Bacteriological findings in urine specimens from women. Association with urinary tract symptoms and sampling methods

Urine sampling techniques were recorded in 147 women who brought a sample of urine voided at home to the general practitioner's surgery. Seventy-two women had lower urinary tract symptoms, and 75 had no symptoms at all. Eighty-nine (61%) had taken a midstream specimen, 77 (52%) had cleansed the periurethral area, and 15 (10%) had held the labia apart during micturition. Combinations of these techniques were used by 71 women while 40 (27%) had used no specific technique. The bacterial content of the urine (defined as the number of different bacterial strains found) was not reduced by either cleansing or by taking a midstream specimen, but it was significantly reduced in the women who had held the labia apart during voiding (p less than 0.05). Urine samples from women with symptoms had significantly lower bacterial content than those from patients who were free of symptoms (p less than 0.01). Women should be encouraged to ensure the free flow of urine by holding the labia apart during urine sampling.