Author: Rachel Doran

For further advice either speak to the nurse looking after you or
contact
Infection Prevention and Control Team
on
01502 445255

Compliments, comments, concerns or complaints
Patient Liaison -
may be the best starting point if you have a question or concern about the NHS. If you would like to find an NHS dentist, know where your nearest doctor is or talk through a problem you have had with a service, you can contact the PALS service.
To contact Patient Liaison Team:
Call 01502 445447
Monday to Friday,
Email: patientliaison@ecchcic.nhs.uk
Or write to:
Patient Liaison Team
East Coast Community Healthcare
Hamilton House, Battery Green Road, Lowestoft, NR32 1DE

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Taking a Mid Stream Urine Specimen
(MSU)
Information leaflet

Produced by East Coast Community Healthcare Infection,
Prevention and Control Team
Issued: September 2018 revised October 2023

What is an MSU?
A mid-stream urine sample means you don't collect the first or last part of urine that comes out. This reduces the risk of the sample being contaminated with bacteria from your hands or the skin around the urethra, the tube that carries urine out of the body. The aim is to obtain a sample (specimen) of urine from the middle of your bladder. Urine does not normally have any germs (bacteria) in it (urine should be sterile). If bacteria are found in the sample, it means that the urine is infected. A midstream sample is best.
The “gold standard” for the diagnosis of urinary tract infection is culture, which requires 18 -24 hours before a result is available.
What is the purpose of an MSU test?
To confirm the diagnosis of a urine infection — The usual symptoms of a urine infection are pain when you pass urine and passing urine frequently. However, symptoms are not always typical, particularly in the elderly, so a urine test may be needed.
To decide the best antibiotic to use — Some germs (bacteria) are resistant to some antibiotics. If the test shows that you have bacteria in your urine then the bacteria are tested against various antibiotics. This finds which antibiotics will kill the bacteria in the urine.
How do I collect a midstream specimen of urine (MSU)
Before doing an MSU, wash your hands and ideally your genitals as well.
Take the entire top yellow lid off pot 1 when you are ready to take the sample., do not take off the top sticky label yet.
Women - hold open the entrance to the vagina (your labia).
Men - pull back your foreskin.
Pass some urine into the toilet then, without stopping the flow of urine, catch some urine in the clear pot. Once you have enough urine in the pot about 3/4 full is perfect, finish off passing the rest of your urine into the toilet.
Avoid touching any part of your genitals with the pot, as this will increase the risk of contamination. Put the yellow lid back on pot 1.

MSU pots
Your GP practice will provide you with the urine collection system.
This consists of the yellow pot 1 and the green topped bottle 2 which contains the preservative.
Instructions for this below.
1 2

TOP

Collect urine in yellow top pot 1 following the instructions in this leaflet.
Ignore the name label on pot 1.
As soon as possible and within 2 hours transfer urine to the green topped bottle 2

The green top bottle 2 contains preservative (white powder) This allows urine to be tested without
overgrowth of
bacteria.
Please do not open this bottle at any point of the process

Remove the top
label on pot 1 place the top of the green bottle 2 into the hole in pot 1 so urine can be
transferred
without spillage or
contamination, Do not turn pot 1 upside down during this
process

Urine is now
preserved
Label and take bottle 2 to your GP
Practice .
The yellow pot does not need to be returned to the GP surgery and can be
disposed of in your own
domestic waste