Urine collection methods for precontinent children
| Non-invasive methods | Invasive methods | ||||
| Nappy pad | Urine bag | Clean catch | Catheter | SPA | |
| Procedure | Pad placed inside nappy. | Bag affixed over genitalia. | Wait until child voids spontaneously, catch sample opportunistically. | Catheter inserted into bladder via urethra, removed once urine sample obtained. | Needle inserted into bladder through skin of lower abdomen above pubic symphisis. |
| Advantages | Convenient. Useful for dipstick screening. | Convenient. Useful for dipstick screening. | Least contamination of non-invasive methods. Voiding stimulation methods can increase success. | Low contamination. High success rate. | Ultra-low contamination. Ultrasound to confirm adequate bladder filling can increase success. |
| Limitations | High contamination. Unreliable for culture. | High contamination. Unreliable for culture. | Moderate contamination. Can be time-consuming. | Invasive and painful. Requires equipment and expertise. | Invasive and painful. Requires equipment and expertise. |
| Contamination rate | >60%2 | ≈50%15 17 | 25%17 | 10%17 | 1%17 |
| Cost per definitive sample in an emergency department setting | – | £112.2847 | £64.82 standard clean catch or £52.25 with 5 min voiding stimulation47 | £49.3947 | £51.8447 |
SPA, suprapubic needle aspiration.