1. Urine analysis:
This is the most basic investigation asked by urologist. First morning sample of urine is required in specific conditions, for which urologist will clearly mention it to you. It is of utmost importance to correctly collect the urine sample, any contamination or incorrect methodology is the most common cause of erroneous report, which can derail whole treatment
Clean catch mid stream urine
Men: Retract your foreskin and clean the exposed part of glans preferably with soap and water. As you start to urinate, discard the initial part of urinary stream. The middle part of the urinary stream is to be collected in sample bottle provided by the laboratory. Ensure that mouth of bottle is not touched anywhere. Remember to pull back the foreskin to its natural position after the sample is collected.
Clean the private parts with water, separate labia and collect mid-stream urine as in men.
Ensure the collected sample is deposited in the laboratory within 30 minutes. If it is not possible, then the sample should be refrigerated or else the report may be erroneous.
2. Blood tests
These may include blood counts, kidney function tests and few others as may deemed be necessary by your consultant.
3. S. PSA
This is a test conducted on blood sample, fasting sample is not necessary. S.PSA (prostate specific antigen) is a prostatic specific marker, which tells about health of the prostate. It may be elevated due to benign enlargement of prostate, prostatic infection or in prostatic cancer. There is no specific cut-off value, which can diagnose cancer. The urologist is the best person to interpret the report along with your symptoms and results of physical examination.
Men should remember to abstain from ejaculation at least 48 hours before giving sample to avoid erroneous increase in s.PSA levels.
4. X-ray KUB
This is one of the most basic investigations to evaluate for stones. It is best done in the morning, empty stomach.
5. USG KUB
This is one of the basic, easily available investigations, which can give a lot of information about the urinary tract. The results are dependent upon the skills of the ultrasonologist (doctor trained in diagnostic radiology). The patient should report to the USG room with full urinary bladder. Drink lots of water before going for this examination. Patients who are on catheter (a plastic tube to drain urine) should ensure that the catheter is clamped/blocked to ensure filling of urine bladder before going for USG examination.
These are specialized investigations ordered for specific indications. A non-contrast CT scan is one of the most sensitive investigations for diagnosing stones. (98% sensitive)
7. IVP study
This study is conducted after injecting a dye into veins and getting 4 -5 X-rays of tummy. It gives information about shape and functioning of kidneys and any abnormalities thereof, including stones. In many a places, it has been replaced by CT-urogram.
These are specialized investigations for evaluating urinary bladder and urethra, whenever there is clinical suspicion of stricture (abnormal narrowing or urinary passage from urinary bladder to outside)
The patient is asked to urinate on a commode with attached machine, which measures the flow of urine stream and amount of urine passed. It is used for objective assessment of lower urinary tract symptoms.
The patient must ensure that he/she has adequate filling of urinary bladder before going for this test. At least 150 ml of urine must be passed before the results can be reliably interpreted.
10. Urodynamic study
This is a very specialized test for evaluating bladder. It is ordered in cases of lower urinary tract symptoms/bladder outlet obstruction whenever there is some diagnostic dilemma, or in cases of neurogenic disorder associated with bladder symptoms.
The patient is asked for a urine culture report before the procedure. He/She has to report to the examination center after ensuring clean motions (empty bowels) in the morning of examination.