Success rate of BladderScan-assisted suprapubic aspiration

Suprapubic aspiration (SPA) is the gold standard for obtaining uncontaminated urine specimens in young febrile children. The use of real-time ultrasound (RTUS) has been shown to increase the success rate of SPA. The BladderScan (BSUS) Verathon(®) is an alternative portable ultrasound device designed to provide automated measurement of bladder volume. Although simple and requiring minimal training, there are no data on the success rate of SPA using the device.

An audit of current SPA practice using BSUS in the ED of a tertiary referral children's hospital was conducted. We assessed the success rate of SPA to obtain urine and correlate with BSUS readings and techniques.

Sixty SPAs (mean age 5.0 months) were observed over an 8-month period between August 2009 and March 2010. The audit showed an overall success rate of 53% (32/60) [95% confidence interval 41-66%]. Success rates were 63%, 32%, 82% and 63% for the largest BSUS readings of 0-9 mL (n = 8), 10-19 mL (n = 25), 20-29 mL (n = 11) and 30+ mL (n = 16), respectively, or 39% at <20 mL and 70% at ≥20 mL (P = 0.02).

The success rate of SPA in 'real-life' non-standardised clinical practice was low at 53% overall. The BSUS-assisted SPA success rate was higher in patients with readings ≥20 mL. These rates are lower than success rates reported using RTUS. Parameters for using BSUS to assist SPA should be established.