Does perception of catheterization limit its use in pediatric UTI?

Selekman, Rachel E.; Sanford, Melissa T.; Ko, Lauren N.; Allen, I. Elaine; Copp, Hillary L.

doi:10.1016/j.jpurol.2016.09.006

Cited by 17 publications

(11 citation statements)

References 15 publications

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“…Usual care will vary according to these factors, though in some settings urethral catherisation or suprapubic aspiration is already the dominant practice 20. Quality of life was not included in this study, but children’s pain and parents distress are important considerations 29…”

Section: Discussionmentioning

confidence: 99%

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Liquid gold: the cost-effectiveness of urine sample collection methods for young precontinent children

et al. 2019

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BackgroundUrinary tract infection (UTI) is a common childhood infection. Many febrile children require a urine sample to diagnose or exclude UTI. Collecting urine from young children can be time-consuming, unsuccessful or contaminated. Cost-effectiveness of each collection method in the emergency department is unknown.ObjectiveTo determine the cost-effectiveness of urine collection methods for precontinent children.MethodsA cost-effectiveness analysis was conducted comparing non-invasive (urine bag, clean catch and 5 min voiding stimulation for clean catch) and invasive (catheterisation and suprapubic aspirate (SPA)) collection methods, for children aged 0–24 months in the emergency department. Costs included equipment, staff time and hospital bed occupancy. If initial collection attempts were unsuccessful subsequent collection using catheterisation was assumed. The final outcome was a definitive sample incorporating progressive dipstick, culture and contamination results. Average costs and outcomes were calculated for initial collection attempts and obtaining a definitive sample. One-way and probabilistic sensitivity analyses were performed.ResultsFor initial collection attempts, catheterisation had the lowest cost per successful collection (GBP£25.98) compared with SPA (£37.80), voiding stimulation (£41.32), clean catch (£52.84) and urine bag (£92.60). For definitive collection, catheterisation had the lowest cost per definitive sample (£49.39) compared with SPA (£51.84), voiding stimulation (£52.25), clean catch (£64.82) and urine bag (£112.28). Time occupying a hospital bed was the most significant determinant of cost.ConclusionCatheterisation is the most cost-effective urine collection method, and voiding stimulation is the most cost-effective non-invasive method. Urine bags are the most expensive method. Although clinical factors influence choice of method, considering cost-effectiveness for this common procedure has potential for significant aggregate savings.

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Section: Discussionmentioning

confidence: 99%

“…We did not include parental costs such as travel and time off work, although these would likely strengthen conclusions given parental costs likely reflect time taken. Quality of life was not included, but children’s pain and parents’ distress are important considerations 28 29…”

Section: Discussionmentioning

confidence: 99%

Liquid gold: the cost-effectiveness of urine sample collection methods for young precontinent children

et al. 2019

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“…[4][5][6] Although the preferred source of urine collection is transurethral bladder catheterization in young patients unable to provide a midstream voided collection, parents often refuse the procedure because of perceived pain. 7,8 Robust literature exists to support the use of lidocaine gel before transurethral bladder catheterization to reduce procedural pain among adults. 9,10 However, the literature evaluating urethral lidocaine in children is inconsistent.…”

Section: Commentarymentioning

confidence: 99%

Does Lidocaine Gel Decrease Procedural Pain for Pediatric Urethral Catheterization?

Long

April

2018

Annals of Emergency Medicine

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“…3 Catheterization is also associated with adverse effects in over 20% of patients including dysuria, genital pain, urinary retention, and gross hematuria, 4 and can cause "extreme distress" in parents observing their child's catheterization. 5 Instead, some EDs routinely place urine bags to avoid an intrusive procedure. Although this method is non-invasive, urine bags have a high contamination rate, making it unreliable for culture.…”

Section: Introductionmentioning

confidence: 99%

Reducing infant catheterization in the emergency department through clean‐catch urine collection

2020

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Does perception of catheterization limit its use in pediatric UTI?

Cited by 17 publications

References 15 publications

Liquid gold: the cost-effectiveness of urine sample collection methods for young precontinent children

Liquid gold: the cost-effectiveness of urine sample collection methods for young precontinent children

Does Lidocaine Gel Decrease Procedural Pain for Pediatric Urethral Catheterization?

Reducing infant catheterization in the emergency department through clean‐catch urine collection

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