterile. These instructions are often referred to as the "clean catch method." The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
Your health care provider may ask you to monitor your urine glucose at home with a test kit. He or she will provide you with either a kit or a recommendation of which kit to buy. Your urine glucose test kit will include instructions on how to perform the test and a package of strips for testing. Be sure to follow the kit instructions carefully, and talk to your health care provider if you have any questions.
Glucose is not normally found in urine. If results show glucose, it may be a sign of:
- Diabetes
- Pregnancy. As many half of all pregnant women have some glucose in their urine during pregnancy. Too much glucose may indicate gestational diabetes.
- A kidney disorder
A urine glucose test is only a screening test. If glucose is found in your urine, your provider will order a blood glucose test to help make a diagnosis.
1. https://medlineplus.gov/lab-tests/glucose-in-urine-test/ [accessed on Sep 15, 2019]
2. https://medlineplus.gov/ency/article/003581.htm [accessed on Sep 15, 2019]
3. https://www.labcorp.com/test-menu/26061/glucose-quantitative-urine [accessed on Sep 15, 2019]
4. https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=glucose_urine [accessed on Sep 15, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (6)

Abdomen Revealing Pancreas and Kidney

Sugar is one of the nutrients your body uses for energy. It is the product of the body's breakdown of complex carbohydrates and is circulated in the blood to all your cells. Although blood sugar levels change depending on whether you just ate or exercised, in general, your body keeps the sugar levels within a narrow range. Not enough sugar - hypoglycemia - and you can get hungry, shaky, sweaty, tired, and even faint. Too much sugar - hyperglycemia - is a cardiovascular risk factor leading to arteriosclerosis (hardening of the arteries). To control blood sugar levels, your body depends on a hormone called insulin.

Image by TheVisualMD

Diabetes Symptoms

(left to right) Fatigue: dehydration, lack of ability to utilize glucose for energy and other factors cause fatigue; weight loss: because it can't use glucose for energy, the body breaks down muscle instead; constant hunger: diabetes prevents glucose from entering cells, leading to constant hunger due to cell starvation; increased thirst: too much urination leaves tissues dehydrated and causes increased thirst; frequent urination: fluids are drawn from tissues and the kidneys constantly filter out glucose, leading to frequent urination.

Image by TheVisualMD

Male Figure with Urinary System

Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.

Image by TheVisualMD

Kidney Glomeruli, Compromised Filtration

Our kidneys are remarkable filters. Each day, they filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Proteins are also normally filtered out of the blood and recycled in the body by the kidneys. When kidneys are diseased or damaged, however, their ability to filter out proteins is compromised, which allows protein to then leak into urine.

Image by TheVisualMD

Diseased and Aging Kidney Tissue Comparisons

As a person ages, the number of nephrons, the kidneys' vital filters, decreases, as does the overall amount of tissue in the kidneys. A healthy aging kidney will not function like a 20-year-old kidney, but it can still do its job. The difference between an aging kidney in a healthy body and a kidney damaged by hypertension or diabetes can be as stark as the difference between someone who is a picture of health and someone who is debilitated by illness.

Image by TheVisualMD

Glomerulonephritis

Our kidneys filter about 200 quarts of blood each day to extract about 2 quarts of waste, which is then eliminated as urine. The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli. Glomerulonephritis is the inflammation of these tiny filters and can be caused by diabetes and chronic high blood pressure or, in acute cases, infection. When kidney function declines, waste products normally filtered out and excreted into the urine begin instead to accumulate in the blood.

Image by TheVisualMD

Abdomen Revealing Pancreas and Kidney

TheVisualMD

Diabetes Symptoms

TheVisualMD

Male Figure with Urinary System

TheVisualMD

Kidney Glomeruli, Compromised Filtration

TheVisualMD

Diseased and Aging Kidney Tissue Comparisons

TheVisualMD

Glomerulonephritis

TheVisualMD

Bilirubin in Urine Test

Bilirubin in Urine Test

Also called: Total Urine Bilirubin, Bilirubin

Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. When the liver is damaged, bilirubin can leak into your urine. A bilirubin in urine test can help detect liver disease.

Bilirubin in Urine Test

Also called: Total Urine Bilirubin, Bilirubin

Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. When the liver is damaged, bilirubin can leak into your urine. A bilirubin in urine test can help detect liver disease.

{"label":"Bilirubin Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"Bilirubin is not normally found in the urine.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"High levels of bilirubin could mean your liver is not functioning correctly. However, high levels can also be due to medications, exercise, or certain foods.","conditions":["Biliary tract disease","Cirrhosis","Gallstones in the biliary tract","Hepatitis","Liver disease","Tumors of the liver or gallbladder"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your health.
Your result is Negative.
Bilirubin is not normally found in the urine.
Related conditions
Your health care provider may have ordered a bilirubin in urine test as part of your regular checkup, or if you have symptoms of liver disease. These symptoms include:
- Jaundice, a condition that causes your skin and eyes to turn yellow
- Dark-colored urine
- Abdominal pain
- Nausea and vomiting
- Fatigue
Because bilirubin in urine can indicate liver damage before other symptoms appear, your health care provider may order a bilirubin in urine test if you are at a higher risk for liver damage. Risk factors for liver disease include:
- Family history of liver disease
- Heavy drinking
- Exposure or possible exposure to hepatitis virus
- Obesity
- Diabetes
- Taking certain medicines that can cause liver damage
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
6. Finish urinating into the toilet.
7. Return the sample container to your health care provider.
If bilirubin is found in your urine, it may indicate:
- A liver disease such as hepatitis
- A blockage in the structures that carry bile from your liver
- A problem with liver function
A bilirubin in urine test is only one measure of liver function. If your results are abnormal, your health care provider may order additional blood and urine tests, including a liver panel. A liver panel is a series of blood tests that measure various enzymes, proteins, and substances in the liver. It is often used to detect liver disease.
1. Bilirubin in Urine: MedlinePlus Lab Test Information [accessed on Aug 22, 2021]
2. https://medlineplus.gov/ency/article/003595.htm [accessed on Aug 22, 2021]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Ketones in Urine Test

Ketones in Urine Test

Also called: Urine Ketones, Ketone Bodies (Urine), Ketones Urine Test

Ketones in urine may indicate a problem with the body's ability to burn energy. Diabetics are at a higher risk for developing urine ketones. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.

Ketones in Urine Test

Also called: Urine Ketones, Ketone Bodies (Urine), Ketones Urine Test

Ketones in urine may indicate a problem with the body's ability to burn energy. Diabetics are at a higher risk for developing urine ketones. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.

{"label":"Ketones in Urine Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"N","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":20},"text":"A negative test result is normal.","conditions":[]},{"flag":"borderline","label":{"short":"S","long":"Small","orientation":"horizontal"},"values":{"min":20,"max":40},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]},{"flag":"abnormal","label":{"short":"M","long":"Moderate","orientation":"horizontal"},"values":{"min":40,"max":60},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]},{"flag":"abnormal","label":{"short":"L","long":"Large","orientation":"horizontal"},"values":{"min":60,"max":80},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]}],"value":10}[{"normal":0},{"borderline":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your health.
Your result is Normal.
A negative test result is normal.
Related conditions
The test is often used to help monitor people at a higher risk of developing ketones. These include people with type 1 or type 2 diabetes. If you have diabetes, ketones in urine can mean that you are not getting enough insulin. If you don't have diabetes, you may still be at risk for developing ketones if you:
- Experience chronic vomiting and/or diarrhea
- Have a digestive disorder
- Participate in strenuous exercise
- Are on a very low-carbohydrate diet
- Have an eating disorder
- Are pregnant
Your health care provider may order a ketones in urine test if you have diabetes or other risk factors for developing ketones. You may also need this test if you have symptoms of ketoacidosis. These include:
- Nausea or vomiting
- Abdominal pain
- Confusion
- Trouble breathing
- Feeling extremely sleepy
People with type 1 diabetes are at a higher risk for ketoacidosis.
A ketones in urine test can be done in the home as well as in a lab. If in a lab, you will be given instructions to provide a "clean catch" sample. The clean catch method generally includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
If you do the test at home, follow the instructions that are in your test kit. Your kit will include a package of strips for testing. You will either be instructed to provide a clean catch sample in a container as described above or to put the test strip directly in the stream of your urine. Talk to your health care provider about specific instructions.
1. Ketones in Urine: MedlinePlus Lab Test Information [accessed on Sep 15, 2019]
2. https://medlineplus.gov/ency/article/003585.htm [accessed on Sep 15, 2019]
3. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=ketone_bodies_urine [accessed on Sep 15, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (5)

DKA - Diabetic Ketoacidosis

Video by DrER.tv/YouTube

Symptoms of Ketoacidosis

Video by Diabetes.co.uk/YouTube

Diabetes & Associated Complications

Video by Boehringer Ingelheim/YouTube

Acute complications of diabetes - Diabetic ketoacidosis | NCLEX-RN | Khan Academy

Video by khanacademymedicine/YouTube

A medical illustration depicting a ketone urine test

A medical illustration depicting a ketone urine test

Image by BruceBlaus

5:46

DKA - Diabetic Ketoacidosis

DrER.tv/YouTube

1:00

Symptoms of Ketoacidosis

Diabetes.co.uk/YouTube

5:50

Diabetes & Associated Complications

Boehringer Ingelheim/YouTube

11:26

Acute complications of diabetes - Diabetic ketoacidosis | NCLEX-RN | Khan Academy

khanacademymedicine/YouTube

A medical illustration depicting a ketone urine test

BruceBlaus

Urine Specific Gravity Test

Urine Specific Gravity Test

Also called: Urine SG, Specific Gravity of Urine, Urine Density

A urine specific gravity test measures the concentration of solutes in your urine, which shows if your kidneys are properly diluting urine. This test is a partial analysis used in case of suspected kidney disorder.

