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Review
. 2021 Jul;36(7):1697-1708.
doi: 10.1007/s00467-020-04742-w. Epub 2020 Sep 12.

Urine collection methods and dipstick testing in non-toilet-trained children

James Diviney  1 , Mervyn S Jaswon  2   3
Affiliations
Review

Urine collection methods and dipstick testing in non-toilet-trained children

James Diviney et al. Pediatr Nephrol. 2021 Jul.

Erratum in

Abstract

Urinary tract infection is a commonly occurring paediatric infection associated with significant morbidity. Diagnosis is challenging as symptoms are non-specific and definitive diagnosis requires an uncontaminated urine sample to be obtained. Common techniques for sampling in non-toilet-trained children include clean catch, bag, pad, in-out catheterisation and suprapubic aspiration. The pros and cons of each method are examined in detail in this review. They differ significantly in frequency of use, contamination rates and acceptability to parents and clinicians. National guidance of which to use differs significantly internationally. No method is clearly superior. For non-invasive testing, clean catch sampling has a lower likelihood of contamination and can be made more efficient through stimulation of voiding in younger children. In invasive testing, suprapubic aspiration gives a lower likelihood of contamination, a high success rate and a low complication rate, but is considered painful and is not preferred by parents. Urine dipstick testing is validated for ruling in or out UTI provided that leucocyte esterase (LE) and nitrite testing are used in combination.

Keywords: Clean catch; Dipstick testing; In-out catheterisation; Suprapubic aspiration; UTI; Urinary tract infection; Urine sampling.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

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