Prospective evaluation of a cutaneous stimulation technique to induce on-demand urination in non-toilet-trained infants

Valleix-Leclerc, M.; Bahans, Claire; Tahir, Aqsa; Faubert, S.; Fargeot, A.; Abouchi, S.; Dallocchio, A.; Mussgnug, M.; Guigonis, Vincent

doi:10.1016/j.arcped.2016.05.004

Cited by 10 publications

(18 citation statements)

References 13 publications

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“…Three RCTs,17–19 two non-randomised studies (a feasibility study which compared an intervention at two different temperatures and a comparison of tapping with collection in urine bags)20 21 and six uncontrolled pre–post trials were identified22–27 (tables 1 and 2).…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies other than RCTs were identified and included a total of 729 patients 20–27. Age of participants varied with means ranging from 31.5 hours to 7.5 months (median of 10 months reported in one study).…”

Section: Resultsmentioning

confidence: 99%

“…Age of participants varied with means ranging from 31.5 hours to 7.5 months (median of 10 months reported in one study). Techniques used in these studies included saline-soaked gauze rubbed over the suprapubic region,21 a finger tapping technique,20 while the majority of studies used the finger tapping and lumbar paravertebral massage technique22–27 described by Herreros Fernández et al (tables 2 and 5). 22…”

Section: Resultsmentioning

confidence: 99%

“…Quality of the non-randomised and observational studies was assessed using the Downs and Black tool and was found to be poor with scores of less than 14 in six of the eight20–24 27 and fair in the remaining two 25 26…”

Section: Resultsmentioning

confidence: 99%

“…Six studies used the tapping plus lumbar paravertebral massage technique 22–27. Voiding within a pre-specified time was reported in five studies testing the tapping plus massage technique: three studies reported rates within 5 min of 27%, 49% and 86%, respectively 22 25 26. One study reported voiding within 4 min and a success rate of 91%,27 and another reported voiding within 3 min with a success rate of 56% 24.…”

Section: Resultsmentioning

confidence: 99%

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Non-invasive techniques for stimulating urine production in non-toilet trained children: a systematic review

et al. 2020

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BackgroundUrinary tract infection requires collection of a sterile urine specimen for diagnosis, which is difficult and time consuming in pre-continent children. This systematic review summarises evidence of the effectiveness of bladder stimulation techniques on urine collection in pre-continent children, compared with standard techniques.MethodsMEDLINE, PubMed, EMBASE and CINAHL were searched to May 2019. Selection, data extraction, risk of bias and quality assessment were undertaken by two independent reviewers. Inclusion: (1) all study designs; (2) pre-continent, age <3 years receiving bladder stimulation techniques; (3) outcomes including time to urine collection or contamination rates; (4) English-language articles. Exclusion: coexisting neurological disorders.ResultsThree randomised controlled trials (RCTs) were identified using three techniques in 568 participants aged 1 day to 35 months. Two RCTs demonstrated an increased success in voiding within 5 min, one using a finger tapping and lumbar paravertebral massage technique and the other cold saline-soaked gauze rubbed over the suprapubic region, compared with no active intervention. A third RCT using a mechanical vibration device demonstrated no difference in time to voiding from advice alone. Non-randomised studies compared different temperatures for the gauze intervention and tapping alone versus urine bags. Six uncontrolled studies tested the finger tapping and massage technique. Risk of bias was low for one RCT and unclear for two RCTs with the other studies rated poor to fair quality. Overall, the evidence on success rates was graded low for tapping plus massage and moderate for the gauze rubbing intervention. Adverse effects included crying and mild distress.DiscussionThe results suggest a positive effect of stimulation techniquesbut lack of replication in rigorous RCTs and heterogeneity of techniques and outcomes assessed prevent conclusive recommendations being made. Further RCTs are required comparing non-invasive stimulation methods and assessing time to successful collection, contamination rates, adverse effects, caregiver and clinical staff acceptability.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Non-invasive techniques for stimulating urine production in non-toilet trained children: a systematic review

et al. 2020

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

Diviney

Jaswon

2020

Pediatr Nephrol

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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.

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Urine collection methods used for non-toilet-trained children in pediatric emergency departments in France: A medical practice analysis

Cousin

Ryckewaert

Jorna

et al. 2019

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Prospective evaluation of a cutaneous stimulation technique to induce on-demand urination in non-toilet-trained infants

Cited by 10 publications

References 13 publications

Non-invasive techniques for stimulating urine production in non-toilet trained children: a systematic review

Non-invasive techniques for stimulating urine production in non-toilet trained children: a systematic review

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

Urine collection methods used for non-toilet-trained children in pediatric emergency departments in France: A medical practice analysis

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