Urine Collection Pads Research Articles

The Reliability of Iodine Concentration in Diaper-Retrieved Infant Urine Using Urine Collection Pads, and in Their Mothers’ Breastmilk

Mild to moderate iodine deficiency is common among women of childbearing age. Data on iodine status in infants are sparse, partly due to the challenges in collecting urine. Urinary iodine concentration (UIC) is considered a good marker for recent dietary iodine intake and status in populations. The aim of this study was to investigate the reliability of iodine concentration measured in two spot-samples from the same day of diaper-retrieved infant urine and in their mothers’ breastmilk. We collected urine and breastmilk from a sample of 27 infants and 25 mothers participating in a cross-sectional study at two public healthcare clinics in Norway. The reliability of iodine concentration was assessed by calculating the intraclass correlation coefficients (ICC) and the coefficient of variation (CV). The ICC for infants’ urine was 0.64 (95% confidence interval (CI) 0.36–0.82), while the ICC for breastmilk was 0.83 (95% CI 0.65–0.92) Similarly, the intraindividual CV for UIC was 0.25 and 0.14 for breastmilk iodine concentration (BIC). Compared to standard methods of collecting urine for measuring iodine concentration, the diaper-pad collection method does not substantially affect the reliability of the measurements.

Non-Invasive Urine Sampling in Infants: A Review Paper

Good quality urine samples play a crucial role in establishing an early and accurate diagnosis of urinary tract infection in infants. Invasive methods are more reliable but cause pain and discomfort in infants as well as anxiety in clinicians and parents. The current available non-invasive methods are less efficient and produce low quality urine samples being less apprehensive in infants and parents. To date, no studies have been conducted in South East Asia, including Malaysia, to identify the most feasible non-invasive urine sampling method. This literature review aimed to compare various non-invasive urine sample collection methods (bladder stimulation techniques, standard clean-catch urine, urine collection pads and urine bags) which could be more feasible for a district hospital setting in Malaysia. In total, 17 studies were included and reviewed. This review concluded that bladder stimulation techniques are potentially good and feasible alternatives to the current common practices in Malaysia (standard clean-catch urine and catherization) due to its high success rate, fast collection and low contamination rate. There is a higher likelihood to implement these techniques in a tertiary setting if further research on bladder stimulation techniques is found feasible in a less resourceful district hospital setting.

Erosional injuries inflicted by a home‐made urine collection device: a case report and beyond

ABSTRACTWith a progressive growth of the elderly population in China, cerebrovascular accidents are increasing rapidly. As one of the most common consequences, urinary incontinence management in a long‐term (LT) home health care (HHC) setting has been emerging as a huge challenge for society. We report here a case of erosional penile and urethral injuries identified in an elderly male patient with urinary incontinence. In this case, the improper use of an external, homemade urine collection device in a LT HHC setting may very well be responsible for the medical complications identified in this patient. Noticeably, urine collection pads had been tied with knots at the base of the penis to secure the device in the patient's routine urinary incontinence HHC practice. Eczematoid dermatitides, cutaneous ulceration and scarring erosion induced by LT excessive extrinsic compression were observed on the genitalia and perineal areas. Urinary tract infection was also confirmed by urine culture. Antibiotics were administered, and suprapubic cystostomy was performed afterwards. This case highlights the importance of careful inspection of external urine collection devices focusing on risk assessment and prevention of pressure ulceration, as well as continuous patient/caregiver education/support for proper urinary incontinence management in a LT HHC setting.