Urine Specific Gravity Test

Also called: Urine SG, Specific Gravity of Urine, Urine Density

A urine specific gravity test measures the concentration of solutes in your urine, which shows if your kidneys are properly diluting urine. This test is a partial analysis used in case of suspected kidney disorder.

{"label":"Urine Specific Gravity Reference Range","scale":"lin","step":0.01,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0.8,"max":1.002},"text":"Your urine is too diluted.","conditions":["Diabetes","Kidney disorders","Glomerulonephritis","Pyelonephritis","Kidney failure","Overhydration"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":1.002,"max":1.03},"text":"Normal results can slightly vary from laboratory to laboratory.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":1.03,"max":1.2},"text":"Your urine is too concentrated. ","conditions":["Liver disease","Adrenal glands disorder","Heart disease","Dehydration","Shock"]}],"value":1.02}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
1.002
1.03
Your result is Normal.
Normal results can slightly vary from laboratory to laboratory.
Related conditions
Your doctor may order a urine specific gravity test as part of your routine health checkup, or to help diagnose or monitor the following conditions:
- Urinary tract infection
- Dehydration or overhydration
- Kidney infection (pyelonephritis)
- Kidney failure
- Shifts in sodium levels (hypernatremia or hyponatremia)
- Diabetes
- Shock
- Heart failure
The normal value for urine specific gravity is 1.002-1.030.
Lower-than-normal values of urine gravity may indicate:
- Diabetes
- Kidney disorders (glomerulonephritis, pyelonephritis)
- Kidney failure
- Drinking too much fluid (overhydration)
Higher-than-normal urine gravity test results may refer to an increased level of some substances in your urine, such as proteins, bacteria, glucose, urine crystals, red and white blood cells. These findings may occur in cases of:
- Liver disease
- Adrenal glands disorder
- Heart disease
- Dehydration (not consuming enough water, or losing too much fluid through sweating, vomiting, or diarrhea)
- Shock
1. https://medlineplus.gov/ency/article/003587.htm [accessed on Oct 09, 2021]
2. Urine Specific Gravity Test: Overview, Tests, and Procedure [accessed on Oct 29, 2018]
3. Urine specific gravity test: Procedure and results [accessed on Oct 29, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (20)

Hematuria

Hematuria Trauma : Gross hematuria due to kidney trauma.

Image by James Heilman, MD

Hematuria by anatomic location

Source of Hematuria by anatomic location

Image by Copene

Phenazopyridine

Pyridiumurine : The characteristic color of urine after taking pyridium.

Image by James Heilman, MD

Drawing of a kidney with an inset of a nephron

The glomeruli are sets of looping blood vessels in nephrons--the tiny working units of the kidneys that filter wastes and remove extra fluid from the blood.

Image by NIDDK Image Library

Urine samples

Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Urine samples are evaluated visually, for color, clarity and concentration; chemically, for various substances, such as glucose and proteins, in solution; and microscopically, for signs of bacteria, crystals and other contaminants.

Image by TheVisualMD

Urine in Vial

Urine is tested for a variety of reasons and can reveal a wealth of information about the source individual. More than 100 different tests can be done on urine. In addition to visual characteristics, for example color and clarity, urine may be examined for the presence of glucose, nitrites, or ketones. Microscopic examination may reveal the presence of red or white blood cells, or bacteria, yeast cells, or parasites. Urine samples may contain tumor markers, which can suggest cancer.

Image by TheVisualMD

Ureteropelvic junction obstruction

Drawing of a swollen kidney that results from ureteropelvic junction obstruction. The point of blockage is labeled UPJ obstruction. UPJ obstruction occurs when urine is blocked where the ureter joins the kidney.

Image by NIDDK Image Library

Bilirubin, Jaundice Urine

When damaged or dying red blood cells are broken down, bilirubin, a yellow pigment and component of hemoglobin, is released into the bloodstream. Bilirubin is usually eliminated from the body by the liver as a component of bile, which is released into the small intestine to aid digestion. Under normal circumstances, very little, if any, bilirubin is excreted in the urine, but in cases of liver damage or a blockage of the bile ducts, some bilirubin can leak out and appear in the urine, turning it a darker color.

Image by TheVisualMD

Urine Color Chart

Urine Color Chart - Hydration

Image by OpenStax College

Healthy vs Damaged Kidney

A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. Urine Test for Albumin If you are at risk for kidney disease, your provider may check your urine for albumin. Albumin is a protein found in your blood. A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. The less albumin in your urine, the better. Having albumin in the urine is called albuminuria. A diagram showing a healthy kidney with albumin only found in blood, and a damaged kidney that has albumin in both blood and urine. A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. A health care provider can check for albumin in your urine in two ways: Dipstick test for albumin. A provider uses a urine sample to look for albumin in your urine. You collect the urine sample in a container in a health care provider’s office or lab. For the test, a provider places a strip of chemically treated paper, called a dipstick, into the urine. The dipstick changes color if albumin is present in the urine. Urine albumin-to-creatinine ratio (UACR). This test measures and compares the amount of albumin with the amount of creatinine in your urine sample. Providers use your UACR to estimate how much albumin would pass into your urine over 24 hours. A urine albumin result of 30 mg/g or less is normal more than 30 mg/g may be a sign of kidney disease If you have albumin in your urine, your provider may want you to repeat the urine test one or two more times to confirm the results. Talk with your provider about what your specific numbers mean for you. If you have kidney disease, measuring the albumin in your urine helps your provider know which treatment is best for you. A urine albumin level that stays the same or goes down may mean that treatments are working.

Image by The National Institute of Diabetes and Digestive and Kidney Diseases/NIH

Drawing of a urine sample and dipstick

A strip of chemically treated paper will change color when dipped in urine with too much protein.

Image by NIDDK Image Library

Struvite crystals (urine)

Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.

Image by Doruk Salancı

Uric acid crystals (urine)

Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.

Image by Doruk Salancı

Male Figure with Urinary System

Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.

Image by TheVisualMD

Adequate water intake and kidney health

Adequate water intake and kidney health. Replacing the water lost through sweating and waste elimination is vital to our health. Remaining hydrated is one way to help prevent kidney stones, which can form when certain waste minerals are highly concentrated in the urine. In this 3-D visualization, a clear bottle pours water into a model of a human kidney.

Image by TheVisualMD

Urine

Sample of human urine

Image by Markhamilton

Urine Culture: Preventing UTIs

There are a number of ways you can help to prevent UTIs. Drinking plenty of liquids, especially water, not only aids your kidneys in filtering out wastes, it also dilutes your urine and makes you urinate more frequently. This flushes out bacteria and other pathogens from your urinary tract and helps to prevent infections. Urinating after having sex also helps to flush out bacteria. Women should wipe from front to back when using the toilet and change tampons and pads frequently during their periods.

Image by TheVisualMD

formation of urine

Anatomy and physiology of animals Summary of the processes involved in the formation of urine.

Image by Sunshineconnelly

male's urinary system

Urinary system in the male. Urine flows from the kidneys via the ureters into the bladder where it is stored. When urinating, urine flows through the urethra (longer in males, shorter in females) to exit the body

Image by BruceBlaus

Urine of patient with porphyria

Change in urine color before and after sun exposure Left figure is urine of the first day. Right figure is urine after sun exposure for 3 days. Urine color changed to “port wine” color after sun exposure. This color change is due to increased concentrations of porphyrin intermediates in the urine, indicating an abnormality in production and a partial block within the enzymatic porphyrin chain with metabolite formation. The urine color usually becomes darker with acute illness, even dark reddish or brown after sun exposure.

