Urine Test: A Complete Patient Guide to Understanding Your Urine Collection and Laboratory Analysis Process

What is this urine test and what important health information can it provide to your doctor about your condition?

The 17-ketogenic steroids test measures the amount of steroid hormone breakdown products (metabolites) in your urine. These metabolites are produced when your body breaks down hormones like cortisol and androgens. The test is performed after taking a high-dose medication called dexamethasone, which is part of a special test called the high-dose dexamethasone suppression test. This test helps doctors understand why your body may be producing too much cortisol (a condition called Cushing's syndrome).

To prepare for the urine test, you should drink a normal amount of water, avoid strenuous exercise, and tell your healthcare provider about any prescription or over-the-counter medications you are currently taking.

Your doctor will give you specific instructions about taking the dexamethasone medication. Typically, you will take 2 mg of dexamethasone every 6 hours for 2.5 days (a total of 10 doses). It is important to take the medication exactly as prescribed. You should inform your doctor about all medications you are taking, as certain drugs can affect the test results. Avoid strenuous exercise and excessive stress during the collection period, as these can affect hormone levels.

How is the urine collected and what specific steps should you follow to provide a clean and valid sample at the clinic?

You will receive a special container from the laboratory for collecting your urine. On the morning you start collecting (48 hours after beginning dexamethasone), empty your bladder completely and record the time. From that point, collect ALL urine for the next 24 hours. This means every time you urinate, you must collect the urine in the container provided. Keep the container refrigerated or in a cool place. At the end of 24 hours, empty your bladder one final time and add this sample to the container. Return the container to the laboratory as instructed.

What happens after the test is completed and when will your physician contact you with the laboratory results and next steps?

The laboratory will analyze your urine sample to measure the amount of 17-ketogenic steroids. Your doctor will interpret the results along with other test results to determine the cause of your symptoms. The results help distinguish between different causes of excess cortisol production, such as a pituitary tumor, adrenal tumor, or ectopic ACTH production. Your doctor will discuss the results with you at a follow-up appointment.