What is the collection procedure for the four glass urine test to diagnose chronic bacterial prostatitis (CBP)?

Updated: Jan 15, 2019
  • Author: Samantha D Kraemer, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Collecting urine specimens before, during, and after prostatic massage can help localize the bacterial infection within the urinary tract. The traditional four-glass urine collection technique, as described by Meares and Stamey in 1968, includes examination of four urine specimens. The collection procedure is as follows:

  1. The first specimen is voided bladder–1 (VB1), which is the first 10 mL of urine and represents the urethral specimen.
  2. The patient then voids another 100-150 mL of urine.
  3. The second specimen, voided bladder–2 (VB2), is collected, which is another 10 mL of urine and represents the bladder specimen.
  4. The third specimen is the expressed prostatic specimen (EPS), which is the fluid collected during prostatic massage.
  5. The fourth specimen, voided bladder–3 (VB3), consists of the first 10 mL of urine collected after EPS; it contains any EPS trapped in the prostatic urethra.

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