Image by Chen GL, Yang DH, Wu JY, Kuo CW, Hsu WH

Hematuria

James Heilman, MD

Hematuria by anatomic location

Copene

Phenazopyridine

James Heilman, MD

Drawing of a kidney with an inset of a nephron

NIDDK Image Library

Urine samples

TheVisualMD

Urine in Vial

TheVisualMD

Ureteropelvic junction obstruction

NIDDK Image Library

Bilirubin, Jaundice Urine

TheVisualMD

Urine Color Chart

OpenStax College

Healthy vs Damaged Kidney

The National Institute of Diabetes and Digestive and Kidney Diseases/NIH

Drawing of a urine sample and dipstick

NIDDK Image Library

Struvite crystals (urine)

Doruk Salancı

Uric acid crystals (urine)

Doruk Salancı

Male Figure with Urinary System

TheVisualMD

Adequate water intake and kidney health

TheVisualMD

Urine

Markhamilton

Urine Culture: Preventing UTIs

TheVisualMD

formation of urine

Sunshineconnelly

male's urinary system

BruceBlaus

Urine of patient with porphyria

Chen GL, Yang DH, Wu JY, Kuo CW, Hsu WH

Blood in Urine Test

Blood in Urine Test

Also called: Hematuria, Bloody urine

A blood in urine test is part of a urinalysis, a test that measures different cells, chemicals, and other substances in urine. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection,

Blood in Urine Test

Also called: Hematuria, Bloody urine

A blood in urine test is part of a urinalysis, a test that measures different cells, chemicals, and other substances in urine. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection,

{"label":"Blood in Urine Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"","conditions":[]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your health.
Your result is Negative.
Related conditions
Your health care provider may have ordered a urinalysis as part of a routine exam. You may also need this test if you have seen blood in your urine or have other symptoms of a urinary disorder. These symptoms include:
- Painful urination
- Frequent urination
- Back pain
- Abdominal pain
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." It includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the needed amounts.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
There are a variety of factors that can cause red or white blood cells to be present in the urine. Many are not cause for concern. Small amounts of blood in the urine may be due to certain medicines, intense exercise, sexual activity, or menstruation. If larger amounts of blood are found, your health care provider may request further testing.
Increased red blood cells in urine may indicate:
- A viral infection
- Inflammation of the kidney or bladder
- A blood disorder
- Bladder or kidney cancer
Increased white blood cells in urine may indicate:
- A bacterial urinary tract infection. This is the most common cause of a high white blood cell count in urine.
- Inflammation of the urinary tract or kidneys
To learn what your results mean, talk to your health care provider.
1. Lab Tests Online: Blood in Urine (Hematuria) [accessed on Aug 19, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (12)

Urine Color Chart

Urine Color Chart - Hydration

Image by OpenStax College

Hematuria (Blood in the Urine)

Video by mdconversation/YouTube

Blood in the Urine: What does it mean?

Video by Frederick Memorial Hospital/YouTube

Blood in the Urine

Video by St. Mark's Hospital/YouTube

Hematuria

Microscopic hematuria

Image by Bobjgalindo

Hematuria

Hematuria Trauma : Gross hematuria due to kidney trauma.

Image by James Heilman, MD

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Image by Bobjgalindo

Hematuria by anatomic location

Source of Hematuria by anatomic location

Image by Copene

Microphotography - sample of urine with hematuria

Microphotography - sample of urine with hematuria

Image by J3D3

This browser does not support the video element.

Bleeding Tissue

Blood continues to flow into tissue after the piercing needle has left the finger. Camera starts off looking at the cut edges of bleeding capillaries in the tissue and then looks down at the cavity where blood is beginning to pool.

Video by TheVisualMD

Microhematuria

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Image by Bobjgalindo

Phenazopyridine

Pyridiumurine : The characteristic color of urine after taking pyridium.

Image by James Heilman, MD

Urine Color Chart

OpenStax College

12:53

Hematuria (Blood in the Urine)

mdconversation/YouTube

0:50

Blood in the Urine: What does it mean?

Frederick Memorial Hospital/YouTube

2:24

Blood in the Urine

St. Mark's Hospital/YouTube

Hematuria

Bobjgalindo

Hematuria

James Heilman, MD

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Bobjgalindo

Hematuria by anatomic location

Copene

Microphotography - sample of urine with hematuria

J3D3

0:08

Bleeding Tissue

TheVisualMD

Microhematuria

Bobjgalindo

Phenazopyridine

James Heilman, MD

PH of Urine Test

PH of Urine Test

Also called: Acid Loading Test, Urine pH, Alkaline Urine Test, Acidic Urine Test

A urine pH test is used to detect a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. Any pH higher than 8 is basic or alkaline, and any under 6 is acidic. A urine pH test is carried out as a part of a urinalysis.

PH of Urine Test

Also called: Acid Loading Test, Urine pH, Alkaline Urine Test, Acidic Urine Test

A urine pH test is used to detect a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. Any pH higher than 8 is basic or alkaline, and any under 6 is acidic. A urine pH test is carried out as a part of a urinalysis.

{"label":"Urine pH reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":1,"max":4.5},"text":"This means that your urine is acidic. This can be seen in people who eat large quantities of meat, and it's also related to other health issues. ","conditions":["Metabolic acidosis","Respiratory acidosis","Xanthine kidney stones","Cystine kidney stones","Uric acid kidney stones","Diabetes","Diarrhea","Starvation","Fanconi syndrome","Milkman syndrome"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":4.5,"max":8},"text":"A normal urine pH range is between 4.5 and 8.0.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":8,"max":14},"text":"This means that your urine is alkaline. This can be seen in people who eat large quantities of citrus fruit and vegetables, and it's also related to other health issues. ","conditions":["Kidney failure","Urinary tract infection","Calcium carbonate kidney stones","Calcium phosphate kidney stones","Struvite kidney stones","Respiratory alkalosis","Metabolic alkalosis"]}],"units":[{"printSymbol":"pH","code":"[pH]","name":"pH"}],"value":6.2}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
pH
4.5
8
Your result is Normal.
A normal urine pH range is between 4.5 and 8.0.
Related conditions
Some of the most common uses of the urine pH test are:
- Evaluate the risk of developing kidney stones (nephrolithiasis)
- Assessment of metabolic acidosis
- Monitor treatment of uric acid kidney stones
- Help identify crystals in the urine
Under normal conditions, the urine is acidic with pH levels that range from 4.5 to 8.0
A high urine pH (alkaline urine) can be found in people who eat large quantities of citrus fruit and vegetables. Other causes include:
- Kidney failure
- Urinary tract infection
- Kidney stones made up from calcium carbonate, calcium phosphate, and struvite (magnesium ammonium phosphate)
- Respiratory alkalosis
- Metabolic alkalosis
A low urine pH (acid urine) can be found in people who eat large quantities of meat. Other causes include:
- Metabolic acidosis
- Respiratory acidosis
- Kidney stones made up from xanthine, cystine, and uric acid
- Diabetes
- Diarrhea
- Starvation
- Fanconi syndrome
- Milkman syndrome
1. 013037: pH, Urine | LabCorp [accessed on Jan 04, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Protein in Urine Test

Protein in Urine Test

Also called: Urine Protein

A protein in urine test measures how much protein is in your urine. A large amount of protein can indicate a problem with your kidneys.

Protein in Urine Test

Also called: Urine Protein

A protein in urine test measures how much protein is in your urine. A large amount of protein can indicate a problem with your kidneys.

