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Shy Bladder Procedures

The term "shy bladder" refers to a situation where the donor is unable to provide the sufficient amount of urine required for a drug screen.

If the donor indicates upon arrival at the collection site that he or she cannot provide a specimen, the collector should begin the collection process anyway and have the donor make an attempt to provide a specimen.

If after an attempt the donor cannot provide a specimen or can only provide a specimen of insufficient volume, the donor must be instructed not to leave the collection site and to do so will be considered a refusal to test. The donor should be monitored either by the collector or by another member of the collection site staff. The donor should be encouraged to drink up to 40 ounces of fluid reasonably distributed over a period of up to three (3) hours, or until the donor can provide a sufficient amount of urine, which ever comes first.

If no specimen is provided on the first attempt, the same collection container may be used for the next attempt. The donor may keep possession of the container during the waiting period. The same CCF is used.

Note: Collectors should be sensitive to how frequently they should ask the donor to provide a specimen. For example, asking the donor to provide a specimen every half hour may not produce sufficient specimen, although in total, the amount would have been at least 45 mL. In this case, the collector needs to determine if a longer time is needed for the donor to consume fluids and produce a sufficient volume of specimen. If the donor refuses to drink fluids, this is not considered a refusal to test, although the collector should explain to the donor that not drinking sufficient fluids may result in the donor’s inability to provide a sufficient specimen and would require a medical evaluation. Under no circumstances can a collector “combine” urine collected from separate voids to create one specimen of sufficient volume.