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Urinalysis
A urinalysis is a test of your urine. It is often done to check for a urinary tract infections, kidney problems, or diabetes. You may also have one during a checkup, if you are admitted to the hospital, before you have surgery, or if you are pregnant. It can also monitor some medical conditions and treatments.
A urinalysis involves checking the urine for:
- Its color
- Its appearance (whether it is clear or cloudy)
- Any odor
- The pH level (acidity)
- Whether there are substances that are not normally in urine, such as blood, too much protein, glucose, ketones, and bilirubin
- Whether there are cells, crystals, and casts (tube-shaped proteins)
- Whether it contains bacteria or other germs
Urine and Urination
Your kidneys make urine by filtering wastes and extra water from your blood. The waste is called urea. Your blood carries it to the kidneys. From the kidneys, urine travels down two thin tubes called ureters to the bladder. The bladder stores urine until you are ready to urinate. It swells into a round shape when it is full and gets smaller when empty. If your urinary system is healthy, your bladder can hold up to 16 ounces (2 cups) of urine comfortably for 2 to 5 hours.
You may have problems with urination if you have:
- Kidney failure
- Urinary tract infections
- An enlarged prostate
- Bladder control problems like incontinence, overactive bladder, or interstitial cystitis
- A blockage that prevents you from emptying your bladder
Some conditions may also cause you to have blood or protein in your urine. If you have a urinary problem, see your health care provider. Urinalysis and other urine tests can help to diagnose the problem. Treatment depends on the cause.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Kidney Diseases
You have two kidneys, each about the size of your fist. They are near the middle of your back, just below the rib cage. Inside each kidney there are about a million tiny structures called nephrons. They filter your blood. They remove wastes and extra water, which become urine. The urine flows through tubes called ureters. It goes to your bladder, which stores the urine until you go to the bathroom.
Most kidney diseases attack the nephrons. This damage may leave kidneys unable to remove wastes. Causes can include genetic problems, injuries, or medicines. You have a higher risk of kidney disease if you have diabetes, high blood pressure, or a close family member with kidney disease. Chronic kidney disease damages the nephrons slowly over several years. Other kidney problems include:
- Cancer
- Cysts
- Stones
- Infections
Your doctor can do blood and urine tests to check if you have kidney disease. If your kidneys fail, you will need dialysis or a kidney transplant.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Kidney Tests
You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. Your kidneys filter and clean your blood, taking out waste products and making urine. Kidney tests check to see how well your kidneys are working. They include blood, urine, and imaging tests.
Early kidney disease usually does not have signs or symptoms. Testing is the only way to know how your kidneys are doing. It is important for you to get checked for kidney disease if you have the key risk factors - diabetes, high blood pressure, heart disease, or a family history of kidney failure.
Specific kidney tests include:
- Glomerular filtration rate (GFR) - one of the most common blood tests to check for chronic kidney disease. It tells how well your kidneys are filtering.
- Creatinine blood and urine tests - check the levels of creatinine, a waste product that your kidneys remove from your blood
- Albumin urine test - checks for albumin, a protein that can pass into the urine if the kidneys are damaged
- Imaging tests, such as an ultrasound - provide pictures of the kidneys. The pictures help the health care provider see the size and shape of the kidneys, and check for anything unusual.
- Kidney biopsy - a procedure that involves taking a small piece of kidney tissue for examination with a microscope. It checks for the cause of kidney disease and how damaged your kidneys are.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Laboratory Tests
Laboratory tests check a sample of your blood, urine, or body tissues. A technician or your doctor analyzes the test samples to see if your results fall within the normal range. The tests use a range because what is normal differs from person to person. Many factors affect test results. These include:
- Your sex, age and race
- What you eat and drink
- Medicines you take
- How well you followed pre-test instructions
Your doctor may also compare your results to results from previous tests. Laboratory tests are often part of a routine checkup to look for changes in your health. They also help doctors diagnose medical conditions, plan or evaluate treatments, and monitor diseases.
Bladder Diseases
The bladder is a hollow organ in your lower abdomen that stores urine. Many conditions can affect your bladder. Some common ones are:
- Cystitis - inflammation of the bladder, often from an infection
- Urinary incontinence - loss of bladder control
- Overactive bladder - a condition in which the bladder squeezes urine out at the wrong time
- Interstitial cystitis - a chronic problem that causes bladder pain and frequent, urgent urination
- Bladder cancer
Doctors diagnose bladder diseases using different tests. These include urine tests, x-rays, and an examination of the bladder wall with a scope called a cystoscope. Treatment depends on the cause of the problem. It may include medicines and, in severe cases, surgery.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Tuberculosis
What is tuberculosis (TB)?
Tuberculosis (TB) is a bacterial disease that usually attacks the lungs. But it can also attack other parts of the body, including the kidneys, spine, and brain.
Not everyone infected with TB bacteria (germs) becomes sick. So, there are two types of TB conditions:
- Inactive (latent) TB infection, where the TB germs live in your body but don't make you sick.
- TB disease (active TB) where you get sick from the TB germs. TB disease can almost always be cured with antibiotics. But if it's not treated properly, it can be fatal.
