American Journal of Pediatrics

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The Effect of Bladder and Lumbar Stimulation Technique for Collection of Urine in Newborns

Received: Apr. 11, 2019    Accepted: May 10, 2019    Published: Jun. 04, 2019
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Abstract

Background: Sign and symptoms of urinary tract infections (UTI) are not specific in infants and young children, fever being the commonest sign. Therefore, collecting urine samples for culture is required to diagnose or exclude UTI. Obtaining a clean catch urine sample in neonates and infants is a great challenge as it is unpredictable, time consuming and requires lot of patience. Objectives: The objectives of the study were to determine the effect of bladder and lumbar stimulation technique (BLST) for collection of midstream urine in newborns and to evaluate contamination rates of urine samples collected. Methods: An experimental research was conducted in BPKIHS, Dharan, Nepal including total of 54 term newborns. Urine culture was indicated for different reasons to the admitted newborns. They were randomly assigned either to the experimental group or the control group. Twenty-five minutes after feeding, the genitals and perineal area of the babies were cleaned. The newborns were held under the armpits with legs dangling. Bladder and Lumbar stimulation technique was only applied to the newborns in the experimental group. Success was defined as collection of urine sample within 5 minutes (<300s) of starting the stimulation maneuver in the experimental group and of holding under the armpits in the control group. Results: The success rate of urine collection was significantly higher in the experimental group (88.88%) than in the control group (25.92%) p<0.001. The median time for sample collection was 1.07 minutes (64.2s) [IQR=1.52minutes (91.2s)] in experimental group and 1.52minutes (91.2s) [IQR= 2.78 minutes (166.8s) for control group (p=0.069). Contamination was not found in urine samples collected by BLST in experimental group. Conclusion: The study suggests that bladder and lumbar stimulation technique is safe, quick and effective way of collecting midstream clean catch urine in newborns.

DOI 10.11648/j.ajp.20190502.15
Published in American Journal of Pediatrics ( Volume 5, Issue 2, June 2019 )
Page(s) 64-69
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Bladder and Lumbar Stimulation Technique (BLST), Supra Pubic Aspiration (SPA), Urinary Tract Infections (UTI)

References
[1] Whiting P, West wood M, Bojke L, Palmer S, Richardson G, Cooper J et al. clinical effectiveness and cost effectiveness of tests for diagnosis and investigation of urinary tract infection in children: a systematic review and economic model. Health technology assessment 2006; 10 (36): 1-179.
[2] Indian Pediatric Nephrology Group, Indian Academy of Pediatrics. Indian Pediatrics 2001; 38: 1106-1115.
[3] Shaikh N, Morone NE, Bost JE, Farrell MH. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J 2008 April; 27 (4): 302-8.
[4] Ahmed SM, Swedlund SK. Evaluation and treatment of urinary tract infections in children. Am Fam Physician 1998; 57: 1573–80,1583–4.
[5] Atluntas N, Tayfur A. C, Kocak M, Razi H C, Akkurt S. Midstream clean-catch urine collection in newborns: a randomized controlled study. Eur J Pediatr 2015; 174 (5): 577-82.
[6] Herreros Fernandez ML, Gonzalez Merino N, Tagarro Garcia A, Perez Seoane B, Serna Martinez M, Contreras Abad M et al. A new technique for fast and safe collection of urine in newborns. Arch Dis Child 2013; 98: 27–29.
[7] Nepal A, Basnet R, Acharya R, Shrestha S, Koirala S, Poudel A et al. A Technique for Fast and Safe Collection of Urine in Newborns. Journal of Kathmandu medical college 2016; 5 (3): 82-83.
[8] Urinary tract infection in children: diagnosis, treatment and long term management. NICE clinical guideline 2007; 54: 1-35.
[9] Prasad RS, Smith SJ, Wright H. lower abdominal pressure versus external bladder stimulation to aid bladder emptying in multiple sclerosis: a randomized controlled study. Clin Rehabil 2003 feb; 17 (1): 42-47.
[10] Davis P, Greenwood R, Benger J. Randomised trial of vibrating bladder stimulator- the time to pee study. Arch Dis Child 2008; 93: 423–424.
[11] Karacan C, Erkek N, Senel S, Akin Gunduz S, Catli G, Tavil B. Evaluation of urine collection methods for the diagnosis of urinary tract infection in children. Med Princ Pract 2010; 19 (3): 188–191.
[12] Kalager T, Digranes A. Unusual complication after suprapubic bladder puncture. Br Med J 1979; 1 (6156): 91–92.
[13] Taylor M R, Dillon M, Keane CT. Reduction of mixed growth rates in urine by using a "finger tap" method of collection. British Medical Journal 1986; 292: 990.
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[16] Boshell BR, Sanford JP. A screening method for the evaluation of urinary tract infections in female patients without catheterization. Ann Intern Med 1958; 48 (5): 1040–1045.
[17] Urine collection from a child. Children's Emergency Dept & Medical Photography and Illustration 2008.
[18] Fowler C J, Panicker J N, Drake M, Harris C, Harrison SCW, Kirby M et al. A UK Consensus on the Management of the Bladder in Multiple Sclerosis. J Neurol Neurosurg Psychiatry 2009; 80: 470–477.
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[20] Das Gupta P, Haslam C, Goodwin R, Fowler CJ. The “queen square bladder Stimulator”: a device for assisting emptying of Neurogenic Bladder. British Journal of Urology 1997 Aug; 80 (2); 234-237.
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  • APA Style

