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Quick-Wee versus bladder stimulation to collect midstream urine from precontinent infants under 1 year of age: a
Sarah Marchal1, Jade Janicot2, Julie Salicis3
1Service des Urgences Pédiatriques, Hôpitaux Pédiatriques de Nice CHU-LENVAL, Nice, France marchal.s@pediatrie-chulenval-nice.fr.
Insights
Collecting urine samples from infants can be challenging. This study compares two methods, bladder stimulation and the Quick-Wee method, to find the most effective way to obtain urine samples for infection diagnosis in infants.
Area of Science:
- Pediatric emergency medicine
- Urology
- Infectious disease diagnostics
Background:
- Urinary tract infections (UTIs) are common in infants, but diagnosis is difficult due to non-specific symptoms and contamination risks with current urine collection methods.
- Standard methods like transurethral catheterization and suprapubic aspiration are invasive, while clean catch methods are challenging in pre-continent infants.
- Newer, less invasive techniques like bladder stimulation and the Quick-Wee method have been proposed for urine sample collection.
Purpose of the Study:
- To compare the effectiveness of bladder stimulation versus the Quick-Wee method for collecting midstream urine in infants under one year old.
- To evaluate the success rate, time to collection, infant comfort, and urine quality for both methods.
Main Methods:
- A multicenter randomized controlled trial involving 230 infants under one year of age requiring urine analysis.
- Infants were randomized into two groups: one receiving bladder stimulation and the other the Quick-Wee method.
- The primary endpoint was the success rate of voiding at least 2 mL of urine within 5 minutes.
Main Results:
- The study aims to determine the success rate of voiding at least 2 mL of urine in less than 5 minutes for both methods.
- Secondary outcomes include time to collect urine, infant comfort, urine quality, and risk factors for failure.
- Results will be published in a peer-reviewed journal.
Conclusions:
- This study will provide valuable data on the efficacy and safety of two novel methods for urine sample collection in infants.
- Findings will help guide clinical practice towards less invasive and more effective diagnostic procedures for UTIs in young children.
- The research contributes to improving the diagnosis and management of urinary tract infections in pre-continent infants.
Introduction:
Urinary tract infections occur in around 1%-4% of boys and 3%-8% of girls under 2 years old. Diagnosis is difficult because of non-specific symptoms and the risk of urine analysis contamination depending on the sampling method used for precontinent infants. The American Academy of Pediatrics recommend transurethral catheterisation and suprapubic aspiration because of a low contamination rate but these techniques are invasive. On the other hand, while the National Institute for Health and Care Excellence advocate clean catch urine for its minimal invasiveness and acceptable contamination rate, it is difficult to accomplish in precontinent infants. Two recent methods have been described: the Quick-Wee method by Kaufman et al (suprapubic stimulation with cold saline-soaked gauze); and bladder stimulation by Herreros et al then by Tran et al (pubic tapping alternating with lumbar massage). This study aims to compare the effectiveness in collecting midstream urine by bladder stimulation vs the Quick-Wee method in infants under 1 year, before walking.
Methods And Analysis:
This study is a multicentre randomised controlled trial of 230 infants under 1 year and before walking who need urine analysis, conducted in four paediatric emergency departments in France. Patients will be randomised into two groups: bladder stimulation and Quick-Wee method.The primary endpoint will be the success rate of voiding at least 2 mL of urine in less than 5 min.Secondary outcomes are the time to collect at least 2 mL of urine, comfort, quality of urine and the risk factors associated with failure of the two techniques.
Ethics And Dissemination:
The study protocol was approved by the French national ethic committee (consultative committee of the protection of persons). The results of the study will be published in a peer-reviewed journal.
Trial Registration Number:
Clinical Trials Registry - NCT04587999.
Date And Protocol Version Identifier:
October 2020, V.1.
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