TB is found in the U.S., but it is more common in certain other countries.
What causes tuberculosis (TB)?
TB is caused by bacteria (germs) called Mycobacterium tuberculosis. The germs spread from person to person through the air. People who have TB disease in their throat or lungs spread the germs in the air when they cough, sneeze, talk, or sing. If you breathe in the air that has the germs, you can get TB.
TB is not spread by touching, kissing, or sharing food or dishes.
You're more likely to catch TB from people you live or work with than from people you see for shorter amounts of time.
Who is more likely to get infected with tuberculosis (TB) germs?
Anyone who is near a person with TB disease can get infected with the germs. You are more likely to be near someone with TB disease if you:
- Were born in or often travel to countries where TB disease is common
- Are a health care worker
- Work or live in a place where TB is more common, such as shelters for people without homes, jails, and nursing homes
Who is more likely to develop TB disease?
Certain people are more likely to get sick with TB disease after they get infected. They include people who:
- Have HIV
- Became infected with TB in the last 2 years
- Have other diseases, such as diabetes, that make it hard for your body to fight TB germs
- Have alcohol use disorder (AUD) or inject illegal drugs
- Were not treated correctly for TB in the past
- Are under age 5
- Are an older adult
- Take medicines that weaken the immune system, such as medicines taken after an organ transplant, steroids, and specialized treatments for certain autoimmune diseases
What are the symptoms of tuberculosis (TB)?
Most people who have TB germs in their bodies don't get sick with TB disease. Instead, they have inactive TB infection. With an inactive TB infection, you:
- Don't have symptoms
- Can't spread TB to others
- Could get sick with active TB disease in the future if your immune system becomes weak for another reason
- Need to take medicine to prevent getting sick with active TB disease in the future
If you have TB disease, the TB germs are active, meaning that they are growing (multiplying) inside your body and making you sick. If the TB is growing in your lungs or throat, you can spread the TB germs to other people. You can get sick with TB disease weeks to years after you're infected with TB germs.
With TB disease, your symptoms will depend on where the TB is growing in your body:
- General symptoms may include:
- Chills and fever
- Night sweats (heavy sweating during sleep)
- Losing weight without trying
- Loss of appetite
- Weakness or fatigue
- Symptoms from TB disease in your lungs may include:
- A cough that lasts longer than 3 weeks
- Coughing up blood or sputum (a thick mucus from the lungs)
- Chest pain
How is tuberculosis (TB) diagnosed?
Your health care provider or your local health department can test you to find out if you have TB germs in your body. They will give you either a TB skin or blood test.
If your test shows that you have TB germs, you'll need to have other tests to see if the germs are actively growing:
- Tests for TB disease in the lungs usually include testing samples of your sputum and having chest x-rays.
- Tests for TB disease in other parts of your body may include tests of urine and tissue samples.
You may need a TB test if you have symptoms of TB disease or if you are at high risk because you are more likely to be near someone with TB disease.
People who have HIV also need to get tested for TB. HIV weakens your immune system. So if you have both HIV and inactive TB, the TB can quickly become active TB disease. You will need treatment for the inactive TB as soon as possible to prevent active TB disease.
What is the treatment for tuberculosis (TB)?
The treatment for both inactive TB infection and TB disease is antibiotics. To make sure you get rid of all the TB germs in your body, it's very important to follow the directions for taking your medicine.
If you don't follow the directions, the TB germs in your body could change and become antibiotic resistant. That means the medicine may stop working and your TB may become hard to cure.
- For inactive TB infections, you need to take medicines for three, four, six, or nine months, depending on the treatment plan. Treatment helps make sure you don't get TB disease in the future.
- For active TB disease, you usually need to take medicines for four, six, or nine months, depending on the treatment plan. Treatment will almost always cure you if you take your pills the right way.
- For TB disease in your lungs or throat, you'll need to stay home for a few weeks, so you don't spread disease to other people. You can protect the people you live with by:
- Covering your nose and mouth.
- Opening windows when possible.
- Not getting too close to them.
- For drug-resistant TB disease, which means that the TB germs are resistant to certain TB medicines, you will need to take special medicines. Treatment may take a long time, sometimes months or years. The medicines can cause side effects. Your provider will closely monitor your treatment to make sure the medicines are working.
By following medical advice for TB testing and treatment, you can keep yourself healthy and help stop the spread of TB.
Centers for Disease Control and Prevention
Urinary Incontinence
What is urinary incontinence (UI)?
Urinary incontinence (UI) is the loss of bladder control, or being unable to control urination. It is a common condition. It can range from being a minor problem to something that greatly affects your daily life. In any case, it can get better with proper treatment.
What are the types of urinary incontinence (UI)?
There are several different types of UI. Each type has different symptoms and causes:
- Stress incontinence happens when stress or pressure on your bladder causes you to leak urine. This could be due to coughing, sneezing, laughing, lifting something heavy, or physical activity. Causes include weak pelvic floor muscles and the bladder being out of its normal position.
