Urinary Tract Infections in ChildrenNCT07654725
Bladder Stimulation Technique for Urine Collection in the Pediatric Emergency Department
A study testing Bladder Stimulation Technique and Traditional Urine Bag Application in people with Urinary Tract Infections in Children and Diagnostic Techniques, Urological, run by Istanbul Medeniyet University at 1 site in Turkey (Türkiye).
Trial summary
The purpose of this prospective, quasi-experimental study is to evaluate the efficacy of the Bladder Stimulation Technique (BST) compared to the traditional urine collection bag method in non-toilet-trained infants presenting to the Pediatric Emergency Department. Read more about this study
- Who is it for?
- Ages 0 days to 6 months
- Conditions the study is for
- Urinary Tract Infections in Children, Diagnostic Techniques, Urological
- What is being tested?
- Bladder Stimulation Technique and Traditional Urine Bag Application
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 124 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Feb 2026to 15 Jun 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 0 days to 6 months
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Infants strictly under 6 months of age.
- Patients presenting to the pediatric emergency department who require a urine sample collection for any clinical indication (e.g., fever without a source, suspected urinary tract infection).
- Infants who are able to be fed orally or enterally (as the protocol requires the procedure to be performed 20 minutes after feeding to ensure bladder volume).
- Presence of informed written consent from a parent or legal guardian.
Who cannot join
- Infants aged 6 months or older.
- Patients requiring immediate life-saving resuscitation or those who are hemodynamically unstable.
- Patients with known congenital anomalies of the genitourinary tract.
- Patients with known neurological disorders that may affect normal bladder function or voiding reflexes (e.g., neural tube defects, spina bifida).
- Presence of skin lesions, active infections, trauma, or surgical incisions in the paravertebral (lower back) or suprapubic (lower abdomen) areas that would contraindicate physical massage and tapping.
- Patients with any clinical contraindication to feeding.
- Refusal of parental consent.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Can the Bladder Stimulation Technique Solve the Urine Collection Chaos in the Pediatric Emergency Department?
The purpose of this prospective, quasi-experimental study is to evaluate the efficacy of the Bladder Stimulation Technique (BST) compared to the traditional urine collection bag method in non-toilet-trained infants presenting to the Pediatric Emergency Department. The primary objective is to determine whether BST can significantly reduce urine contamination rates and the time required for successful sample collection. By comparing these two non-invasive methods, the study aims to provide a faster, cleaner, and more reliable diagnostic approach to solve the operational challenges of urine collection in acute pediatric care
Read the detailed description
Diagnosing urinary tract infections (UTIs) in non-toilet-trained infants is a daily and critical challenge in pediatric emergency departments. In this highly vulnerable group, a UTI can rapidly progress to severe complications, making an accurate diagnosis via a sterile or very clean urine sample absolutely essential. Currently, the most common non-invasive method for collecting urine from these infants is the adhesive urine bag. However, this method has significant drawbacks. Bag samples have notoriously high contamination rates-often exceeding 50%-because bacteria from the baby's skin or stool easily mix with the urine.
When a urine sample is contaminated, it frequently leads to false-positive results. This forces physicians to either prescribe unnecessary antibiotics to a very young infant or subject the baby to invasive, painful procedures like urethral catheterization to secure a sterile sample. Furthermore, waiting for an infant to naturally void into a bag is highly unpredictable, often taking hours. This waiting period increases the length of hospital stays, frustrates parents, and creates operational bottlenecks in busy emergency departments.
The Proposed Intervention: Bladder Stimulation Technique (BST) To address these clinical and operational challenges, clinicians are exploring alternative non-invasive methods. The Bladder Stimulation Technique (BST) is a safe, completely non-invasive maneuver that involves gently tapping and massaging the infant's lower abdomen (suprapubic area) and lower back (lumbar region) in a specific sequence. This gentle stimulation triggers the infant's natural reflex to urinate, allowing healthcare providers to catch a midstream urine sample directly into a sterile container.
Study Design and Methodology This is a prospective, quasi-experimental comparative study conducted in a high-volume Pediatric Emergency Department. The study is designed to directly compare the traditional adhesive urine bag method with the Bladder Stimulation Technique.
The study will specifically include infants younger than 6 months of age who present to the emergency department and require a urine sample for clinical evaluation. Eligible infants will be evaluated using one of the two collection methods, and the study will rigorously track and compare the outcomes of both approaches in real-time.
Primary and Secondary Objectives
The study focuses on three main questions regarding this specific age group:
Contamination Rates: Does BST provide a cleaner urine sample compared to the bag method in infants under 6 months, thereby significantly reducing the rate of false-positive cultures?
