Clean Catch Urine Collection

Aka: Clean Catch Urine Collection, Midstream Urine Collection, Bag Urine Collection, Noninvasive Urine Collection, Urine Collection in Infants and Young Children, Quick-Wee Method, Bladder Stimulation Technique for Urine Collection

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II. Precautions

  1. Obtain "dirty urine" first if testing for Sexually Transmitted Infection
    1. See STD Screening
    2. First-Stream Urine without Urethral Cleansing ("Dirty Urine")
    3. Preferred sample in men and women (equivalent to endocervical, vaginal or Urethral swabs)

III. Technique: Urine collection technique for women

  1. Wash hands with soap and water
  2. Spread labia with 1 hand and hold apart for collection
  3. Use three Povidone-Iodine swabs to clean area
    1. Wipe down one side, front to back, with one swab
    2. Wipe down other side, front to back, with second swab
    3. Wipe down center, front to back, with last swab
  4. Dry area with sterile gauze
  5. Void into toilet for a few seconds and then collect
    1. Mid-stream urine is most important in obtaining a clean sample
  6. Avoid stopping urine flow while positioning cup
    1. Stopping flow increases risk of contaminated sample
  7. Collect in sterile container
  8. Cap and avoid touching inside of container

IV. Technique: Urine collection technique for men

  1. Wash hands with soap and water
  2. Retract foreskin if needed
  3. Use Povidone-Iodine swabs to clean tip of penis
    1. Clean glans penis
    2. Clean Urethral opening
  4. Dry area with sterile gauze
  5. Void into toilet for a few seconds and then collect
  6. Collect in sterile container
  7. Avoid stopping urine flow while positioning cup
    1. Stopping flow increases risk of contaminated sample
  8. Cap and avoid touching inside of container

V. Technique: Urine collection technique for infants and children <age 2 years (urine bag)

  1. Precautions
    1. Bag urine samples are contaminated in 40-60% of cases
    2. Bag urine is only useful if negative (normal)
    3. If bag urine is positive (abnormal), obtain catheterized sample
  2. Bag Urine Collection (not recommended)
    1. Wash hands with soap and water
    2. Use Povidone-Iodine swabs to clean as above
    3. Place sterile urine bag over penis or labia
    4. Reclean and replace new urine bag if no urine in 30 min
    5. Empty bag into sterile urine container
  3. Alternative techniques to stimulate urination in young children (pre-Toilet Training)
    1. Quick-Wee Method
      1. Forceps with cold saline soaked gauze, rubbed on suprapubic area
      2. Results in urine within 5 minutes of procedure in 31% of children (NNT 5)
      3. Kaufman (2017) BMJ 357:j1341 +PMID:28389435 [PubMed]
    2. Bladder stimulation technique (infants <1 month)
      1. Perform after infant completes feeding
        1. Suspend from under axilla
        2. First: Tap on Bladder for 30 seconds
        3. Next: Light circular massage over lumbar area
      2. Urine obtained within 45 seconds in 56-86% of infants under age 1 month
        1. Herreros (2013) Arch Dis Child 90(1): 27-9 [PubMed]
        2. Tran (2016) PLoS One 11(3): e0152598 +PMID:27031953 [PubMed]
  4. References
    1. Claudius and Behar in Herbert (2018) EM:Rap 18(1): 17

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