Collection of Urine Specimen By Bladder Stimulation Technique

 

Reviewed by Jodie Daculan
September 2014
Clinical Guidelines Back Newborn Services Home Page

Urine collection by bladder stimulation technique

The bladder stimulation technique can be used to collect a clean urine sample as it facilitates bladder emptying when there is bladder dysfunction1.
The bladder is stimulated by gentle tapping of the suprapubic area for 30 s alternated by massaging of the lower back for 30 s. This is done for 5 min in total or until urine has passed. A successful urine collection was seen within 5 min in 69 out of 80 eligible babies with a mean collection time of 57s1.

This technique should be used to collect a urine sample for investigation purposes only and should be requested by the medical staff.

Urine can be used for analysis of microscopy & culture, biochemical analysis or toxicology.
 

Eligible babies:

The bladder stimulation technique is only considered in a stable baby, with stable at the time of collection being defined as:

Equipment:

Method:

Three people are needed for this technique. At least one of them should be a nurse practioner or a trained staff in performing the technique.
 

Follow the steps below.
 

Step Action
1 The first step is either breast-feeding or providing formula intake appropriate to the age and weight of the newborn.
If the baby is nil by mouth, discuss if the baby is well enough for this technique with the medical team and make sure the baby has not recently had a wet nappy. Consider imaging by ultrasound to check if the bladder is full.
2 Twenty-five minutes after feeding, the infant’s genitals should be cleaned with antiseptic solution (esp. important if collection is for microbiology).
3 Consider to give sucrose 0.2 ml if the baby is >1,500 g and > 31 weeks’ CGA
4 One person holds the baby under the armpits with their legs dangling and lower body undressed.
5 A second person then starts the bladder stimulation, which consists of a gentle tapping in the suprapubic area at a frequency of 100 taps or blows per minute for 30 s.

6 The next step is stimulation of the lumbar paravertebral zone in the lower back with a light circular massage for 30 s.

7 Repeat step 4 and step 5, for maximum 5 minutes, until the baby passes urine
8 Collect the urine sample in a sterile container

 

Reference:

1.

M. L. Herreros Fernández, N. González Merino, A. Tagarro García, et al. A new technique for fast and safe collection of urine in newborns. Arch Dis Child. 2013;98(1):27-29.