Table 1

Urine collection methods for precontinent children

Non-invasive methodsInvasive methods
Nappy padUrine bagClean catchCatheterSPA
ProcedurePad 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.
AdvantagesConvenient.
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.
LimitationsHigh 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 1725%1710%171%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.