Can the Bladder Stimulation Technique Solve the Urine Collection Chaos in the Pediatric Emergency Department? A...

Background/Objectives: Non-invasive urine collection in the pediatric emergency department (ED) is frequently complicated by prolonged collection times and unacceptably high contamination rates associated with the traditional bag specimen urine (BSU) method. This prospective study aimed to compare the operational efficiency and diagnostic reliability of the bladder stimulation technique (BST)-a highly promising alternative-against the traditional BSU method. Methods: The study included 149 infants aged ≤ 6 months (BST group: n = 81; BSU group: n = 68) requiring urinalysis. We systematically evaluated procedural success rates, time-to-collection metrics, and sample contamination frequencies. Furthermore, we assessed the influence of patient age, weight, behavioral state, and sex on BST efficacy. Results: The BST demonstrated superior clinical performance, significantly reducing the total mean time-to-collection to 21 min, compared to 60 min-often extending up to 4 h-typically required for BSU. Notably, the actual stimulation maneuver required only about 78 s. While approximately half of the BSU samples were contaminated, BST markedly decreased this rate (16% vs. 58%). Factors associated with the highest procedural success included patient age ≤ 3 months, weight ≤ 6000 g, and remaining calm during the procedure. Infant sex did not significantly affect success rates. Conclusions: Functioning as both an "operational accelerator" and a "diagnostic firewall," the BST mitigates the inherent limitations of conventional methods and has the potential to replace the traditional urine bag. By offering a rapid, predictable, and clean alternative, it facilitates the swift initiation of accurate treatment and helps prevent families from leaving the ED before sample collection.