Effectiveness of the Bladder Stimulation Technique for Infant Urine Collection in the Pediatric Emergency Department: A Randomized Controlled Trial.

INTRODUCTION: Collecting urine samples from nontoilet-trained infants is challenging and time-consuming, and current methods have notable limitations. This study aimed to evaluate the success rate, procedure duration, pain, and physiological effects of the bladder stimulation technique in infants aged 1 to 12 months. METHODS: In this randomized controlled trial, 64 infants were assigned to either an experimental group receiving the bladder stimulation technique or a control group with standard positioning. Data were obtained using a structured form and the face, legs, activity, cry, and consolability (FLACC) pain scale. The procedure was considered successful if urine was collected within 3 minutes, and the procedure duration was measured as the time until urine collection. Heart rate, oxygen saturation, and FLACC scores were recorded at baseline and at the first and third minutes of the intervention. RESULTS: The experimental group had a higher urine collection success rate than the control group (53.1% vs 25.0%; P = .021), with a relative risk of 2.13 (95% CI, 1.05-4.30) and an absolute risk difference of 28.1% (95% CI, 5.8%-50.4%). Median procedure duration did not differ significantly between the groups (46 vs 82.5 seconds; P = .38). FLACC scores increased over time in both groups (P < .001), with a rise from 2 to 3 points in the experimental group (P < .001) but not in the controls (P = .30). Heart rate increased and peripheral oxygen saturation decreased in both groups (P < .001), without between-group differences (P > .05). DISCUSSION: The bladder stimulation technique increased the success of procedural urine collection within a predefined 3-minute window in infants aged 1 to 12 months. However, it did not significantly reduce the duration of the procedure. The technique was associated with mild discomfort and no clinically concerning physiological changes under standardized study conditions. Because contamination rates, urine culture validity, and subsequent urine collection procedures were not assessed, these findings support the short-term procedural feasibility rather than diagnostic adequacy.