Urine dipstick for leukocyte esterase
What is this test?
This test uses a special strip of paper (dipstick) to detect an enzyme called leukocyte esterase in urine. This enzyme suggests there may be white blood cells in the urine. It is used as a screening test when pus in the urine is suspected in patients at risk for urinary tract infection.
What are other names for this test?
- Urine dipstick for leucocyte esterase
- Urine dipstick for leucocytes
- Urine dipstick for leukocytes
- Urine dipstick for white cells
What are related tests?
- Neisseria gonorrhoeae nucleic acid amplification test
- Chlamydia trachomatis nucleic acid amplification test
- Urine dipstick for nitrite
Why do I need this test?
Laboratory tests may be done for many reasons. Tests are performed for routine health screenings or if a disease or toxicity is suspected. Lab tests may be used to determine if a medical condition is improving or worsening. Lab tests may also be used to measure the success or failure of a medication or treatment plan. Lab tests may be ordered for professional or legal reasons. You may need this test if you have:
- Urine containing pus
When and how often should I have this test?
When and how often laboratory tests are done may depend on many factors. The timing of laboratory tests may rely on the results or completion of other tests, procedures, or treatments. Lab tests may be performed immediately in an emergency, or tests may be delayed as a condition is treated or monitored. A test may be suggested or become necessary when certain signs or symptoms appear.
Due to changes in the way your body naturally functions through the course of a day, lab tests may need to be performed at a certain time of day. If you have prepared for a test by changing your food or fluid intake, lab tests may be timed in accordance with those changes. Timing of tests may be based on increased and decreased levels of medications, drugs or other substances in the body.
The age or gender of the person being tested may affect when and how often a lab test is required. Chronic or progressive conditions may need ongoing monitoring through the use of lab tests. Conditions that worsen and improve may also need frequent monitoring. Certain tests may be repeated to obtain a series of results, or tests may need to be repeated to confirm or disprove results. Timing and frequency of lab tests may vary if they are performed for professional or legal reasons.
How should I get ready for the test?
To prepare for giving a urine sample, be sure to drink enough fluids before the test, unless you have been given other instructions. Try not to empty your bladder before the test.
Some medications, such as antibiotics and vitamin C, may affect the results of this test. Before the test, tell the healthcare worker all the medications you are currently taking.
How is the test done?
Immediately before a test that requires a clean urine sample, males must clean, rinse, and dry the head of the penis. Females must clean, rinse, and dry the urethral area. As you begin urinating, allow a small amount of urine to go into the toilet, and then stop the urine stream. Position the container to collect your urine, and urinate into the container. Remove the container when it has a sufficient amount of urine in it, and finish urinating into the toilet.
The urine sample may also be collected from a urinary catheter. If a catheter is present, the healthcare worker will collect urine from the catheter for testing. If there is no catheter present, a catheter may need to be inserted temporarily to collect the sample. The area will be cleaned, and a sterile catheter will be inserted into your urethra. Urine will drain from the catheter into a container for the test. When sufficient urine has been collected, the catheter will be removed. A special bag may be used to collect a urine sample from an infant.
How will the test feel?
The amount of discomfort you feel will depend on many factors, including your sensitivity to pain. Communicate how you are feeling with the person doing the test. Inform the person doing the test if you feel that you cannot continue with the test.
There is usually no pain experienced when a clean-catch urine sample is given or when the sample is taken from an existing urinary catheter. If an intermittent (temporary) catheter is used to obtain the sample, you may feel some discomfort.
What should I do after the test?
After collecting a urine sample, close the container if it has a lid. Place the container where the healthcare worker asked you to put it. Clean your hands with soap and water.
What are the risks?
Clean urine: There are several different ways that may be used to collect a sample of clean urine. Urine may be collected by urinating in a cup using the clean-catch technique, or by collecting urine from an existing urinary catheter. Generally, there are no risks when collecting a clean urine sample using either of these methods. Another way to collect a clean urine sample is by inserting a temporary urinary catheter. Risks of using this method include bleeding, infection, catheter misplacement, and damage to the urethra or bladder. If you have a medical condition, or are using a medication or supplement that causes excessive bleeding, you are at a higher risk of bleeding. The person doing this test may need to perform it more than once. Talk to your healthcare worker if you have any concerns about the risks of clean urine collection.
What are normal results for this test?
Laboratory test results may vary depending on your age, gender, health history, the method used for the test, and many other factors. If your results are different from the results suggested below, this may not mean that you have a disease. Contact your healthcare worker if you have any questions. The following is considered to be a normal result for this test:
- Adults and Children: Negative or no color change 
What might affect my test results?
- Results decreased in :
- Elevated urine specific gravity
What follow up should I do after this test?
Ask your healthcare worker how you will be informed of the test results. You may be asked to call for results, schedule an appointment to discuss results, or notified of results by mail. Follow up care varies depending on many factors related to your test. Sometimes there is no follow up after you have been notified of test results. At other times follow up may be suggested or necessary. Some examples of follow up care include changes to medication or treatment plans, referral to a specialist, more or less frequent monitoring, and additional tests or procedures. Talk with your healthcare worker about any concerns or questions you have regarding follow up care or instructions.
Where can I get more information?
- National Kidney and Urologic Diseases Information Clearinghouse - http://kidney.niddk.nih.gov/
- National Kidney Foundation - http://www.kidney.org
 Henry JB (Ed): Clinical Diagnosis and Management by Laboratory Methods, Twentieth. W.B. Saunders Company, Philadelphia, PA, USA, 2001.
 Lammers RL, Gibson S, Kovacs D, et al: Comparison of test characteristics of urine dipstick and urinalysis at various test cutoff points. Ann Emerg Med 2001; 38(5):505-512.
 Lohr JA, Portilla MG, Geuder TG, et al: Making a presumptive diagnosis of urinary tract infection by using a urinalysis performed in an on-site laboratory. J Pediatr 1993; 122(1):22-25.
 Pfaller MA & Koontz FP: Laboratory evaluation of leukocyte esterase and nitrite tests for the detection of bacteriuria. J Clin Microbiol 1985; 21(5):840-842.
 Leighton PM & Little JA: Leucocyte esterase determination as a secondary procedure for urine screening. J Clin Pathol 1985; 38(2):229-232.
Last Updated: 7/4/2018