Qualitative changes in urine

Not all urological diseases occur with any changes in urine, but in some cases qualitative changes in urine act as leading symptoms. So, for example, with inflammatory diseases of the urino-genital organs (pyelonephritis, cystitis, urethritis, urinary tract tuberculosis), pyuria (leukocyturia) is considered an obligatory symptom.

An equally important sign of a urological disease is hematuria (an admixture of blood in the urine).

Change in the quality of urine is of great importance in the diagnosis of urological diseases.

To determine the qualitative change in urine, it is necessary to examine freshly excreted urine.

• Normal freshly excreted urine should be clear.
• In the presence of pathological impurities (pus, bacteria, salt, mucus, blood), the properties of urine change: it becomes turbid, a possible admixture of blood.

[1], [2], [3], [4], [5]

Forms

[6], [7], [8], [9], [10], [11]

Cloudy urine

Assess the significance of a symptom in combination with other clinical signs. Urine turbidity can be associated with an increase in its content of salts - phosphates, oxalates, urates. This fact can be confirmed by heating urine with the addition of acetic or hydrochloric acid: if it becomes transparent, the turbidity is actually caused by the presence of salts. If there are no changes, the cause will help to establish microscopic examination. The presence of pus in the urine (pyuria) indicates an inflammatory process in the kidneys and urinary tract. For an approximate determination of the localization of the inflammatory process in men (bladder, upper urinary tract, kidney, urethra, prostate), a three-stage test is used.

[12], [13], [14],

Three-glassed sample

A three-glassed sample is taken in the morning. The patient should come to the doctor with a filled bladder. Before the study, the head and the foreskin of the penis must be treated with a disinfectant solution. Then the patient urinates, without interrupting the urine stream, first into one, then into another glass, leaving a small amount of urine in the bladder. In this case, its quantity in the first portion should be greater than in the second. After this, the patient is treated with a prostate massage, and he urinates in a third glass (to get a prostatic secret).

If the first portion is cloudy, and the second one is clear, then the inflammatory process is localized in the distal part of the urethra. If the urine is turbid in both portions, then the inflammatory process in the kidney, bladder, urethra, or prostate is not excluded. If pus is found only in the third dose, then the source of inflammation is located in the prostate or seminal vesicles.

Leukocytes in the urine

With leukocyturia in the urine, a large number of microorganisms (bacteriuria) are most often found. Their absence (aseptic pyuria) is observed in tuberculosis of the urinary tract.

Change in relative density of urine

Do not forget about the need to determine the relative density of urine. With a plentiful intake of liquid, it decreases; with increased sweating. Stay in a hot climate, the amount of urine decreases, and the relative density rises.

A persistent decrease in the relative density of urine (below 1010) hyposthenuria indicates a violation of the concentration ability of the kidneys and may indicate chronic renal failure.

[15], [16], [17], [18], [19], [20],

Diagnostics of the qualitative changes in urine

Change in the reaction of urine

When examining urine, you should pay attention to her reaction; in a healthy person, the urine reaction is usually slightly acidic. The reaction of urine varies depending on the nature of the food. With an alkaline reaction of urine and the absence of leukocytes in it (with a microscopic examination), the inflammatory process can not be excluded, since in the alkaline medium the formed elements, including the leukocytes, disintegrate.

The color of normal freshly released urine is straw-yellow.

[21], [22], [23], [24]