A prospective comparative pilot study comparing the urine collection pad with clean catch urine technique in non-toilet-trained children

IntroductionThere are many different methods for collecting urine from paediatric patients in emergency departments. Therefore, the aims of the study were to:(i)Compare the contamination rate of urine collection pad samples (UCP) and clean catch urine (CCU).(ii)Compare the time taken for each urine collection technique.(iii)Undertake a comparative cost analysis of the two urine collection techniques.(iv)Survey parents/carers perceptions of the two urine collection techniques. MethodsThe three month study was a prospective non-randomised comparative paediatric pilot study. A purposeful sample of children, requiring a urine microscopy for clinical management, presenting to one district emergency department was enrolled in the study to compare two non-invasive techniques of urine collection. ResultsThirty-three patients were enrolled and satisfactory samples were obtained from 22 patients. The heavy (mixed growth) contamination rate in the UCP group (n=2; 9.1%) versus the CCU group (n=1; 4.5%) was not statistically significant (p=0.50 by Fisher’s exact test). The rate of agreement (n=20; 91%) in diagnosing or excluding urinary tract infection between the two groups was high. The median time to urine collection between the two groups (UCP method 30min; CCU 107.5min) was statistically significant (p<0.002, Mann–Whitney U test). ConclusionsThis study suggests that UCPs are practicable in Australasian Emergency Departments and may lead to faster diagnosis, disposition and reduced hospital stay.

Reliable laboratory urinalysis results using a new standardised urine collection device

ObjectivesWhile urine sampling is necessary in the diagnosis of urinary tract infection and electrolyte disturbances, the collection of urine in neonates and non-toilet-trained children is often difficult. A universal urine collection method providing representative urinalyses results is needed. The objective of this study is to evaluate the applicability of the currently used urine collection pads (gauze compresses) and a new urine collection device (Peespot). Design and methodsWe tested the reliability of routine (semi-)quantitative urinalysis results with these two different kinds of urine collection methods in a laboratory model. Although important in clinical diagnosis, we did not evaluate the effects on cellular and other components such as casts in the urinary sediment. ResultsMost semi-quantitative variables determined by urine stick (pH, blood, protein, leukocytes, nitrite, glucose, ketones, bilirubin and urobilinogen) gave concordant results for both methods compared with native urine. Using the Peespot urine collection device, reliable quantitative results were obtained for calcium, chloride, glucose, magnesium, phosphate, potassium, sodium, osmolality, urea nitrogen and urate compared with native urine. Data were concordant only for chloride, phosphate, glucose, sodium and urea nitrogen by use of gauze compresses. ConclusionsUrine collection pads are non-invasive methods useful in the collection of urine in non-toilet-trained children. Because of better practical standardisation and more reliable (semi-) quantitative urinalysis results, the Peespot urine collection device is preferred for the collection of urine.

Reliability of urine collection pads for routine and metabolic biochemistry in infants and young children

The aim of our study was to evaluate whether specifically designed urine collection pads give reliable results for routine and metabolic biochemistry tests in paediatric urine. Urine collected by bag or clean-catch from infants and children <2 yrs without metabolic disorders was divided into two aliquots, one of which was added to a collection pad, incubated for 15 min at 37 degrees C (simulating in vivo collection conditions), then recovered by aspiration. Urine from adults with phaeochromocytoma and aqueous solutions of catecholamines were similarly treated. Routine, catecholamine, and metabolic analyses were performed on pad/non-pad aliquots. Selected metabolic analyses were also performed on pad/non-pad urine from patients with diagnosed inborn errors and urine containing added metabolites to simulate metabolic disorders. Routine tests (urea, electrolytes, creatinine, osmolality, calcium:creatinine, phosphate:creatinine, magnesium:creatinine, urate:creatinine [n = 32], oxalate:creatinine [n = 10]), and catecholamines (n = 12) showed good or acceptable concordance with no clinically significant pad/non-pad differences. Metabolic tests in infants and children without metabolic disorders all showed good pad/non-pad concordance for amino acids (n = 10), organic acids (n = 12), and glycosaminoglycans (n = 8). In patients with metabolic disorders (phenylketonuria [n = 1], homozygous/heterozygous cystinuria [n = 3], mucopolysaccharidoses II [n = 2] and III [n = 1], organic acid disorders [n = 6]) and urine containing added orotic acid to simulate urea cycle disorders, there was also good pad/non-pad concordance for diagnostic urinary metabolites. No extraneous organic acids were eluted from the pads. Sugar chromatography showed identical staining intensity in pad/non-pad samples. In conclusion, urine collection pads give reliable results for a wide range of routine and metabolic biochemistry tests in urine from paediatric patients.

