Suprapubic Urine Collection
Management guidelines for students, interns and registrars on a variety of routine and emergency situations in our neonatal service at Tygerberg Children’s Hospital. Published in 2014.
Complications of the procedure
Indications
Babies less than 3 months with suspected urinary tract and systemic infection (as part of the infection screen).
Requirements
- 5-10 ml syringe
- Number 22 or 23 needle (or butterfly needle)
- Iodine and alcohol disinfectant
- Disposable alcohol swab
- Gloves
Procedure
Try and do the procedure after confirming that the baby has not passed urine following the last feed i.e. when the bladder is potentially full (palpate bladder).
The infant should be supine with the legs spread-eagled and held by an assistant (frog leg position). See sketch on next page.
Clean the supra pubic area with iodine and alcohol or with an alcohol swab (wait at least 15 - 30 seconds).
Connect the syringe and needle and insert the needle in the abdominal midline ± ½ - 1 cm above the symphysis pubis.
Aim the needle posteriorly (45 - 90°) in the direction of the coccyx while advancing 1 - 2 cm and applying negative suction to the syringe.
A volume of 2 - 3 mls of urine should be collected.
If no urine can be aspirated, repeat the procedure later after a feed or after a period of 35 - 45 minutes.
± 30% of first attempts fail.
This procedure can only be performed with an assistant.
Contraindications
Abdominal distention secondary to dilated bowel loops.
Bleeding tendency.
Complications of the procedure
Transient haematuria.
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