Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2019 Mar/Apr;25(2):e28-e33.
doi: 10.1097/SPV.0000000000000693.

A Cross-sectional Pilot Cohort Study Comparing Standard Urine Collection to the Peezy Midstream Device for Research Studies Involving Women

Elizabeth Southworth, Baylie Hochstedler  1 , Travis K Price  1 , Cara Joyce  2 , Alan J Wolfe  1 , Elizabeth R Mueller
Affiliations
Randomized Controlled Trial

A Cross-sectional Pilot Cohort Study Comparing Standard Urine Collection to the Peezy Midstream Device for Research Studies Involving Women

Elizabeth Southworth et al. Female Pelvic Med Reconstr Surg. 2019 Mar/Apr.

Abstract

Objectives: The expanded quantitative urine culture protocol was used to compare the microbial abundance and diversity of voided urines obtained using a standard urine collection or using the Peezy midstream device versus paired periurethral specimens.

Methods: Sixty-two female participants were assigned to 1 of 3 cohorts. One cohort used a standard clean catch midstream urine protocol that included a castile soap wipe, the second cohort used a Peezy midstream collection device with castile soap wipe and the third used the Peezy device without a castile soap wipe. Each participant watched a video that detailed the collection method. Before using the castile soap wipe, a periurethral swab was obtained to measure periurethral microbial abundance. Demographics and pelvic floor symptoms were assessed by validated questionnaires. Microbes were detected using expanded quantitative urine culture. Diversity within each sample was analyzed using alpha diversity measures.

Results: Paired periurethral and urine samples for each woman were analyzed and compared for species abundance, richness, and diversity. Bacterial profiles of Peezy-collected urines differed significantly by multiple diversity indices and had significantly reduced colony-forming units compared to paired periurethral swabs. In contrast, within the standard clean catch cohort, voided urine had higher abundance and richness than paired periurethral swabs.

Conclusions: Compared with standard clean catch method, the Peezy urine collection device with and without the castile soap wipe resulted in urine with lower bacterial abundance that was distinct from the periurethra. Voided urine collected by Peezy may reduce postbladder microbial contribution.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST STATEMENT:

Dr. Mueller discloses research support from Astellas, Advisory board position with Boston Scientific and legal consultation with Butler-Snow/Ethicon. Dr. Wolfe discloses research support from Astellas and Kimberly Clark. The remaining authors (Southworth and Hochstedler) report no disclosures.

Figures

Figure 1:
Figure 1:. Participant flow.
There were no losses or exclusions after randomization. Recruitment began June 2017 and ended February 2018.
Figure 2:
Figure 2:. Comparison of diversity between Peezy and SCC cohorts.
Diversity measures for voided urines were compared to the paired peri-urethral swab. Median values are marked with black lines. Significant differences are denoted with underlined p values (see also Supplemental Table 1).
See this image and copyright information in PMC

References

    1. Wolfe AJ, Toh E, Shibata N, et al. Evidence of uncultivated bacteria in the adult female bladder. J Clin Microbiol. 2012;50(4):1376–83. - PMC - PubMed
    1. Hilt EE, McKinley K, Pearce MM, et al. Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder. J Clin Microbiol. 2014;52(3):871–6. - PMC - PubMed
    1. Pearce MM, Hilt EE, Rosenfeld AB, et al. The female urinary microbiome: a comparison of women with and without urgency urinary incontinence. mBio. 2014;5:4. - PMC - PubMed
    1. Price TK, Dune TD, Hilt EE, et al. The clinical urine culture: enhanced techniques improve detection of clinically relevant microorganisms. J Clin Microbiol. 2016;54:1216–1222. - PMC - PubMed
    1. Khasriya R, Sathiananthamoorthy S, Ismail S, Kelsey M, et al. Spectrum of bacterial colonization associated with urothelial cells from patients with chronic lower urinary tract symptoms. J Clin Microbiol. 2013;51(7):2054–62. - PMC - PubMed

Publication types