The fascinating story of urine examination: From uroscopy to the era of microscopy and beyond

Abstract

The purpose of this study was to present the evolution of ideas on the examination of urine from antiquity till our days. A thorough study of texts, medical books from antiquity till twentieth century along with a thorough review of the available literature in PubMed was conducted. The first observation on urine examination can be traced back to the Babylonian and Sumerian texts. Almost all physicians in antiquity including Hippocrates referred to the value of urine examination in the diagnosis and prognosis of diseases. The construction of first compound microscope lead to the examination of urine sediment and the development of Urine Cytology which was revolutionized during the twentieth century with the studies of important cytologists such as George Papanicolaou, Geoffrey Krabbe, and Leopold Koss. The introduction of molecular tests in the diagnosis of urothelial cancer inaugurated a new era in the study of urine cytology. The history of urine examination spans a period of 6,000 years. The application of microscope in the examination of urine sediment during the nineteenth century established urine analysis as an important diagnostic tool in clinical practice.

Pelvic floor myofascial pain in patients with symptoms of urinary tract infection

“…Historically, the evaluation of urine to help predict disease began 6000 years ago on the basis of evidence from Sumerian and Babylonian clay tablets. The analytic methods improved with the invention of microscopy for urinalysis and chemical indicators for rapid bedside testing by urine dipstick . A urine dipstick allows only for indirect analysis by chemical reactions, which show visible color changes as indicators for pH, protein, red blood cells, leucocyte esterase, and nitrite as the surrogate for presence of bacteria.…”

“…The analytic methods improved with the invention of microscopy for urinalysis and chemical indicators for rapid bedside testing by urine dipstick. 16 perhaps be even more helpful to eliminate the subjective component in the myofascial exam even further such that it can be quantified. We have made strides in this direction by use of a pressure algometer placed on the examiner's fingers.…”

Un posible recipiente uroscópico de época romana

“…Uroscopy tests remained unchanged until Theophilus Protospatharius, a Byzantine medical doctor who wrote De Urinis (Περὶ Οὔρων), thus adding important methodological innovations to the macroscopic observation of urine (Magiorkinis andDiamantis, 2015: 1021). He possibly pioneered the drafting of the above mentioned uroscopy diagram (Fine, 1986), for the first time defining ten colour tones (Kouba et al, 2007: 50-52), associated with different categories of urine thickness.…”

Urine: Waste product or biologically active tissue?

“…Historically, urine has been viewed primarily as a waste product with no biological role in the overall health of an individual, except perhaps as the “culture‐media” for uropathic Escherichia coli ( E. coli ) during the course of urinary tract infections (UTIs). The examination of urine as a diagnostic tool of systemic health spans more than 8000 years of human history . Johannes de Ketham published the urine wheel in 1491 to illustrate how the color and consistency of urine could be used to determine a diagnosis.…”

“…The examination of urine as a diagnostic tool of systemic health spans more than 8000 years of human history. 2,3 Johannes de Ketham published the urine wheel in 1491 to illustrate how the color and consistency of urine could be used to determine a diagnosis. Macroscopic examination of urine (uroscopy) was performed throughout antiquity and middle ages; urine was visually examined, smelled, and even tasted to determine the internal state of the body.…”