The Effect of Collection Method on Urinalysis Results in Women With Pelvic Organ Prolapse

Dara F. Shalom, MD; Christina Liao, MD; Danielle L. O'Shaughnessy, MD; Harvey A. Winkler, MD


Urol Nurs. 2014;34(3):128-130. 

In This Article

Abstract and Introduction


Midstream clean catch and catheterized urine specimens were obtained for each patient and samples were compared by microscopic urinalysis. The results of this study demonstrate that a midstream clean catch does not yield accurate urinalysis results in women with advanced urogenital prolapse.


The midstream clean-catch (MSCC) technique is currently the preferred method of urine collection in the outpatient setting. Historically, to minimize contamination from the vaginal area and skin, urethral catheterization was routinely used to obtain urine specimens. In 1958, the first studies were published revealing the MSCC technique to be equivalent to urethral catheterization (Beeson, 1958; Boshell & Sanford, 1958). Walter and Knopp (1989) have confirmed this finding, and as a result, the MSCC technique became the standard for outpatient urine collection.

Pelvic organ prolapse is a growing problem worldwide, with a reported prevalence of up to 50% in parous women (Digesu, Chaliha, Salvatore, Hutchings, & Khullar, 2005). Patients with urogenital prolapse commonly present with lower urinary tract symptoms, such as incontinence, frequency, ur gency, and obstructed voiding. These patients often undergo urinalysis to rule out infection and microscopic hematuria. Regard less of the extent of urogenital prolapse, MSCC has continued to remain the de facto standard for outpatient urine collection. There are no previously published studies evaluating the accuracy of the MSCC technique in women with urogenital prolapse. The primary objective of this study was to determine the equivalence between MSCC and catheterized urine specimens in women with urogenital prolapse to or beyond the hymen. We hypothesize that the MSCC technique does not yield accurate urinalysis results in women with advanced pelvic organ prolapse.