{"label":"Protein in Urine Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"Normal results vary based on the laboratory and the method used.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"If a large amount of protein is found in your urine sample, it doesn't necessarily mean that you have a medical problem needing treatment. Strenuous exercise, diet, stress, pregnancy, and other factors can cause a temporary rise in urine protein levels.<br \/>\n<br \/>\nIf your urine protein levels are consistently high, it may indicate kidney damage or other medical condition.","conditions":["Urinary tract infection","Lupus","High blood pressure","Preeclampsia","Diabetes","Certain types of cancer"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your health.
Your result is Negative.
Normal results vary based on the laboratory and the method used.
Related conditions
Your health care provider may have ordered a protein test as part of your regular checkup, or if you have symptoms of kidney disease. These symptoms include:
- Difficulty urinating
- Frequent urination, especially at night
- Nausea and vomiting
- Loss of appetite
- Swelling in the hands and feet
- Fatigue
- Itching
A protein in urine test can be done in the home as well as in a lab. If in a lab, you will receive instructions to provide a "clean catch" sample. The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
If at home, you will use a test kit. The kit will include a package of strips for testing and instructions on how to provide a clean catch sample. Talk to your health care provider if you have any questions.
Your health care provider may also request you collect all your urine during a 24-hour period. This "24-hour urine sample test" is used because the amounts of substances in urine, including protein, can vary throughout the day. Collecting several samples in a day may provide a more accurate picture of your urine content.
If a large amount of protein is found in your urine sample, it doesn't necessarily mean that you have a medical problem needing treatment. Strenuous exercise, diet, stress, pregnancy, and other factors can cause a temporary rise in urine protein levels. Your health care provider may recommend additional urinalysis tests if a high level of protein is found. This testing may include a 24-hour urine sample test.
If your urine protein levels are consistently high, it may indicate kidney damage or other medical condition. These include:
- Urinary tract infection
- Lupus
- High blood pressure
- Preeclampsia, a serious complication of pregnancy, marked by high blood pressure. If it is not treated, preeclampsia can be life-threatening to the mother and baby.
- Diabetes
- Certain types of cancer
To learn what your results mean, talk to your health care provider.

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (2)

Urine Color Chart

Urine Color Chart - Hydration

Image by OpenStax College

When kidneys are diseased or damaged, their ability to filter out proteins is compromised, which allows protein to then leak into urine.

Urine Total Protein Test for Diseased Glomerulus : The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli, which remove waste products from the blood while preventing the loss of other components, including proteins, which are recycled in the body. When kidneys are diseased or damaged, however, their ability to filter out proteins is compromised, which allows protein to then leak into urine.

Image by TheVisualMD

Urine Color Chart

OpenStax College

When kidneys are diseased or damaged, their ability to filter out proteins is compromised, which allows protein to then leak into urine.

TheVisualMD

Urobilinogen Test

Urobilinogen Test

Also called: Urinary Urobilinogen

A urobilinogen in urine test looks for liver disease or damage. It may be included in a routine exam or if a liver problem is suspected.

Urobilinogen Test

Also called: Urinary Urobilinogen

A urobilinogen in urine test looks for liver disease or damage. It may be included in a routine exam or if a liver problem is suspected.

{"label":"Urobilinogen Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"If your test results show too little or no urobilinogen in your urine, it may indicate a blockage in the blood flow of the liver or structures that carry bile from your liver or a problem with liver function.","conditions":["Liver issues"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":1,"max":3.5},"text":"Normal results vary based on the laboratory and the method used.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":3.5,"max":5},"text":"Urinary urobilinogen may be increased in the presence of a hemolytic process such as hemolytic anemia. It may also be increased with infectious hepatitis, or with cirrhosis.","conditions":["Hepatitis","Cirrhosis","Liver damage","Hemolytic anemia"]}],"value":2.25}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
Your health care provider may have ordered this test as part of your regular checkup, to monitor an existing liver condition, or if you have symptoms of a liver disease. These include:
- Jaundice, a condition that causes your skin and eyes to turn yellow
- Nausea and/or vomiting
- Dark colored urine
- Pain and swelling in the abdomen
- Itchy skin
Your health care provider will need to collect a sample of your urine. He or she will provide you with special instructions to ensure the sample is sterile. These instructions are often called as the "clean catch method." The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
If your test results show too little or no urobilinogen in your urine, it may indicate:
- A blockage in the structures that carry bile from your liver
- A blockage in the blood flow of the liver
- A problem with liver function
If your test results show a higher-than-normal level of urobilinogen, it may indicate:
- Hepatitis
- Cirrhosis
- Liver damage due to drugs
- Hemolytic anemia, a condition in which red blood cells are destroyed before they can be replaced. This leaves the body without enough healthy red blood cells
If your results are abnormal, it does not necessarily indicate you have a medical condition requiring treatment. Be sure to tell your health care provider about any medicines and supplements you are taking, as these can affect your results. If you are a woman, you should tell your health care provider if you are menstruating.

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (4)

Bilirubin Metabolism

Video by Armando Hasudungan/YouTube

Urinalysis

Kidneys and Related Conditions : The value of routine urinalysis is that abnormal levels of substances such as protein or glucose, for example, will often appear in the urine before patients are aware they may have a problem. It is also used to detect disorders of the urinary tract, most commonly infections. Abnormal urine screens are typically followed up by more specific diagnostic tests.

Image by TheVisualMD

Alkaline Phosphatase, Liver

The liver is the body's central chemical plant, filtering blood and removing toxins, storing sugars, lipids, and vitamins, and producing important blood proteins. Liver function is typically evaluated by a panel of tests, including one for alkaline phosphatase (ALP), an enzyme made in liver cells, that help doctors distinguish among the many different possible causes of liver damage. Many types of liver damage, including hepatitis, cirrhosis, liver cancer or drug toxicity, can elevate ALP levels.

Image by TheVisualMD

Liver and Gallbladder with Associated Vessel

The liver is the body's central chemical plant, filtering blood and removing toxins, storing sugars, lipids, and vitamins, and producing important blood proteins such as albumin as well as those involved in blood clotting. The liver also produces most of body's cholesterol (the rest comes from food) as well as a quart of bile each day, a greenish-brown, alkaline fluid that aids digestion. The gallbladder stores bile for release into the small intestine; bile contains cholesterol, bile salts, and bilirubin, a yellowish pigment produced by the breakdown of red blood cells.

Image by TheVisualMD

8:44

Bilirubin Metabolism

Armando Hasudungan/YouTube

Urinalysis

TheVisualMD

Alkaline Phosphatase, Liver

TheVisualMD

Liver and Gallbladder with Associated Vessel

TheVisualMD

Nitrites in Urine Test

Nitrites in Urine Test

Also called: Urine Nitrite

A nitrites in urine test is part of a urinalysis, a test that measures different substances in urine. If nitrites are present, it may indicate an infection.

Nitrites in Urine Test

Also called: Urine Nitrite

A nitrites in urine test is part of a urinalysis, a test that measures different substances in urine. If nitrites are present, it may indicate an infection.

{"label":"Nitrites in Urine Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"Even if no nitrites are found, you still may have an infection, because bacteria don't always change nitrates into nitrites.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"If there are nitrites in your urine, it may mean that you have a urinary tract infection.","conditions":["UTI"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your health.
Your result is Negative.
Even if no nitrites are found, you still may have an infection, because bacteria don't always change nitrates into nitrites.
Related conditions
Your health care provider may have ordered a urinalysis as part of a routine checkup or if you have symptoms of a UTI. Symptoms of a UTI may include:
- Frequent urge to urinate, but little urine comes out
- Painful urination
- Dark, cloudy, or reddish colored urine
- Bad smelling urine
- Weakness and fatigue, particularly in older women and men
- Fever
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (2)

Urine Color Chart

Urine Color Chart - Hydration

Image by OpenStax College

Lower urinary tract infection (cystitis) - an Osmosis preview

Video by Osmosis/YouTube

Urine Color Chart

OpenStax College

0:45

Lower urinary tract infection (cystitis) - an Osmosis preview

Osmosis/YouTube

Red Blood Cells in Urine Test

Red Blood Cells in Urine Test

Also called: RBC urine

Red blood cells (RBCs), also known as erythrocytes, may also be found in a urinalysis, or a urine test. High levels of RBCs in your urine indicates that you have hematuria.

Red Blood Cells in Urine Test

Also called: RBC urine

Red blood cells (RBCs), also known as erythrocytes, may also be found in a urinalysis, or a urine test. High levels of RBCs in your urine indicates that you have hematuria.