Audit on the use of magnesium sulphate in asthma

Introduction: It is often difficult to collect urine from infants. The use of specifically designed urine collection pads gives reliable results for routine biochemistry tests of adult urine. Paediatric urine may have a different composition, and whether these pads give reliable results for metabolic investigations is unknown. Our aim was to evaluate whether the pads give reliable results for routine and metabolic biochemistry tests in paediatric urine. Methods: Urine collected by bag or clean-catch from infants under 2 years of age without metabolic disorders was divided into two aliquots, one of which was added to a collection pad, incubated for 15 minutes at 37 °C and then recovered by aspiration. Routine and metabolic analyses were performed on pad/ non-pad aliquots. Additionally, selected metabolic analyses were performed on pad/non-pad urine from patients with diagnosed inborn errors and urine spiked to simulate metabolic disorders. For quantitative analyses, pad/non-pad results were compared using Bland–Altman bias plots, Passing and Bablok regression and paired t-tests. Results: Routine tests (urea, electrolytes, creatinine, osmolality, calcium:creatinine, phosphate:creatinine, magnesium: creatinine, urate:creatinine; n = 32) showed close concordance with no clinically significant pad/non-pad differences. In infants without metabolic disorders, amino acids (n = 10), organic acids (n = 12) and mucopolysaccharides (n = 8), and in patients with metabolic disorders – phenylketonuria (n = 1), mucopolysaccharidoses II (n = 2) and III (n = 1), inborn errors of organic acid metabolism (n = 6) and cystinuria (n = 3) – all showed excellent pad/non-pad concordance. Sugar chromatography showed identical staining intensity in pad/non-pad samples. Conclusions: Urine collection pads give reliable results for a wide range of routine and metabolic tests in paediatric urine.

Obtaining urine for culture from non-potty-trained children

The accurate diagnosis of urinary tract infection (UTI) in young children is important for initial management and the prevention of long-term damage to the developing kidney. Various methods are used for urine collection from the non-potty-trained age group, including catheterisation, suprapubic aspiration, clean-catch sampling, adhesive bag sampling and urine collection pads. Research literature was examined to identify which method is most effective. The themes that evolved from the review were parents' and nurses' views on ease of use, reliability of sample obtained and cost-effectiveness. Although not the most convenient method, clean-catch gives more reliable results making it also the most cost effective approach. Change management strategies are required to overcome barriers to research implementation and to ensure best practice.

Changing a urine collection pad (UCP) every 30 minutes reduced contamination of urine samples more than a UCP kept in the nappy in children with suspected urinary tract infection

Changing a urine collection pad (UCP) every 30 minutes reduced contamination of urine samples more than a UCP kept in the nappy in children with suspected urinary tract infection

Urine collection pads: are samples reliable for urine biochemistry and microscopy?

The aim of the study was to validate the reliability of samples obtained with urine collection pads (UCP) for selected laboratory biochemical analyses, urine cell microscopy, and bedside semi-quantitative stick urinalysis. A series of laboratory experiments was performed to test agreement between urine concentrations, or results, before and after passage through a UCP (incubated for 37 degrees C for 15 min). The following urinalyses were performed: electrolytes, calcium, phosphate, urate, osmolality, pH, protein, catecholamines, toxicology for drugs of abuse, stick urinalysis for glucose, ketones, protein, blood, leucocytes and nitrites, and microscopy for red and white cells. Close agreement was shown for all laboratory analyses except proteinuria, which was underestimated by, on average, 10% after UCP passage. However, stick urinalysis for proteinuria remains sufficiently reliable for clinical use. UCP substantially retain or destroy red and white cells, but stick urinalysis for blood and leucocyte esterase remains reliable. In conclusion, urine samples derived from UCP show good agreement across a clinically relevant range for the biochemical analyses undertaken in this study. Microscopy of UCP samples is unreliable for cellular material but semi-quantitative stick urinalysis for red and white cells is a satisfactory alternative.

