Risk of Contamination of Voided Urine Specimen in Women With Pelvic Organ Prolapse

Soriano, Alex; Sansone, Stephanie; Arora, Ena; Arya, Lily A.; Andy, Uduak U.

doi:10.1097/spv.0000000000000760

Cited by 3 publications

(6 citation statements)

References 14 publications

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“…Previous research has demonstrated that overweight and obese female patients have an increased likelihood of providing a contaminated clean catch specimen, 9 also that women with pelvic organ prolapse would have increased rates of contaminated clean catch specimens. 10 Our study provides additional information for interpreting urine specimen results from 2 collection methodologies, as well as guidance for clinical scenarios specific to a urogynecology patient population.…”

Section: Discussionmentioning

confidence: 97%

Comparing Urine Specimen Collection Methods for Urinalysis and Culture Agreement: A Paired Sample Design

Hubb

Heit²

2021

Female Pelvic Med Reconstr Surg

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Objectives:The primary aim of this study was to determine if results from clean catch urine specimens agree with results from catheterized specimens in a urogynecology patient population. The secondary aim was to identify clinical scenarios in which catheterized specimens are preferred over clean catch specimens.Methods: Both a midstream clean catch and a catheterized specimen were obtained for each participant. Dipstick urinalysis was performed. If either specimen was positive for nitrites, leukocyte esterase, or blood then both were sent for urine culture.Kappa statistics were calculated to measure agreement between the paired specimen data for the total sample and for stratified samples. We agreed to accept clean catch results as preferable to catheterized results if the κ statistic was 0.7 or greater.Results: Three hundred forty-two participants were enrolled. For all participants, the agreement between the paired samples was strong for nitrite (κ = 0.884), moderate for blood and colony count (both κ = 0.656), weak for culture species (κ = 0.566), and minimal for leukocyte esterase (κ = 0.382). When data were stratified for menopause, vaginal estrogen use, body mass index, and prolapse, there were no clinical scenarios in which the κ values were consistently greater than our accepted value of 0.7. Conclusions:Our data indicate that catheterized urine specimens should be used in the evaluation of urinary tract infection or microscopic hematuria in the typical patient presenting to a urogynecology office who is often menopausal, overweight, and may have prolapse.

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Section: Discussionmentioning

confidence: 97%

Comparing Urine Specimen Collection Methods for Urinalysis and Culture Agreement: A Paired Sample Design

Hubb

Heit²

2021

Female Pelvic Med Reconstr Surg

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“…Parasites that may be found in urinary sediments include Trichomonas vaginalis [11,61], Enterobius vermicularis [11,62], and Schistosoma haematobium (Chronically infected adults pass few eggs in the urine, which are often missed when current diagnostic methods are used) [11,63]. Except for S. haematobium, parasites and parasitic ova are usually present in urine sediment as a result of vaginal or fecal contamination [64,65]. The next section will briefly focus on the parasitic contamination which can be detected in urinalysis.…”

Section: Parasitology Urinalysismentioning

confidence: 99%

“…In urine specimens which actually come from female patient, it is believed that the presence of T. vaginalis represents vaginal contamination [92], specifically is contaminated by organisms from the vaginal discharge [64,65]. Despite the fact that the midstream clean-catch technique is commonly used for urine collection [42,64], contaminated urine cultures are commonly happening with distressing regularity [64,65].…”

Section: Trichomonas Vaginalis and How It Contaminated Urinementioning

confidence: 99%

Vaginal or Fecal Contamination Which Contributes to Parasite Existence in Urine Sediment

Siagian

2024

Int. J. Path. Res.

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Aims: intended to deepen our knowledge to date regarding parasites that might found in urine sediment as consequences of vaginal or fecal contamination during voiding Discussion: Urine in the bladder is a sterile waste product composed of water soluble nitrogen products. But during voiding, the passage of the urine through lower/outer portion of the urinary tract might come across normal microbiota which function in maintaining the urothelial integrity and preventing urinary tract infection (UTI), as well as promoting local immune function. Parasites and parasitic ova may be seen in urinary sediments as a result of fecal or vaginal contamination. Identification of parasites in centrifuged deposits of urine sediment is a relatively rare occurrence in clinical practice but still must be considered carefully, whether as a consequence of contamination or definite causes of infection. Two of the common parasite found in urine sediment are Trichomonas vaginalis and Enterobius vermicularis. Urine collection procedure must be explained briefly to the patient along with appropriate informed consent prior obtaining the sample. Conclusion: The possibility of parasites being found in urine sediment remain to happen. An in-depth analysis needs to be carried out to determine whether this occurs due to vaginal or rectal contamination or whether it is due to a definitive infection occurring in the urinary tract.

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“…One study demonstrated that women with POP are more likely to have contaminated urine cultures from a voided specimen than from a straight catheter specimen (odds ratio, 1.89; 95% confidence interval, 1.20-2.99). 5 Our study assessed the agreement between the results of urinalysis and urine culture obtained from a clean-catch versus a straight catheter urine specimen among women who underwent vaginal surgery for POP.…”

Section: Why This Mattersmentioning

confidence: 99%

“…However, this may not be accurate in women with prolapse and particularly in women who recently have undergone vaginal surgery. One study demonstrated that women with POP are more likely to have contaminated urine cultures from a voided specimen than from a straight catheter specimen (odds ratio, 1.89; 95% confidence interval, 1.20–2.99) 5 …”

mentioning

confidence: 99%

Clean-Catch Urine Specimen More Likely to Be Contaminated After Vaginal Surgery for Pelvic Organ Prolapse

O’Meara

Abalyan

O’Sullivan

et al. 2023

UROGC

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Importance Accurate diagnosis of urinary tract infection after pelvic organ prolapse (POP) surgery is essential to postoperative care. Objective Our aim was to determine the agreement between the urinalysis of a clean-catch versus a straight catheter urine specimen in women who underwent vaginal surgery for POP. Study Design This was a cross-sectional study evaluating patients after vaginal surgery for POP. A clean-catch and straight catheter urine specimen were collected at routine postoperative appointments. Routine urinalyses and urine cultures were performed for all patients. A urine culture yielding mixed urogenital flora (which includes Lactobacillus species), coagulase-negative staphylococci, and Streptococcus species was considered a contaminated result. The agreement between the characteristics of urinalysis obtained via the clean catch versus the straight catheter at 3 weeks postoperatively was evaluated using weighted κ statistic. Results Fifty-nine participants enrolled. The agreement between the characteristics of urinalysis obtained via the clean catch versus the straight catheter was poor (κ = 0.018). The urine culture was more likely to be contaminated from the clean-catch urine specimen than from the straight catheter urine specimen (53.7% vs 23.1%). The positive and negative predictive values of leukocyte esterase on clean catch were 22.6% and 100%, respectively. Conclusions Diagnosing urinary tract infection based on contaminated urinalyses may lead to antibiotic overuse and misdiagnosis of postoperative complications. Our results can help educate health care partners and discourage the use of clean-catch urine specimens when assessing women who have recently undergone vaginal surgery.

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Risk of Contamination of Voided Urine Specimen in Women With Pelvic Organ Prolapse

Cited by 3 publications

References 14 publications

Comparing Urine Specimen Collection Methods for Urinalysis and Culture Agreement: A Paired Sample Design

Comparing Urine Specimen Collection Methods for Urinalysis and Culture Agreement: A Paired Sample Design

Vaginal or Fecal Contamination Which Contributes to Parasite Existence in Urine Sediment

Clean-Catch Urine Specimen More Likely to Be Contaminated After Vaginal Surgery for Pelvic Organ Prolapse

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