What is the correct technique for obtaining a clean-catch midstream urine sample?

• A. Rinse the container with the sample before collecting; collect the first stream.
• B. Wash hands; cleanse the external genitalia front to back; start urinating, then collect a midstream sample without touching the inside of the container; cap and label.
• C. Collect urine directly into the container after cleansing; start with the first drop.
• D. Have the patient void fully first, then collect the last part of urine.

Answer: (B)

This approach targets getting a true sample from the bladder by minimizing contamination from the skin and genital area. Start with clean hands and cleanse the external genitalia from front to back to remove bacteria that would otherwise be picked up as the urine begins to flow. For women, wipe front to back; for men, clean the glans or head of the penis and retract the foreskin if needed. Then begin urinating, and after the stream has started, collect a midstream sample into the container without touching the inside of the container or its lips. Cap the container promptly and label it. This avoids the initial flow, which can carry bacteria from the urethra and surrounding skin, and prevents contaminating the sample by touching the container. Avoid rinsing the container with urine and ensure the specimen is sent to the lab promptly.