    Rajbanshi Mamta, Karn Basant Kumar, Yadav Upendra, Shah Sunita, Yadav Satish. (2019). The Effect of Bladder and Lumbar Stimulation Technique for Collection of Urine in Newborns. American Journal of Pediatrics, 5(2), 64-69. https://doi.org/10.11648/j.ajp.20190502.15

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    ACS Style

    Rajbanshi Mamta; Karn Basant Kumar; Yadav Upendra; Shah Sunita; Yadav Satish. The Effect of Bladder and Lumbar Stimulation Technique for Collection of Urine in Newborns. Am. J. Pediatr. 2019, 5(2), 64-69. doi: 10.11648/j.ajp.20190502.15

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    AMA Style

    Rajbanshi Mamta, Karn Basant Kumar, Yadav Upendra, Shah Sunita, Yadav Satish. The Effect of Bladder and Lumbar Stimulation Technique for Collection of Urine in Newborns. Am J Pediatr. 2019;5(2):64-69. doi: 10.11648/j.ajp.20190502.15

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  • @article{10.11648/j.ajp.20190502.15,
      author = {Rajbanshi Mamta and Karn Basant Kumar and Yadav Upendra and Shah Sunita and Yadav Satish},
      title = {The Effect of Bladder and Lumbar Stimulation Technique for Collection of Urine in Newborns},
      journal = {American Journal of Pediatrics},
      volume = {5},
      number = {2},
      pages = {64-69},
      doi = {10.11648/j.ajp.20190502.15},
      url = {https://doi.org/10.11648/j.ajp.20190502.15},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajp.20190502.15},
      abstract = {Background: Sign and symptoms of urinary tract infections (UTI) are not specific in infants and young children, fever being the commonest sign. Therefore, collecting urine samples for culture is required to diagnose or exclude UTI. Obtaining a clean catch urine sample in neonates and infants is a great challenge as it is unpredictable, time consuming and requires lot of patience. Objectives: The objectives of the study were to determine the effect of bladder and lumbar stimulation technique (BLST) for collection of midstream urine in newborns and to evaluate contamination rates of urine samples collected. Methods: An experimental research was conducted in BPKIHS, Dharan, Nepal including total of 54 term newborns. Urine culture was indicated for different reasons to the admitted newborns. They were randomly assigned either to the experimental group or the control group. Twenty-five minutes after feeding, the genitals and perineal area of the babies were cleaned. The newborns were held under the armpits with legs dangling. Bladder and Lumbar stimulation technique was only applied to the newborns in the experimental group. Success was defined as collection of urine sample within 5 minutes (<300s) of starting the stimulation maneuver in the experimental group and of holding under the armpits in the control group. Results: The success rate of urine collection was significantly higher in the experimental group (88.88%) than in the control group (25.92%) p<0.001. The median time for sample collection was 1.07 minutes (64.2s) [IQR=1.52minutes (91.2s)] in experimental group and 1.52minutes (91.2s) [IQR= 2.78 minutes (166.8s) for control group (p=0.069). Contamination was not found in urine samples collected by BLST in experimental group. Conclusion: The study suggests that bladder and lumbar stimulation technique is safe, quick and effective way of collecting midstream clean catch urine in newborns.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - The Effect of Bladder and Lumbar Stimulation Technique for Collection of Urine in Newborns
    AU  - Rajbanshi Mamta
    AU  - Karn Basant Kumar
    AU  - Yadav Upendra
    AU  - Shah Sunita
    AU  - Yadav Satish
    Y1  - 2019/06/04
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ajp.20190502.15
    DO  - 10.11648/j.ajp.20190502.15
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 64
    EP  - 69
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20190502.15
    AB  - Background: Sign and symptoms of urinary tract infections (UTI) are not specific in infants and young children, fever being the commonest sign. Therefore, collecting urine samples for culture is required to diagnose or exclude UTI. Obtaining a clean catch urine sample in neonates and infants is a great challenge as it is unpredictable, time consuming and requires lot of patience. Objectives: The objectives of the study were to determine the effect of bladder and lumbar stimulation technique (BLST) for collection of midstream urine in newborns and to evaluate contamination rates of urine samples collected. Methods: An experimental research was conducted in BPKIHS, Dharan, Nepal including total of 54 term newborns. Urine culture was indicated for different reasons to the admitted newborns. They were randomly assigned either to the experimental group or the control group. Twenty-five minutes after feeding, the genitals and perineal area of the babies were cleaned. The newborns were held under the armpits with legs dangling. Bladder and Lumbar stimulation technique was only applied to the newborns in the experimental group. Success was defined as collection of urine sample within 5 minutes (<300s) of starting the stimulation maneuver in the experimental group and of holding under the armpits in the control group. Results: The success rate of urine collection was significantly higher in the experimental group (88.88%) than in the control group (25.92%) p<0.001. The median time for sample collection was 1.07 minutes (64.2s) [IQR=1.52minutes (91.2s)] in experimental group and 1.52minutes (91.2s) [IQR= 2.78 minutes (166.8s) for control group (p=0.069). Contamination was not found in urine samples collected by BLST in experimental group. Conclusion: The study suggests that bladder and lumbar stimulation technique is safe, quick and effective way of collecting midstream clean catch urine in newborns.
    VL  - 5
    IS  - 2
    ER  - 

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Author Information
  • Department of Nursing, Yeti Health Science Academy, Maharajgunj, Kathmandu, Nepal

  • Department of Child Health Nursing, B. P. Koirala Institute of Health Sciences, Dharan, Nepal

  • Department of Child Health Nursing, B. P. Koirala Institute of Health Sciences, Dharan, Nepal

  • Norvic Institute of Nursing Education, Maharajgunj, Kathmandu, Nepal

  • Department of Pediatric and Adolescent Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal

  • Section