- Urge, or urgency, incontinence happens when you have a strong urge (need) to urinate, and some urine leaks out before you can make it to the toilet. It is often related to an overactive bladder. Urge incontinence is most common in older people. It can sometimes be a sign of a urinary tract infection (UTI). It can also happen in some neurological conditions, such as multiple sclerosis and spinal cord injuries.
- Overflow incontinence happens when your bladder doesn't empty all the way. This causes too much urine to stay in your bladder. Your bladder gets too full, and you leak urine. This form of UI is most common in men. Some of the causes include tumors, kidney stones, diabetes, and certain medicines.
- Functional incontinence happens when a physical or mental disability, trouble speaking, or some other problem keeps you from getting to the toilet in time. For example, someone with arthritis may have trouble unbuttoning his or her pants, or a person with Alzheimer's disease may not realize they need to plan to use the toilet.
- Mixed incontinence means that you have more than one type of incontinence. It's usually a combination of stress and urge incontinence.
- Transient incontinence is urine leakage that is caused by a temporary (transient) situation such as an infection or new medicine. Once the cause is removed, the incontinence goes away.
- Bedwetting refers to urine leakage during sleep. This is most common in children, but adults can also have it.
- Bedwetting is normal for many children. It is more common in boys. Bedwetting is often not considered a health problem, especially when it runs in the family. But if it still happens often at age 5 and older, it may be because of a bladder control problem. This problem could be caused by slow physical development, an illness, making too much urine at night, or another problem. Sometimes there is more than one cause.
- In adults, the causes include some medicines, caffeine, and alcohol. It can also be caused by certain health problems, such as diabetes insipidus, a urinary tract infection (UTI), kidney stones, enlarged prostate (BPH), and sleep apnea.
Who is at risk for urinary incontinence (UI)?
In adults, you are at higher risk of developing UI if you:
- Are female, especially after going through pregnancy, childbirth, and/or menopause
- Are older. As you age, your urinary tract muscles weaken, making it harder to hold in urine.
- Are a man with prostate problems
- Have certain health problems, such as diabetes, obesity, or long-lasting constipation
- Are a smoker
- Have a birth defect that affects the structure of your urinary tract
In children, bedwetting is more common in younger children, boys, and those whose parents wet the bed when they were children.
How is urinary incontinence (UI) diagnosed?
Your health care provider may use many tools to make a diagnosis:
- A medical history, which includes asking about your symptoms. Your provider may ask you to keep a bladder diary for a few days before your appointment. The bladder diary includes how much and when you drink liquids, when and how much you urinate, and whether you leak urine.
- A physical exam, which can include a rectal exam. Women may also get a pelvic exam.
- Urine and/or blood tests
- Bladder function tests
- Imaging tests
What are the treatments for urinary incontinence (UI)?
Treatment depends on the type and cause of your UI. You may need a combination of treatments. Your provider may first suggest self-care treatments, including:
- Lifestyle changes to reduce leaks:
- Drinking the right amount of liquid at the right time
- Being physically active
- Staying at a healthy weigh
- Avoiding constipation
- Not smoking
- Bladder training. This involves urinating according to a schedule. Your provider makes a schedule from you, based on information from your bladder diary. After you adjust to the schedule, you gradually wait a little longer between trips to the bathroom. This can help stretch your bladder so it can hold more urine.
- Doing exercises to strengthen your pelvic floor muscles. Strong pelvic floor muscles hold in urine better than weak muscles. The strengthening exercises are called Kegel exercises. They involve tightening and relaxing the muscles that control urine flow.
If these treatments do not work, your provider may suggest other options such as:
- Medicines, which can be used to
- Relax the bladder muscles, to help prevent bladder spasms
- Block nerve signals that cause urinary frequency and urgency
- In men, shrink the prostate and improve urine flow
- Medical devices, including
- A catheter, which is a tube to carry urine out of the body. You might use one a few times a day or all the time.
- For women, a ring or a tampon-like device inserted into the vagina. The devices pushes up against your urethra to help decrease leaks.
- Bulking agents, which are injected into the bladder neck and urethra tissues to thicken them. This helps close your bladder opening so you have less leaking.
- Electrical nerve stimulation, which involves changing your bladder's reflexes using pulses of electricity
- Surgery to support the bladder in its normal position. This may be done with a sling that is attached to the pubic bone.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Urinary Tract Infections
The urinary system is the body's drainage system for removing wastes and extra water. It includes two kidneys, two ureters, a bladder, and a urethra. Urinary tract infections (UTIs) are the second most common type of infection in the body.
You may have a UTI if you notice:
- Pain or burning when you urinate
- Fever, tiredness, or shakiness
- An urge to urinate often
- Pressure in your lower belly
- Urine that smells bad or looks cloudy or reddish
- Pain in your back or side below the ribs
People of any age or sex can get UTIs. But about four times as many women get UTIs as men. You're also at higher risk if you have diabetes, need a tube to drain your bladder, or have a spinal cord injury.
If you think you have a UTI it is important to see your doctor. Your doctor can tell if you have a UTI with a urine test. Treatment is with antibiotics.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases