Physical Examination of Urine
Introduction
Routine urine examination is detailed analysis of urine. It helps detect alterations in the composition of the urine which help in the diagnosis of many disorders.

When a sample of urine is submitted to a pathological laboratory, the following examinations are done:

Physical Examination
Volume

• Normal volume of an early morning mid–stream sample is 50 – 300ml.
• If it is more than 500ml, it indicates diabetes or polyuria (frequent passing of urine).
• If it is less than 20ml, it indicates some kidney disorder.

Color

• The normal color of urine is pale yellow.
• If it is dark yellow to orange, it indicates some liver disorder.
• If it is white, it shows the presence of pus.
• If it is pink to red, it indicates the presence of red blood cells.
• If it is brownish black, it indicates the presence of melanin or homogenistic acid (a rare disorder).
• If it is blue to green, it is a liver disorder.

Sometimes, due to the intake of some food or medicines also, one could notice a change in the color or their urine e.g. the intake of beet imparts a reddish color to urine. The intake of vitamin B capsules gives a dark yellow color to it, if rimfamycin is taken, it gives an orange tinge to the urine.

Appearance

• Usually, it is clear, sometimes, it is cloudy.
• Sometimes, it is turbid due to the presence of WBCs (White Blood Cells), epithelial cells.
• Sometimes, it is hazy due to mucus.
• Smoky, due to red blood cells.
• Milky due to chyle (lymph).

Reaction

• Usually acidic pH range 4.5 – 7.5.
• If pH less than 4.7 it is more acidic.
• If pH more than 7.5 it is more alkaline.

Odor

• Usually, it is aromatic in normal conditions.
• It has a fruity odor in diabetes.
• Ammoniacal odor in cases of urine retention.
• Foul smelling due to urinary tract infection.

Sediment formation at the bottom of a container after collection

• Usually, there is no or very little formation of sediment in normal conditions.
• If pus cells, red blood cells, cysts or epithelial cells are present, the sedimentation rate ranges from moderate to high.

Specific Gravity

• Usually varies from 1.003 to 1.060.
• A low special gravity indicates diabetes insipidus or kidney infection (chronic).
• High specific gravity indicates diabetes mellitus or acute kidney infection.