New urine collection pad method improves diagnosis

New urine collection pad method improves diagnosis

An improved urine collection pad method: a randomised clinical trial

Aim: To evaluate a modified urine collection pad (UCP) method for its ability to reduce heavy mixed growth bacterial contamination of UCP samples in young children with suspected urinary tract...

A method comparison study to assess the reliability of urine collection pads as a means of obtaining urine specimens from non‐toilet‐trained children for microbiological examination

In young, non-toilet-trained children, the collection of a urine sample for microbiology can be challenging, with the application of a urine bag being the main method of collection. However, recent research has shown that absorbent pads can be used yielding similar results to bag specimens. However, weaknesses in study design erode confidence in research findings. Therefore, improvements in research design are required to fully evaluate the reliability of pad collection. This pilot study sought to test the feasibility of a technique for the collection of concurrent bag/pad urine samples from non-toilet-trained children, and to assess the reliability of urine pads over bags as a collection method for urine specimens for microbiological evaluation. A pilot, method comparison study. Twenty concurrent bag and pad specimens were collected from non-toilet-trained children, following parental consent. Urine specimens were analysed for presence or absence of white cell count (WBC), and bacterial growth, using standard laboratory methods. The Kappa (kappa) statistics and confidence interval (CI) estimation were used to assess agreement between the two collection methods. Despite concurrent samples there was a lack of agreement between bag and pad specimens on both main outcome measures. Agreement between bag and pad specimens for the presence of WBC yielded a kappa=0.10 (95% CI: 0.19, 0.39), indicating poor agreement, while a kappa of 0.5 (95% CI: 0.12, 0.88) was calculated for the degree of agreement in bacterial growth reflecting moderate agreement. Differences in proportions of the presence of WBC between bag and pad did not quite reach significance at the 5% level 0.2 (95% CI: 0.00, 0.42, P=0.062). For cultures the difference was calculated as 0.15 (95% CI: 0.05, 0.35, P=0.125). The pilot study demonstrates that concurrent urine samples can be obtained without difficulty. Despite poor to moderate agreement on outcome measures the level of agreement is greater than reported in those other studies, that use non-current methods of urine collection, suggesting an advantage of the concurrent technique. It is recommended that larger scale studies be undertaken using the concurrent collection technique to assess reliability of these findings.

How quickly do urine collection pads trap white blood cells?

How quickly do urine collection pads trap white blood cells?

Are Newcastle urine collection pads suitable as a means of collecting specimens from infants?

The collection of uncontaminated urine specimens from infants is not straightforward. This quasi-experimental study was designed to investigate whether 'Newcastle urine collection pads' are suitable for this purpose. A minimum of two urine specimens were collected from 50 children aged one day to five years, one using a pad and the other by using a sterile adhesive bag. Since pad specimens successfully demonstrated the presence of urinary tract infection and a lower contamination rate than bag specimens; it is concluded that they are suitable. Pad specimens contained fewer cells than bag specimens, which must be acknowledged by clinicians.

Clean-Catch versus urine collection pads: a prospective trial

Two methods for collecting urine samples from very young children were compared in a paediatric ward of a busy district general hospital. Samples collected using urine collection pads were compared to the standard clean-catch method using sterile foil bowls. No significant differences were observed in the outcome of tests from samples collected by the two methods over the course of a short nurse-led trial, and the hospital has adopted the urine collection pad for routine paediatric UTI sampling.

Urine collection pads overlooked

Urine collection pads overlooked