Paediatrics: Suprapubic aspiration of urine

Suprapubic aspiration of urine

Optimal method for obtaining urine for bacteriology in a child <2yr old.

Equipment

• 21–23G needle.
• 2–5mL syringe.
• An alcohol impregnated swab.
• Sterile urine sample container.
• Cotton wool or gauze swab and adhesive plaster.

Procedure

• Wait at least 30min from last urination.
• If in doubt as to whether the bladder contains adequate urine, perform bladder US to confirm.
• Place child supine (with an assistant holding hips abducted) and then identify site—midline anterior lower abdominal wall 1cm above the pubic bone.
• Clean site with an alcohol impregnated swab.
• Insert needle connected to the syringe at 90° to the skin, aspirating continuously until urine is obtained.
• Insert to almost the depth of the needle. If no urine is obtained, partially withdraw it before inserting again at different angle.
• Once required urine is aspirated, remove the needle, press on puncture site with cotton wool or gauze swab, and then apply an adhesive plaster.
• Place urine in sterile container.
• If unsuccessful, repeat the procedure 30–60min later.