{"label":"Red Blood Cells in Urine Reference Range","scale":"lin","step":0.1,"hideunits":false,"units":[{"printSymbol":"{cells}\/uL","code":"{cells}\/uL","name":"cells per microliter"}],"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":5},"text":"This indicates that only small traces of blood was found in your urine. It is considered normal and does not require further investigation.","conditions":[]},{"flag":"abnormal","label":{"short":"One cross (+)","long":"One cross (+)","orientation":"horizontal"},"values":{"min":5,"max":25},"text":"This indicates that small but significant traces of blood was found in your urine. Repeat test may be necessary and should be looked at in clinical setting.","conditions":["Persistent microscopic haematuria","Glomerular disorders","Glomerulonephritis","Systemic lupus erythematosus","Renal disorders","Polycystic kidney disease","Benign prostatic hyperplasia","Cancer","Cystitis","Pyelonephritis","Nephrolithiasis","Prostatitis","Intake or certain drugs","Trauma"]},{"flag":"abnormal","label":{"short":"Two crosses (++)","long":"Two crosses (++)","orientation":"horizontal"},"values":{"min":25,"max":100},"text":"This indicates that significant traces of blood was found in your urine. Further testing is necessary.","conditions":["Glomerular disorders","Glomerulonephritis","Systemic lupus erythematosus","Renal disorders","Polycystic kidney disease","Benign prostatic hyperplasia","Cancer","Cystitis","Pyelonephritis","Nephrolithiasis","Prostatitis","Intake or certain drugs","Trauma"]}],"value":2.5}[{"normal":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your health.
{cells}/uL
5
25
Your result is Normal.
This indicates that only small traces of blood was found in your urine. It is considered normal and does not require further investigation.
Related conditions
This test is not usually ordered alone but rather as part of a urinalysis. It can be helpful in the following cases:
- Overall check up
- To monitor pregnant women
- If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
- To monitor a medical condition, such as diabetes or kidney disease
You will need to give a clean catch urine sample.
This requires following these simple steps;
1. Clean your genitals
2. Start to urinate in the toilet
3. Stop halfway through
4. Collect about two ounces of midstream urine in the container
5. Stop again and close the container
6. Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
Is not unusual to find RBCs in a urine sample; however, 3 or more red blood cells per high-powered field are regarded as a sign of hematuria (blood loss through urine).; further information should be gathered to make a diagnose.
Presence of RBC’s in urine may be due to:
- Glomerular disorders
- Glomerulonephritis
- Systemic lupus erythematosus
- Renal disorders
- Polycystic kidney disease
- Benign prostatic hyperplasia
- Cancer
- Cystitis
- Pyelonephritis
- Nephrolithiasis
- Prostatitis
- Intake or certain drugs
- Trauma
1. Urinalysis: Reference Range, Interpretation, Collection and Panels [accessed on Jan 10, 2019]
2. Urinalysis [accessed on Jan 10, 2019]
3. Urinalysis: A Comprehensive Review - - American Family Physician [accessed on Jan 10, 2019]
4. https://www.cambridgeshireandpeterboroughccg.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=7479 [accessed on Jan 10, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (5)

Hematuria

Hematuria Trauma : Gross hematuria due to kidney trauma.

Image by James Heilman, MD

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Image by Bobjgalindo

Hematuria by anatomic location

Source of Hematuria by anatomic location

Image by Copene

Microhematuria

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Image by Bobjgalindo

Phenazopyridine

Pyridiumurine : The characteristic color of urine after taking pyridium.

Image by James Heilman, MD

Hematuria

James Heilman, MD

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Bobjgalindo

Hematuria by anatomic location

Copene

Microhematuria

Bobjgalindo

Phenazopyridine

James Heilman, MD

White Blood Cells, Urine Test

White Blood Cells, Urine Test

Also called: Leukocytes in Urine

White blood cells (WBCs), also known as leukocytes, may also be found in a urinalysis, or a urine test. High levels of WBCs in your urine suggest that you have a urinary tract infection (UTI).

White Blood Cells, Urine Test

Also called: Leukocytes in Urine

White blood cells (WBCs), also known as leukocytes, may also be found in a urinalysis, or a urine test. High levels of WBCs in your urine suggest that you have a urinary tract infection (UTI).

{"label":"White Blood Cells, Urine Reference Range","scale":"lin","step":0.1,"hideunits":false,"units":[{"printSymbol":"{cells}\/uL","code":"{cells}\/uL","name":"cells per microliter"}],"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":10},"text":"Normal reference ranges can slightly vary depending on the laboratory and the method used for testing.","conditions":[]},{"flag":"borderline","label":{"short":"Borderline","long":"Borderline","orientation":"horizontal"},"values":{"min":10,"max":100},"text":"This is usually not significant but still requires further clinical assessment. Discuss your result with your doctor. ","conditions":["Urinary tract infection","Vaginal infection"]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":100,"max":200},"text":"A high number of WBCs may indicate a urinary tract infection or inflammation, especially if bacteria is also present.","conditions":["Urinary tract infection","Urinary tract inflammation","Pyelonephritis","Glomerulonephritis","Interstitial nephritis","Renal inflammatory processes"]}],"value":5}[{"normal":0},{"borderline":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
{cells}/uL
10
100
Your result is Normal.
Normal reference ranges can slightly vary depending on the laboratory and the method used for testing.
Related conditions
This test is not ordered alone but rather as part of a urinalysis. It can be helpful in the following cases:
- Overall check up
- To monitor pregnant women
- If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
You will need to give a clean catch urine sample.
This requires following these simple steps;
1. Clean your genitals
2. Start to urinate in the toilet
3. Stop halfway through
4. Collect about two ounces of midstream urine in the container
5. Stop again and close the container
6. Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
The normal range for WBCs in urine is:
- <10 WBC/µl: not significant
- 10-100 WBC/µl: usually not significant but still requires further clinical assessment
- >100 WBC/µl: suggestive of infection
It is also considered normal to have less than 5 WBCs/hpf. A high number of WBCs may indicate a urinary tract infection or inflammation, especially if bacteria is also present.
1. Urinalysis: Reference Range, Interpretation, Collection and Panels [accessed on Jan 10, 2019]
2. Urinalysis [accessed on Jan 10, 2019]
3. Urinalysis: A Comprehensive Review - - American Family Physician [accessed on Jan 10, 2019]
4. https://www.cambridgeshireandpeterboroughccg.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=7479 [accessed on Jan 10, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (1)

Pyuria

Pyuria : White blood cells seen under a microscope from a urine sample.

Image by Bobjgalindo

Pyuria

Bobjgalindo

Epithelial Cells in Urine Test

Epithelial Cells in Urine Test

The test measures the amount of epithelial cells in urine. A large amount may indicate an infection, kidney disease, or other serious medical condition. This test is part of a urinalysis, a test that measures different substances in your urine.

Epithelial Cells in Urine Test

The test measures the amount of epithelial cells in urine. A large amount may indicate an infection, kidney disease, or other serious medical condition. This test is part of a urinalysis, a test that measures different substances in your urine.

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Use the slider below to see how your results affect your health.
Your result is Few.
"Few" cells are generally considered in the normal range.
Related conditions
Your health care provider may have ordered an epithelial cells in urine test as part of your regular checkup or if your visual or chemical urine tests showed abnormal results. You may also need this test if you have symptoms of a urinary or kidney disorder. These symptoms may include:
- Frequent and/or painful urination
- Abdominal pain
- Back pain
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container. The container will have markings to indicate the amounts.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
Results are often reported as an approximate amount, such as "few," moderate," or "many" cells. "Few" cells are generally considered in the normal range. "Moderate" or "many" cells may indicate a medical condition such as:
- Urinary tract infection
- Yeast infection
- Kidney disease
- Liver disease
- Certain types of cancer
If your results are not in the normal range, it doesn't necessarily mean that you have a medical condition that requires treatment. You may need more tests before you can get a diagnosis. To learn what your results mean, talk to your health care provider.

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (5)

Uric acid crystals (urine)

Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.

Image by Doruk Salancı

Struvite crystals (urine)

Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.

Image by Doruk Salancı

Urine Test

Image by frolicsomepl/Pixabay

Urine

Sample of human urine

Image by Markhamilton

Cancer screening

Screening for Cancer: Urine Tests : Urine samples may contain tumor markers, which can suggest cancer. Urinalysis is commonly a part of routine health screening. It is simply an analysis of the urine that can be performed in many healthcare settings including doctors' offices, urgent care facilities, laboratories, and hospitals. Urinalysis can disclose evidence of diseases, even some that have not caused significant signs or symptoms.

Image by TheVisualMD

Uric acid crystals (urine)

Doruk Salancı

Struvite crystals (urine)

Doruk Salancı

Urine Test

frolicsomepl/Pixabay

Urine

Markhamilton

Cancer screening

TheVisualMD

Urinary Casts Test

Urinary Casts Test

Also called: Urine Casts

Urinary casts are tiny structures that can be seen in a urine test (urinalysis) when certain kidney diseases or conditions are present.

Urinary Casts Test

Also called: Urine Casts

Urinary casts are tiny structures that can be seen in a urine test (urinalysis) when certain kidney diseases or conditions are present.

