Turbid urine in the morning

Under normal circumstances, the color of urine we excrete should be clear, slightly yellow or white and transparent. However, some people find that their first urination when they wake up in the morning is turbid. This may be due to recent inflammation. Most men are more likely to have turbid urine, and may have prostatitis or urinary tract infection.

Normal urine is transparent when it is first discharged. After being left for a while, the urine will precipitate and become turbid due to changes in pH or temperature, or due to supersaturation. The turbidity of alkaline urine is mainly due to the precipitation of phosphates and carbonates. If acid is added to the urine, the turbidity will disappear.

When urine containing urate is left to stand, a reddish precipitate of urate will appear. Therefore, urine sedimentation after placement (especially for a long time) is not abnormal.

If the urine is turbid when it is first discharged, it is pathological, suggesting that it may be caused by the following reasons: the urine contains pus cells, red blood cells, epithelial cells and mucus filaments, etc.; the urine contains fat globules leading to chyluria, which can be detected under the microscope and can be dissolved by adding ether (milky white urine becomes clear).

The three-cup urine test is commonly used clinically to identify the cause of turbid urine in men. The method is to artificially divide the urine into three parts during a continuous urination, and place them in three glass containers respectively, and then observe them directly with the naked eye and under a microscope.

If the first cup is turbid and the second and third cups are transparent, it is seen in urethral disease; if the third cup is turbid and the first and second cups are transparent, it is seen in prostatitis and seminal vesiculitis; if all three cups are turbid, it is seen in posterior urethra, bladder or renal pelvis infection.