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Uroflowmetry

Urinary disorders can often indicate a lot of underlying complications. Urination and the excreted product is very significant in evaluating a person's health in associated with kidney function and prostrate health in case of men. Urination is a complex procedure, which involves the contraction of the muscles associated with the detrusor and the external bladder tissues. The cerebral cortex facilitates the initiation and emptying of the bladder during the urination process.


Urination can be affected for various reasons such as weather, emotions, and hormonal imbalance, incontinence due to anatomical disorders and also underlying inflammations or infections. The regulation of blood pressure and adrenal surge is also involved in proper generation of urine. Physicians analyze the uroflowmetry parameters in order to diagnose urinary tract infections and also to evaluate the normal flow rate of urine to determine the normal function of the urinary tract and associated muscles.


Uroflowmetry is widely recommended in many countries, as it has become the foundation for diagnosing prostrate enlargement, urethritis and obstruction. Males over 30 years are advised to undergo this test as it is necessary to detect the early signs of an underlying condition such as prostate cancer, bladder tumor or neurogenic bladder dysfunction where the cause is spinal cord injury or lesion. Typical conditions where uroflowmetry might be advised are difficulty in urinating, frequency of urination, nocturia, enuresis, Benign Prostatic Hyperplasia, urethral stenosis or incomplete bladder emptying.


Preparation and procedure

Patients undergoing uroflowmetry procedure are advised to drink plenty of water in order to fill up the bladder as it provides a comprehensive analysis of the bladder functionality. They are also asked to hold the urine for a few hours before the test. Unlike other urinary examinations, here the specimen is not collected in a cup but the patient is asked to urinate into a funnel that connects to a container underneath. Special toilets are provided in some diagnostic centers for this procedure. The funnel shaped device measures the urine flow rate and quantity and the results obtained are recorded.


The normal flow rate of the urine varies from 10 ml to 20 ml per second. The results associated may vary both in males and females. The flow rate in women is often less as it may take 15 ml to 18 ml per second. In men, urine flow declines with age. Women have lesser change with age.

14 - 45 years

The average flow rate for males is 21 ml/sec.
The average flow rate for females is 18 ml/sec.

46 - 65 years

The average flow rate for males is 12 ml/sec.
The average flow rate for females is 18 ml/sec.

66 - 80 years

The average flow rate for males is 9 ml/sec.
The average flow rate for females is 18 ml/sec.


The diagnostic evaluations based on this can indicate the strength of the bladder muscles and also other disorders. Delayed urine flow indicates obstruction and also infections that are causing tissue inflammation. Increased flow of urine also indicates weak bladder muscles and also lack of cerebral cortex control. Incontinence is widely reported in elderly groups. Neurological conditions and trauma can also affect urine flow rate.


E Coli

E Coli is a bacterium that lives in the digestive tract of humans and animals. It is generally present in the gut of warm blooded animals. Excluding the strain E coli 0157:H7, the rest of the strains are understood to be harmless. The aforementioned strain causes severe diarrhea. There are a few strains that can cause urinary tract infections or other kinds of infections. Though not diagnosed and reported as often, E coli can occur in adults as well as in children of any age group. The infection can be very severe in old people and young children. E coli infection settles down on its own within 10 days from the onset of the condition; however in a few cases it may get life threatening.


  • E-coli infection is contracted when a person comes in contact with the stool or feces of a human who is the carrier of the infectious strain.

  • E coli can also spread from person to person. When an infected person does not wash his/her hands properly and thoroughly after bowel movement, and touches another person's hand or objects there are chances of infection spread.

  • Raw meat, fruits, vegetables and milk can be contaminated by E coli. They can be the carriers of the bacteria.

  • Water is another major source of E coli bacteria. When feces of the infected person get into water bodies, the water gets contaminated and if it consumed without proper purification it can spread the bacteria.

E coli symptoms

Symptoms show up in 3-4 days after coming in contact with the infection source. Common symptoms reported include blood in the stool, bloody diarrhea, nausea, vomiting and stomach cramps. But the symptoms mentioned here are broad and they do not necessarily indicate the specific symptoms of E coli. In severe cases, symptoms may include fever, bruising, minimal urine output and pale skin.