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Use the slider below to see how your results affect your health.
Your result is Negative.
Related conditions
- Hyaline casts: the presence of a few of these casts is usually normal and can occur in physiologic states (e.g., after exercise).
- Fatty casts: these casts can be found in people who have lipids (fat) in the urine and are usually related to a kidney disease complication, such as nephrotic syndrome, glomerulonephritis, or other forms of chronic renal diseases.
- Granular casts: these casts might be found after exercise, but also when certain kidney diseases are present.
- Red blood cell casts: these casts are related to a very small amount of bleeding from the kidney. Red blood cell casts are seen in many kidney diseases.
- Epithelial cell casts: the apparition of these casts implies damage to cells in the kidneys. These casts are seen in conditions such as heavy metal poisoning, and kidney transplant rejection, among others.
- Waxy casts: these casts can be found in people with long-term (chronic) kidney disease and chronic kidney failure.
- White blood cell (WBC) casts: these casts can be found when acute kidney infections are present.

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Ultrasound

Pelvic Ultrasound - Female

Also called: Gynecological Scan, Gynecologic Ultrasound, Female Pelvic Scan, Female Pelvic Sonography, Transabdominal Female Pelvic Ultrasound, Transvaginal Ultrasound, Endovaginal Ultrasound

A female pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a woman’s pelvis, including the uterus, cervix, fallopian tubes, ovaries, vagina, and bladder.

Pelvic Ultrasound - Female

Also called: Gynecological Scan, Gynecologic Ultrasound, Female Pelvic Scan, Female Pelvic Sonography, Transabdominal Female Pelvic Ultrasound, Transvaginal Ultrasound, Endovaginal Ultrasound

A female pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a woman’s pelvis, including the uterus, cervix, fallopian tubes, ovaries, vagina, and bladder.

{"label":"Pelvic Ultrasound - Female Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"This means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"A problem or abnormality was detected during your pelvic ultrasound, either in your uterus, ovaries, fallopian tubes, or bladder. Talk to your doctor to know what this result means in your specific case.","conditions":["Fibroid tumors","Cysts","Ovarian torsion","Pelvic masses","Pelvic inflammatory disease","Ectopic pregnancy","Miscarriage","Free liquid in the pelvic cavity","Endometrial hyperplasia"]}],"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
Your result is Normal.
This means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.
Related conditions
Your doctor may want to order a female pelvic ultrasound to diagnose and assist in the treatment of a wide variety of conditions, such as:
- Abnormalities in the structure of the uterus and endometrium (lining of the uterus)
- Abnormalities in the structure of the ovaries
- Growths such as fibroid tumors, cysts, and other types of tumors within the pelvis
- Pelvic inflammatory disease (PID, which is an infection of your uterus, fallopian tubes, or ovaries)
- Ectopic pregnancy (pregnancy that occurs outside of the uterus)
- Abnormal bleeding or pelvic pain
- Postmenopausal bleeding
- Find an intrauterine contraceptive device (IUD)
- As part of the work-up for infertility and assisted reproduction techniques
A normal result means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.
An abnormal result indicates that a problem was detected, including but not limited to:
- Fibroid tumors
- Cysts
- Ovarian torsion
- Pelvic masses
- Pelvic inflammatory disease
- Ectopic pregnancy
- Miscarriage
- Free liquid in the pelvic cavity
- Endometrial hyperplasia, which is a thickening of the endometrium
1. Pelvic Ultrasound: Purpose, Procedure, Risks, Results [accessed on Dec 27, 2018]
2. Pelvic Ultrasound [accessed on Dec 27, 2018]
3. Pelvic Ultrasound | Johns Hopkins Medicine Health Library [accessed on Dec 27, 2018]
4. Transvaginal Ultrasound: Purpose, Procedure, and Results [accessed on Dec 27, 2018]
5. Pelvic Ultrasound - StatPearls - NCBI Bookshelf [accessed on Dec 27, 2018]
6. HEM Ultrasound | Female Pelvic Ultrasound [accessed on Dec 27, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (1)

What to Expect From a Female Pelvic Ultrasound Exam

Video by RAYUS Radiology™/YouTube

2:19

What to Expect From a Female Pelvic Ultrasound Exam

RAYUS Radiology™/YouTube

Cystoscopy

Cystoscopy

Also called: Bladder Endoscopy

A cystoscopy is a procedure to look inside the urethra and bladder using a thin camera called a cystoscope. The test can help find problems with the urinary tract, including early signs of cancer, infection, narrowing, blockage, or bleeding.

Cystoscopy

Also called: Bladder Endoscopy

A cystoscopy is a procedure to look inside the urethra and bladder using a thin camera called a cystoscope. The test can help find problems with the urinary tract, including early signs of cancer, infection, narrowing, blockage, or bleeding.

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Use the slider below to see how your results affect your health.
Your result is Normal.
The bladder wall should look smooth. The bladder should be of normal size, shape, and position. There should be no blockages, growths, or stones.
Related conditions
A urologist performs a cystoscopy to find the cause of urinary tract problems such as
- Frequent urinary tract infections (UTIs)
- Hematuria—blood in the urine
- Urinary frequency—urination eight or more times a day
- Urinary urgency—the inability to delay urination
- Urinary retention—the inability to empty the bladder completely
- Urinary incontinence—the accidental loss of urine
- Pain or burning before, during, or after urination
- Trouble starting urination, completing urination, or both
- Abnormal cells, such as cancer cells, found in a urine sample
During a cystoscopy, a urologist can see
- Stones—solid pieces of material in the bladder that may have formed in the kidneys or in the bladder when substances that are normally in the urine become highly concentrated.
- Abnormal tissue, polyps, tumors, or cancer in the urethra or bladder.
- Stricture, a narrowing of the urethra. Stricture can be a sign of an enlarged prostate in men or of scar tissue in the urethra.
After a cystoscopy or ureteroscopy, a patient may
- Have a mild burning feeling when urinating
- See small amounts of blood in the urine
- Have mild discomfort in the bladder area or kidney area when urinating
- Need to urinate more frequently or urgently
These problems should not last more than 24 hours. The patient should tell a health care provider right away if bleeding or pain is severe or if problems last more than a day.
The health care provider may recommend that the patient
- Drink 16 ounces of water each hour for 2 hours after the procedure
- Take a warm bath to relieve the burning feeling
- Hold a warm, damp washcloth over the urethral opening to relieve discomfort
- Take an over-the-counter pain reliever
The health care provider may prescribe an antibiotic to take for 1 or 2 days to prevent an infection. A patient should report any signs of infection—including severe pain, chills, or fever—right away to the health care provider.
Most patients go home the same day as the procedure. Recovery depends on the type of anesthesia. A patient who receives only a local anesthetic can go home immediately. A patient who receives general anesthesia may have to wait 1 to 4 hours before going home. A health care provider usually asks the patient to urinate before leaving. In some cases, the patient may need to stay overnight in the hospital. A health care provider will provide discharge instructions for rest, driving, and physical activities after the procedure.
The risks of cystoscopy and ureteroscopy include
- UTIs
- Abnormal bleeding
- Abdominal pain
- A burning feeling or pain during urination
- Injury to the urethra, bladder, or ureters
- Urethral narrowing due to scar tissue formation
- The inability to urinate due to swelling of surrounding tissues
- Complications from anesthesia
Seek immediate medical care
A patient who has any of the following symptoms after a cystoscopy or ureteroscopy should call or see a health care provider right away:
The inability to urinate and the feeling of a full bladder
Burning or painful urination that lasts more than 2 days
Bright red urine or blood clots in the urine
A fever, with or without chills
Severe discomfort
1. Cystoscopy & Ureteroscopy | NIDDK [accessed on Jan 08, 2019]
2. Cystoscopy: MedlinePlus Medical Encyclopedia [accessed on Jan 08, 2019]
3. Cystoscopy for Women - Health Encyclopedia - University of Rochester Medical Center [accessed on Jan 08, 2019]
4. Cystoscopy - NHS [accessed on Jan 08, 2019]
5. What is Cystoscopy? - Urology Care Foundation [accessed on Jan 08, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (7)

How is a Urinary Tract Infection (UTI) Diagnosed?

Diagram showing a cystoscopy for a man and a woman.

Image by Cancer Research UK / Wikimedia Commons

X-ray of urinary bladder filled with contrast media.

Image by Lucien Monfils

Drawing of cystoscope in the bladder

None

Image by NIDDK Image Library

Cystoscopy Female Surgery PreOp® Patient Education

Video by PreOp.com Patient Engagement - Patient Education/YouTube

Cystoscopy Female Vaginal w/PostCare Patient Education

Video by PreOp.com Patient Engagement - Patient Education/YouTube

Having a cystoscopy | Cancer Research UK

Video by Cancer Research UK/YouTube

Sensitive content

This media may include sensitive content

A reduced male cystoscope in holding position

Image by HOWARD A. KELLY (April 1898)

How is a Urinary Tract Infection (UTI) Diagnosed?

