title: Prospective evaluation of a cutaneous stimulation technique to induce on-demand urination in non-toilet-trained infants.
abstract: BACKGROUND
  When a urinary tract infection is suspected, it is recommended to capture a midstream sample of urine for analysis, but this strategy is difficult to apply before successful toilet training. A cutaneous stimulation technique has been reported to be effective in provoking micturition in newborns.
  
  
  OBJECTIVE
  To evaluate the feasibility and the efficacy of this technique in a population of non-toilet-trained infants.
  
  
  METHODS
  Fifty infants were enrolled in this prospective non-controlled study in three pediatric emergency departments. The bladder was stimulated through suprapubic and paravertebral cutaneous stimulation as previously reported in newborns. The evaluation criterion was the proportion of patients from whom urine had been collected within the first 5min of the procedure.
  
  
  RESULTS
  Forty-eight patients (21 boys) were evaluated. The procedure was successful in 27% of the cases overall, but reached 46% for children aged less than 3 months. Elevated weight was associated with failure of the procedure.
  
  
  CONCLUSIONS
  Despite promising results in newborns, the cutaneous stimulation technique to provoke micturition appears to encounter limitations in older children. Nevertheless, the technique is an attractive alternative to urethral catheterization or suprapubic aspiration for infants younger than 3 months.
authors.affiliation: Hôpital Mère-Enfant, Département de pédiatrie, 8, avenue Dominique-Larrey, 87000 Limoges, France.
authors.forename: M
authors.initials: M
authors.lastname: Valleix-Leclerc
authors.affiliation: Hôpital Mère-Enfant, Département de pédiatrie, 8, avenue Dominique-Larrey, 87000 Limoges, France.
authors.forename: C
authors.initials: C
authors.lastname: Bahans
authors.affiliation: Hôpital Mère-Enfant, Département de pédiatrie, 8, avenue Dominique-Larrey, 87000 Limoges, France.
authors.forename: A
authors.initials: A
authors.lastname: Tahir
authors.affiliation: Hôpital Mère-Enfant, Département de pédiatrie, 8, avenue Dominique-Larrey, 87000 Limoges, France.
authors.forename: S
authors.initials: S
authors.lastname: Faubert
authors.affiliation: Centre Hospitalier de Brive, Service de Pédiatrie, 19100 Brive-la-Gaillarde, France.
authors.forename: A
authors.initials: A
authors.lastname: Fargeot
authors.affiliation: Centre Hospitalier de Brive, Service de Pédiatrie, 19100 Brive-la-Gaillarde, France.
authors.forename: S
authors.initials: S
authors.lastname: Abouchi
authors.affiliation: Centre Hospitalier de Tulle, Service de Pédiatrie, 19000 Tulle, France.
authors.forename: A
authors.initials: A
authors.lastname: Dallocchio
authors.affiliation: Centre Hospitalier de Tulle, Service de Pédiatrie, 19000 Tulle, France.
authors.forename: M
authors.initials: M
authors.lastname: Mussgnug
authors.affiliation: Hôpital Mère-Enfant, Département de pédiatrie, 8, avenue Dominique-Larrey, 87000 Limoges, France. Electronic address: vincent.guigonis@unilim.fr.
authors.forename: V
authors.initials: V
authors.lastname: Guigonis
mesh_terms: D004636:Emergency Service, Hospital; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010812:Physical Stimulation / Q000379:methods*; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000175:diagnosis; D014554:Urination; D059349:Urine Specimen Collection / Q000379:methods*