Trick of the Trade: Urine Collection in Neonates

Trick of the Trade: Urine Collection in Neonates

2016-11-11T18:38:43+00:00

Urine sample
The Case: A 8-day-old, uncircumcised male is brought to the ED with fever, irritability, and decreased urination.
The Problem: Getting a clean catch urine in a timely, non-invasive manner
The Solution?

Trick of the Trade

  1. Provide oral intake to the neonate
  2. 25 minutes after feeding, clean genitals with soap and water; dry with sterile gauze
  3. Give non-pharmacologic analgesia (Pacifier or 2% sucrose syrup)
  4. One person holds neonate under the axilla with feet dangling
  5. Another person starts bladder stimulation with gentle tapping of the suprapubic area (100 taps/min) and stimulation of lumbar paravertebral zone (light circular massage)
  6. Perform steps 4 and 5 for 30 secs at a time, as many times as needed
  7. Catch midstream urine sample in a sterile collection container

Study Publication1

  • Study methodology:
    • Prospective feasibility and safety study
    • Single center in Madrid
    • 80 neonates (31 girls and 49 boys)
    • Mean ages: 6.66 day old boys and 6.23 day old girls
  • Results:
    • 86% success rate in obtaining urine in
    • Mean time for sample collection: 57 sec
    • Mean time spent collecting samples in males: 60.48 sec
    • Mean time spent collecting samples in females: 52.04 sec
  • Limitation: Lack of control group
  • Conclusion: Based on a previous study using a vibrating bladder stimulator,2 this manual method to obtain midstream urine in newborns is safe, quick, and effective.

Bottom Line

Urine collection in neonates is a time-consuming and unpredictable task that requires time and attention. Although a small study, this new technique does not cause discomfort or waste time as is typically the case with catheterized urines and bag collection methods, respectively.

1.
Herreros F, González M, Tagarro G, et al. A new technique for fast and safe collection of urine in newborns. Arch Dis Child. 2013;98(1):27-29. [PubMed]
2.
Davies P, Greenwood R, Benger J. Randomised trial of a vibrating bladder stimulator–the time to pee study. Arch Dis Child. 2008;93(5):423-424. [PubMed]
Salim Rezaie, MD

Salim Rezaie, MD

ALiEM Associate Editor
Clinical Assistant Professor of EM and IM
University of Texas Health Science Center at San Antonio
Founder, Editor, Author of R.E.B.E.L. EM and REBEL Reviews
  • Awesome. Definitely need to try this next time. I always prefer non-invasive methods in kids.

    • I have actually tried this twice now, and it worked like a charm. All my nurses won’t stop talking about it, and tell me about other times they have used it and how great it works. Let me know how it does for you.

      Salim

  • This method will also help with the parental anxiety and grief over the placement of an invasive catheter!

  • really helpful for cultural test too as a lot of care is needed in it