Cancer Research UK / Wikimedia Commons

X-ray of urinary bladder filled with contrast media.

Lucien Monfils

Drawing of cystoscope in the bladder

NIDDK Image Library

4:41

Cystoscopy Female Surgery PreOp® Patient Education

PreOp.com Patient Engagement - Patient Education/YouTube

45:06

Cystoscopy Female Vaginal w/PostCare Patient Education

PreOp.com Patient Engagement - Patient Education/YouTube

1:42

Having a cystoscopy | Cancer Research UK

Cancer Research UK/YouTube

Sensitive content

This media may include sensitive content

A reduced male cystoscope in holding position

HOWARD A. KELLY (April 1898)

Treatment

Electrical stimulator for bladder nerves

Image by NIDDK Image Library

Electrical stimulator for bladder nerves

Drawing of an electrical stimulator for bladder nerves, an implanted device that delivers mild electrical pulses to the nerves that control bladder function.

Image by NIDDK Image Library

How Is Urinary Incontinence Treated?

You and your doctor or nurse will work together to create a treatment plan. You may start with steps you can take at home. If these steps do not improve your symptoms, your doctor or nurse may recommend other treatments depending on whether you have stress incontinence or urge incontinence or both.

Be patient as you work with your doctor or nurse on a treatment plan. It may take a month or longer for different treatments to begin working.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (4)

Treating Female Incontinence

Video by Lee Health/YouTube

Treatment for Overactive Bladder & Urge Incontinence, Dr. Ja-Hong Kim | UCLAMDChat

Video by UCLA Health/YouTube

Incontinence: Causes and Treatment Options

Video by MassGeneralHospital/YouTube

Mayo Clinic Minute: Treatment options for stress urinary incontinence

Video by Mayo Clinic/YouTube

1:36

Treating Female Incontinence

Lee Health/YouTube

33:58

Treatment for Overactive Bladder & Urge Incontinence, Dr. Ja-Hong Kim | UCLAMDChat

UCLA Health/YouTube

2:21

Incontinence: Causes and Treatment Options

MassGeneralHospital/YouTube

1:00

Mayo Clinic Minute: Treatment options for stress urinary incontinence

Mayo Clinic/YouTube

What Type of Doctor Should I Go To?

Dr. Jennifer Orr, urogynecologist.

Image by Marcy Sanchez/Wikimedia

Dr. Jennifer Orr, urogynecologist.

Dr. Jennifer Orr, urogynecologist, William Beaumont Army Medical Center, stands in front of WBAMC's robotic surgical system which was used to perform the first robotic-assisted tubal re-anastomosis at WBAMC, Dec. 28. The introduction of robotic assisted tubal re-anastomosis, commonly known as tubal ligation reversal, provides eligible beneficiaries with a third option for the procedure, an option studies show produces higher success rates for post-operation pregnancy.Unit: William Beaumont Army Medical Center Public Affairs OfficeDVIDS Tags: Fort Bliss; El Paso; Pregnancy; Army; William Beaumont Army Medical Center; Army Medicine; WBAMC; Robotic Surgery; Tubal Re-anastomosis; Tubal Ligation; Tubal Ligation Reversal

Image by Marcy Sanchez/Wikimedia

What Type of Doctor or Nurse Should I Go to for Help with Urinary Incontinence?

If you have urinary incontinence, you can make an appointment with your primary care provider, your OB/GYN, or a nurse practitioner. Your doctor or nurse will work with you to treat your urinary incontinence or refer you to a specialist if you need different treatment.

The specialist may be a urologist, who treats urinary problems in both men and women, or a urogynecologist, who has special training in the female urinary system. You might also need to see a pelvic floor specialist, a type of physical therapist, who will work with you to strengthen your pelvic floor muscles that support the urinary tract.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Relief at Home

Obese Woman with visible Adipose Tissue on Stationary Bike

Image by TheVisualMD

Obese Woman with visible Adipose Tissue on Stationary Bike

An adult woman who appears to be obese rides a stationary exercise bike. Her subcutaneous fat is visible under black exercise clothing. The image supports content on overcoming obstacles to exercise, such as obesity. Stationary bikes relieve some of the pressure on knees and hips that make it difficult for obese people to jog or jump rope.

Image by TheVisualMD

What Steps Can I Take at Home to Treat Urinary Incontinence?

Your doctor or nurse may suggest some things you can do at home to help treat urinary incontinence. Some people do not think that such simple actions can treat urinary incontinence. But for many women, these steps make urinary incontinence go away entirely, or help leak less urine. These steps may include:

Doing Kegel exercises. If you have stress incontinence, Kegel exercises to strengthen your pelvic floor muscles may help. Some women have urinary symptoms because the pelvic floor muscles are always tightened. In this situation, Kegel exercises will not help your urinary symptoms and may cause more problems. Talk to your doctor or nurse about your urinary symptoms before doing Kegel exercises.
Training your bladder. You can help control overactive bladder or urge incontinence by going to the bathroom at set times. Start by tracking how often you go to the bathroom each day in a bladder diary (PDF, 499 KB). Then slowly add about 15 minutes between bathroom visits. Urinate each time, even if you do not feel the urge to go. By gradually increasing the amount of time between visits, your bladder learns to hold more urine before it signals the need to go again.
Losing weight. Extra weight puts more pressure on your bladder and nearby muscles, which can lead to problems with bladder control. If you have overweight, your doctor or nurse can help you create a plan to lose weight by choosing healthy foods and getting regular physical activity. Your doctor or nurse may refer you to a dietitian or physical therapist to create a healthy eating and exercise plan.
Changing your eating habits. Drinks with caffeine, carbonation (such as sodas), or alcohol may make bladder leakage or urinary incontinence worse. Your doctor might suggest that you stop drinking these drinks for a while to see if that helps.
Quitting smoking. Smoking can make many health problems, including urinary incontinence, worse.
Treating constipation. Your doctor might recommend that you eat more fiber, since constipation can make urinary incontinence worse. Eating foods with a lot of fiber (PDF, 166 KB) can make you less constipated.

You can also buy pads or protective underwear while you take other steps to treat urinary incontinence. These are sold in many stores that also sell feminine hygiene products like tampons and pads.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Medical Treatment

Pessary

Image by Huckfinne

Pessary

An assortment of pessaries.

Image by Huckfinne

What Are Some Medical Treatments for Stress Incontinence?

If steps you can take at home do not work to improve your stress incontinence, your doctor may talk to you about other options:

Medicine. After menopause, applying vaginal creams, rings, or patches with estrogen (called topical estrogen) can help strengthen the muscles and tissues in the urethra and vaginal areas. A stronger urethra will help with bladder control. Learn more about menopause treatments.
Vaginal pessary. A reusable pessary is a small plastic or silicone device (shaped like a ring or small donut) that you put into your vagina. The pessary pushes up against the wall of the vagina and the urethra to support the pelvic floor muscles and help reduce stress incontinence. Pessaries come in different sizes, so your doctor or nurse must write a prescription for the size that will fit you. Another type of pessary looks like a tampon and is used once and then thrown away. You can get this type of pessary at a store that also sells feminine hygiene products.
Bulking agents. Your doctor can inject a bulking agent, such as collagen, into tissues around the bladder and urethra to cause them to thicken. This helps keep the bladder opening closed and reduces the amount of urine that can leak out.
Surgery. Surgery for urinary incontinence is not recommended if you plan to get pregnant in the future. Pregnancy and childbirth can cause leakage to happen again. The two most common types of surgery for urinary incontinence are:
- Sling procedures. The mid-urethral sling is the most common type of surgery to treat stress incontinence. The sling is either a narrow piece of synthetic (man-made) mesh or a piece of tissue from your own body that your doctor places under your urethra. The sling acts like a hammock to support the urethra and hold the bladder in place. Serious complications from the sling procedure include pain, infection, pain during sex, and damage to nearby organs, such as the bladder. The Food and Drug Administration (FDA) reports that in 1 out of every 50 patients who have synthetic mesh for urinary incontinence, the mesh moves after surgery and stick outs, into the vagina, causing pain. The FDA recommends discussing treatment options with your doctor before surgery, and asking specific questions about side effects.
- Colposuspension. This surgery also helps hold the bladder in place with stitches on either side of the urethra. This is often referred to as a Burch procedure.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (4)

Pessary Insertion

Video by Covenant Health/YouTube

Pelvic Floor - Pessary Use: FAQ's for Calgary Pelvic Floor Clinic

Video by MyHealth.Alberta.ca/YouTube

Urinary Incontinence Fixed by Surgery: Autologous Sling as an Alternative to Vaginal Mesh

Video by Penn Medicine/YouTube

Treating Female Incontinence

Video by Lee Health/YouTube

1:15

Pessary Insertion

Covenant Health/YouTube

12:45

Pelvic Floor - Pessary Use: FAQ's for Calgary Pelvic Floor Clinic

MyHealth.Alberta.ca/YouTube

4:17

Urinary Incontinence Fixed by Surgery: Autologous Sling as an Alternative to Vaginal Mesh

Penn Medicine/YouTube

1:36

Treating Female Incontinence

Lee Health/YouTube

Nonsurgical Treatment

Neurobiological conditions and Medicine

Image by TheVisualMD

Neurobiological conditions and Medicine

Neurobiological conditions and Medicine

Image by TheVisualMD

What Are Some Nonsurgical Treatments for Urge Incontinence?

