This leaflet will provide information for an adult to perform an accurate mid stream sample of urine (MSSU), which can then be tested by the Microbiology laboratory.
What is a MSSU?
A MSSU is the middle part of your urine stream passed in a single urination which is required for testing.
What is being tested?
Your urine is being tested to check for evidence of infection. Your urine should normally be free from germs (micro-organisms). If germs are detected in this test, and you have symptoms of a urinary tract infection (UTI), then the results can confirm this and provide information to ensure you are treated correctly.
Why is a mid-stream urine sample needed?
A sample of urine is required to find out which, if any, germs are present. If a UTI is identified, appropriate antibiotic treatment can be given if needed.
When can a sample of urine be taken?
It is best to collect a sample of urine when the bladder has not been emptied for a while. It is often recommended to obtain a sample from the first time you pass urine in the morning, where possible.
Equipment needed to perform an MSSU
- Sterile pot (will be provided by the person requesting the specimen)
- Dry wipes
- Red lidded urine container containing Boric Acid (this is a preservative – do not swallow)
- Laboratory request form
- Plastic specimen bag
How to obtain a MSSU for laboratory testing
Ensure hands are clean by washing them with soap and water before the procedure.
The urine sample should be collected in a clean, sterile container completely free from detergents (it should not be collected in a container made from pulp as this can distort the result).
It can be collected into the red lidded container provided it is mid-stream collection.
Some patients may find it difficult to use a red lidded container and therefore a larger sterile container should be made available.
The first quantity (stream) of urine that is passed may be contaminated with germs from the skin. Urine is normally sterile (no germs present).
Cleaning around the genital area is therefore advised to minimize the risk of germs contaminating the sample.
Do not open the sterile pot or red lidded urine container until ready to collect the urine sample as this can also contaminate the sample.
Instructions for Women:
- Clean around the labia (entrance to the vagina) using a dry wipe which has been dampened with tap water - wipe downwards from front to back of the vaginal area using a separate wipe each time.
- It is advised to hold open the labia (entrance to the vagina) and pass some urine into the toilet (approximately 15mls to 30mls). Then without stopping the flow of urine, pass urine into the sterile pot (supplied by the nurse or doctor).
- Once the pot is near full, finishpassing the rest of the urine into the toilet.
Instructions for Men:
- Retract the foreskin and clean the skin using a dry wipe which has been dampened with tap water.
- Pass the first part of the stream of urine (approx 15 to 30mls) into a urinal, toilet or bedpan/bottle.
- Place the sterile container (supplied by the nurse or doctor) into the urine stream without interrupting the flow, collecting the mid stream part of the urine.
- Continue the remaining part of the urine stream into the urinal, toilet or bedpan/bottle.
After the procedure
- The Mid-Stream Sample of Urine (MSSU) can then be transferred into the red-lidded urine container containing Boric Acid. The container does not need to be filled to the top; a line on the sticker will indicate the ideal amount of urine. However, the minimum amount required is that the container is half filled, and that the lid is screwed on securely so it does not leak.
- The sticker on the pot should be labelled correctly with name, date of birth, date and time of sample taken and the nurse or doctor should add the unique identification number e.g. hospital or NHS number
- The sample should be placed in the plastic specimen bag
- Wash your hands with soap and water after collecting the sample / going to the toilet.
- The sample should be taken to the surgery/laboratory promptly (i.e within the day it has been produced). The sooner it is given in, the more accurate the result will be.
When will a MSSU result be available?
The results of your test should be with your medical doctor or GP within four days.
What problems can occur with the results?
Sometimes the results can come back contaminated. Likely causes are contamination with germs from the skin, not cleaning properly around the genital area or using an unsterile sample container. Therefore, please follow the instructions within this leaflet.
As at 03.05.2016