Effectiveness of the Bladder Stimulation Technique for Infant Urine Collection in the Pediatric Emergency Department: A Randomized Controlled Trial.

In 30 seconds

This randomized controlled trial compared bladder stimulation with standard positioning for urine collection in 64 nontoilet-trained infants aged 1 to 12 months. Collection within the predefined 3-minute window was more successful with bladder stimulation (53.1% vs 25.0%; P = .021; relative risk, 2.13 [95% CI, 1.05-4.30]). Median collection time did not differ significantly (46 vs 82.5 seconds; P = .38). Pain scores rose modestly in the stimulation group, while heart rate and oxygen saturation changed in both groups without significant between-group differences. The study supports short-term procedural feasibility, not diagnostic adequacy.

Key findings

• Urine collection success within 3 minutes was 53.1% with bladder stimulation versus 25.0% with standard positioning (P = .021).
• The relative risk of successful collection was 2.13 (95% CI, 1.05-4.30), with an absolute risk difference of 28.1% (95% CI, 5.8%-50.4%).
• Median procedure duration was 46 versus 82.5 seconds, with no significant between-group difference (P = .38).
• FLACC scores rose from 2 to 3 points with stimulation (P < .001); physiological changes occurred in both groups without between-group differences.

Why it matters

Obtaining urine from infants who are not toilet trained can be difficult, and a higher chance of collection within a short window may help make this procedure more feasible. The findings also indicate that improved collection success did not translate into a demonstrated reduction in procedure time. Because diagnostic adequacy was not evaluated, success in obtaining a sample should not be equated with a valid culture or diagnosis.

What to keep in mind

The trial did not assess contamination rates, urine culture validity, or subsequent collection procedures; its findings therefore address short-term procedural feasibility rather than diagnostic adequacy.