If steps you can take at home do not work to improve your urge incontinence, your doctor may suggest one or more of the following treatments:

Medicines. Medicines to treat urge incontinence help relax the bladder muscle and increase the amount of urine your bladder can hold. Common side effects of these medicines include constipation and dry eyes and mouth.
Botox. Botox injections in the bladder can help if other treatments don’t work. Botox helps relax the bladder and increases the amount of urine your bladder can hold. You may need to get Botox treatments about once every 3 months.
Nerve stimulation. This treatment uses mild electric pulses to stimulate nerves in the bladder. The pulses may increase blood flow to the bladder and strengthen the muscles that help control the bladder. Talk to your doctor about the different types of nerve stimulation.
Biofeedback. Biofeedback helps you see how your bladder responds on a screen. A therapist puts an electrical patch on the skin over your bladder and urethral muscles. A wire connected to the patch is linked to a screen. You and your therapist watch the screen to see when these muscles contract so you can learn to control them.
Surgery. If you have severe urge incontinence, your doctor may recommend surgery to help increase the amount of urine your bladder can hold or to remove your bladder. Removing your bladder is a serious surgery and is an option only when no other treatments work and the quality of your life is seriously affected.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (2)

How does BOTOX work, what is Botox & 5 surprising uses for it!

Video by Physiology with Dr Christian/YouTube

What is biofeedback and neurofeedback? A Mind Media video featuring NeXus

Video by Biofeedbacknews/YouTube

3:15

How does BOTOX work, what is Botox & 5 surprising uses for it!

Physiology with Dr Christian/YouTube

4:50

What is biofeedback and neurofeedback? A Mind Media video featuring NeXus

Biofeedbacknews/YouTube

Should I Drink Less Water?

Waste Removal

Image by TheVisualMD

Waste Removal

Water plays many important roles in the body. It aids in the excretion of waste in urine and feces. Our bodies utilize water to preventive and therapeutic effect similarly to how we use water in daily activities. Just as we wash dirt from our skin (or our cars, for that matter), surfaces inside the body are cleansed and lubricated as their cells are bathed in water. Tears, for instance, clear dirt from the eyes. Due to its ability to cool and warm the body, the water in your bloodstream is sometimes likened to the antifreeze that circulates in a car engine. The simile is appropriate, too, except that your body is far smarter than an automobile. Not only does it have the ability to cool the body on a need basis; it can even adjust to different temperatures at specific sites. Water is a key ingredient in nutrient metabolism, which is the process of converting food into energy. And water helps transport nutrients from the foods we eat throughout our bodies.

Image by TheVisualMD

Should I Drink Less Water or Other Fluids If I Have Urinary Incontinence?

No. Many people with urinary incontinence think they need to drink less to reduce how much urine leaks out. But you need fluids, especially water, for good health. (But alcohol and caffeine can irritate or stress the bladder and make urinary incontinence worse.)

Women need 91 ounces (about 11 cups) of fluids a day from food and drinks. Getting enough fluids helps keep your kidneys and bladder healthy, prevents urinary tract infections, and prevents constipation, which may make urinary incontinence worse.

After age 60, people are less likely to get enough water, putting them at risk for dehydration and conditions that make urinary incontinence worse.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Prevention

Break the Cycle and Peel the Layers of Fat Off 1

Break the Cycle and Peel the Layers of Fat Off 2

Break the Cycle and Peel the Layers of Fat Off 3

1

2

3

Break the Cycle and Peel the Layers of Fat Off

Interactive by TheVisualMD

Break the Cycle and Peel the Layers of Fat Off 1

Break the Cycle and Peel the Layers of Fat Off 2

Break the Cycle and Peel the Layers of Fat Off 3

1

2

3

Break the Cycle and Peel the Layers of Fat Off

Break the Cycle and Peel the Layers of Fat Off

Interactive by TheVisualMD

How Can I Prevent Urinary Incontinence?

Although you can’t always prevent urinary incontinence, you can take steps to lower your risk:

Practice Kegels daily, especially during pregnancy and after talking to your doctor, nurse, or midwife.
Reach or stay at a healthy weight.
Eat foods with fiber to help prevent constipation.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Kegel Exercises

Kegel Exercises

Image by Gend27

Kegel Exercises

Kegel exercises diagram

Image by Gend27

What Are Kegel Exercises?

Kegel exercises, also called Kegels or pelvic floor muscle training, are exercises for your pelvic floor muscles to help prevent or reduce stress urinary incontinence. Your pelvic floor muscles support your uterus, bladder, small intestine, and rectum.

Four in 10 women improved their symptoms after trying Kegels. Kegels can be done daily and may be especially helpful during pregnancy. They can help prevent the weakening of pelvic floor muscles, which often happens during pregnancy and childbirth. Your pelvic floor muscles may also weaken with age and less physical activity.

Some women have urinary symptoms because the pelvic floor muscles are always tightened. In this situation, Kegel exercises will not help your urinary symptoms and may cause more problems. Talk to your doctor or nurse about your urinary symptoms before doing Kegel exercises.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (2)

How to Do Kegel Exercises for Bladder Control - Urinary Incontinence Treatment

Video by WaysAndHow/YouTube

Better Kegels: How to do kegel exercises, and why they work

Video by Michigan Medicine/YouTube

3:41

How to Do Kegel Exercises for Bladder Control - Urinary Incontinence Treatment

WaysAndHow/YouTube

4:01

Better Kegels: How to do kegel exercises, and why they work

Michigan Medicine/YouTube

How Do I Do Kegel Exercises?

Pelvic Floor

Image by PatriciaMoraleda/Pixabay

Pelvic Floor

Image by PatriciaMoraleda/Pixabay

How Do I Do Kegel Exercises?

To do Kegels:

Lie down. It may be easier to learn how to do Kegels correctly while lying down. You don’t have to lie down once you learn to do Kegels correctly.
Squeeze the muscles in your genital area as if you were trying to stop the flow of urine or passing gas. Try not to squeeze the muscles in your belly or legs at the same time. Try to squeeze only the pelvic muscles. Be extra careful not to tighten your stomach, legs, or buttocks (because then you will not be using your pelvic floor muscles).
Relax.Squeeze the muscles again and hold for 3 seconds. Then relax for 3 seconds. Work up to 3 sets of 10 each day.
Practice Kegels anywhere. When your muscles get stronger, try doing Kegels while sitting or standing. You can do these exercises at any time, such as while sitting at your desk or in the car, waiting in line, or doing the dishes. Don’t do Kegel exercises at the same time you are urinating. This can weaken your pelvic floor muscles over time.

If you are uncomfortable or uncertain about doing Kegel exercises on your own, a doctor or nurse can also teach you how to do Kegels. A pelvic floor physical therapist or other specialist may also be available in your area to help teach you how to strengthen these muscles.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

How Soon Will I Get Better?

Exercising for Two

Image by TheVisualMD

Exercising for Two

During pregnancy, a carefully planned routine will keep you active, flexible and strong. Staying toned and limber will aid labor and delivery, speed your recovery and benefit your tiny passenger as well. There are a few precautions and limitations to keep in mind, though.

Image by TheVisualMD

How Soon After Starting Kegel Exercises Will Urinary Incontinence Get Better?

It may take 4 to 6 weeks before you notice any improvement in your symptoms.

Kegel exercises work differently for each person. Your symptoms may go away totally, you may notice an improvement in your symptoms but still have some leakage, or you may not see any improvement at all. But even if your symptoms don’t get better, Kegel exercises can help prevent your incontinence from getting worse.

You may need to continue doing Kegel exercises for the rest of your life. Even if your symptoms improve, urinary incontinence can come back if you stop doing the exercises.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

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