E coli can be diagnosed through stool culture. In general the condition settles down on its own. Sipping water frequently helps the body to recover from dehydration. Do not indulge in self treatment as anti diarrhea pills at this stage may slow down the recovery. In severe cases of infection, blood transfusion and dialysis is suggested.

E coli prevention


  • Drink only treated, purified and chlorinated water.
  • Avoid eating raw fruits and vegetables while traveling out.
  • Avoid drinking water from outside taps.
  • Avoid consuming pink hamburger.
  • Avoid using ice cubes from unclean sources.
  • Defrost meat in oven or in the refrigerator, do not allow it to defrost on its own over the counter.
  • Cook all types of beef at 160 degrees F.
  • Do not taste raw ground beef while cooking.
  • Do not transfer cooked beef to a plate that had raw beef before.
  • Wash your hands thoroughly with soap and water after using the bathroom.
  • In the kitchen wash your hands thoroughly with warm water and soap particularly after handling meat products.
  • Always store raw meat, poultry and other food items separately.
  • Use pasteurized milk and dairy products.
  • Do not drink water without boiling it.
  • Refrigerate left over food immediately if you plan to consume it again.

Urinalysis

Urinalysis refers to a group of tests conducted on urine sample to determine the various chemical components of the urine. Urine analysis is an examination of the urine sample that gives useful information regarding the renal and metabolic disorders, kidney or urinary tract infections, diabetes and host of other diseases. Urinalysis does not diagnose the disease itself, rather the presence of abnormal substances in the urine that will help direct the course of further evaluation and diagnosis. Depending upon the symptoms reported, urinalysis is conducted in three different phases.


1. Visual analysis or physical examination
2. Chemical analysis
3. Microscopic analysis


Physical examination of urine

Color: Normally urine looks pale yellow; any change in the color of the urine indicates some abnormality, for example dark yellow urine indicates dehydration whereas bile pigments cause brown urine. Urine turns red when there is blood in the urine. Sometimes consumption of certain foods such as blackberries, rhubarb and beets turns the urine red.

Clarity: Normal urine is usually clear, cloudy urine indicates the presence of bacteria, blood, sperm, crystals, or mucus. Odor: Normal urine has a nutty odor to it whereas diabetes gives urine a fruity odor and bacterial infections lead to bad odor of the urine.

Chemical analysis of urine

Chemical examination is normally conducted with the help of the dipstick. The change in the colors of the different pads on the dipstick indicates varied health conditions.

pH balance: pH balance measures the acidic and alkaline balance of the urine. The lower or higher pH indicates kidney disorders. pH balance can be changed by consuming the appropriate diet.

Protein: Protein test normally involves examining the albumin levels in the urine. The elevated albumin level is the initial symptom of kidney disorder.

Glucose: Higher glucose levels in the urine is associated with diabetes and other conditions like hormonal disorders, liver disease and pregnancy.

Ketones: When the body does not get enough carbohydrates, it starts metabolizing the fats to gather energy and in process releases ketones into the urine, thus indicating the low levels of insulin.

Blood: Urine is also tested for the presence of red blood cells. Various kidney and urinary tract diseases and trauma, injury, medications, smoking, or strenuous exercise lead to the contamination of urine with the blood.

Nitrites: UTI or urinary tract infection changes the urinary nitrates into nitrites. Therefore the presence of nitrites indicates the presence of UTI. Likewise urine is also tested for Leukocytes as they too indicate the presence of UTI.

Microscopic urine analysis

This test involves collection of urine in centrifuge to be spun for few minutes, so that sediments settle at the bottom. The sediment substance is then spread on the slide and examined under microscope. The urine is tested for the following:

If the urine shows red or white blood cells, it signals an inflammation, kidney disease or an injury of the ureters, bladder, or urethra. Microscopic examination of urine also reveals the presence of crystals. Large number of Crystals in the urine indicates dehydration, pH imbalance, UTI or a condition called Urolithiasis, signifying kidney stone or bladder stones. Urine is also tested for bacteria, yeast cells, or parasites, as any of these organisms in the urine signals infection. Increased quantity of epithelial cells in urine could indicate some health problems.


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Bibliography / Reference

Collection of Pages - Last revised Date: December 9, 2019