Point-of-Care Ultrasound-Guided Versus Conventional Bladder Catheterization for Urine Sampling in Children Aged 0 to 24 Months

Pediatr Emerg Care. 2021 Aug 1;37(8):413-416. doi: 10.1097/PEC.0000000000002490.


Objectives: It can be difficult to obtain urine samples, especially in children aged 0 to 24 months who have not yet completed toilet training. Bladder catheterization is a common method for urine sampling in this age group. However, if the bladder is not adequately filled, this process fails and repeat catheterization is necessary. Point-of-care ultrasonography (POCUS) is often used to assist invasive procedures in the pediatric emergency department. This study aimed to compare success rates of bladder catheterization in patients with and without POCUS to guide the timing of the procedure.

Methods: This was a prospective cohort study of children 0 to 24 months presenting to a pediatric emergency department in a tertiary center hospital. Patients were divided into 2 groups; the one group received conventional catheterization (CC group) without POCUS and the other group had catheterization after POCUS (POCUS group). The transverse and anterior-posterior diameter measurements of the bladder were obtained from one view in the transverse orientation using the (6-3 MHz) convex probe. Successful catheterization was defined by obtaining 3 mL or more of urine.

Results: A total of 110 patients were included in the study, with 56 in the POCUS group and 54 in the CC group. There was no difference between the mean age and sex of the groups. The success rates of obtaining urine samples were 93% and 78% in the POCUS group and CC group, respectively. This difference was statistically significant (P = 0.03). No significant difference was found between measurements of bladder catheterizations with and without obtaining 3 mL or greater urine volumes in the ultrasound group (P > 0.05).

Conclusions: The use of POCUS during bladder catheterization in children was found to be effective and successful. In addition, the detection of any amount of urine in the bladder using POCUS increases the success rate of bladder catheterization.

MeSH terms

  • Child
  • Emergency Service, Hospital
  • Humans
  • Point-of-Care Systems*
  • Prospective Studies
  • Ultrasonography
  • Ultrasonography, Interventional
  • Urinary Bladder* / diagnostic imaging
  • Urinary Catheterization