Time Efficiency: Does BST reduce the time required to successfully collect a urine sample compared to waiting for a bag collection?
Success Rate: What is the overall success rate of obtaining a viable urine sample using BST versus the bag method within a standard emergency room timeframe? The findings of this study have the potential to immediately change clinical guidelines and daily practices in acute pediatric care. If the Bladder Stimulation Technique proves to be faster and less prone to contamination than the traditional bag method, it will serve as a crucial "diagnostic firewall." For parents, this means less time waiting in the emergency room, protection from unnecessary antibiotic treatments, and avoiding the pain and trauma of invasive catheterization for their babies. For healthcare systems, it offers a cost-effective, evidence-based solution to resolve diagnostic dilemmas and operational bottlenecks in emergency departments.
- Being tested
- Bladder Stimulation Technique, Traditional Urine Bag Application
- Keywords
- Physical Stimulation, Bladder Massage, Paravertebral Massage, Suprapubic Tapping, bladder stimulation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Bladder Stimulation TechniqueProcedure or surgery
In the intervention group, the Bladder Stimulation Technique (BST) was performed. The infant was held safely suspended in the air by their armpits by a researcher to relax the abdominal muscles. The physician then initiated a stimulation cycle consisting of 30 seconds of gentle paravertebral (lower back) massage, followed immediately by 30 seconds of light suprapubic (lower abdomen) tapping. This 1-minute cycle was repeated continuously for a maximum of 5 minutes. The moment the natural voiding reflex was triggered and the infant began to urinate, a midstream urine sample was directly caught into a sterile specimen container
Traditional Urine Bag ApplicationProcedure or surgery
The current standard care method for urine collection in non-toilet-trained infants. The infant's perineal area is cleaned, and a standard, sterile pediatric adhesive urine collection bag is attached. The infant is then closely monitored in the emergency department until spontaneous natural voiding occurs into the bag.
| Study group | Role | What they receive |
|---|---|---|
| Arm 1: Bladder Stimulation Technique | Experimental | Infants in this arm will undergo the Bladder Stimulation Technique. This completely non-invasive method involves a specific sequence of paravertebral (lower back) massage and suprapubic (lower abdomen) tapping to trigger the infant's natural voiding reflex, allowing for a midstream urine sample to be collected directly into a sterile container. Receives: Procedure: Bladder Stimulation Technique |
| Arm 2: Traditional Urine Bag Method | Active comparator | Infants in this arm will undergo the current standard of care. A standard, sterile adhesive urine collection bag will be applied to the infant's perineal area. The patient will be monitored until natural voiding occurs into the bag Receives: Procedure: Traditional Urine Bag Application |
What is being measured
The primary outcome is the main question the study is designed to answer.
Success Rate of the Bladder Stimulation Technique and Influencing Factors
The primary objective is to evaluate the percentage of successful urine collections, strictly defined as obtaining at least 1 cc (mL) of clean-catch midstream urine, achieved specifically by using bladder stimulation maneuvers (paravertebral massage and suprapubic tapping). Additionally, this outcome evaluates the clinical and demographic factors (e.g., patient age, gender, weight) that influence the success of this specific maneuver.
Measured: From the start of the stimulation maneuver until at least 1 cc of urine is obtained (maximum of 5 minutes)
Secondary outcomes (1)
Effect on Emergency Department Waiting Time
To evaluate and compare the effect of both urine collection methods (the bladder stimulation technique versus the traditional adhesive bag) on the total waiting time in the emergency department, measured from the initiation of the procedure until at least 1 cc of urine is successfully obtained.
Measured: Up to 5 minutes for the bladder stimulation group, and until at least 1 cc of urine is obtained for the traditional bag group
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Jun 2026
- Study start1 Feb 2026
- Primary completion30 Apr 2026
- Study completion15 Jun 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Urinary Tract Infections in ChildrenStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Diagnosis
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Model description
- Interventional, Quasi-experimental
- Masking
- None (open label)
- Enrolment
- 124 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Istanbul Medeniyet University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Aytaç Göktuğ, Istanbul Medeniyet University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07654725
- Sponsor's protocol ID
- IstabulMU-PED-AG-01
- Status last verified
- Jun 2026
- First submitted
- 12 Jun 2026
- Last updated
- 22 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 22 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Can the Bladder Stimulation Technique Solve the Urine Collection Chaos in the Pediatric Emergency Department?
- ClinicalTrials.gov ID
- NCT07654725
- Acronym / sponsor ID
- IstabulMU-PED-AG-01
- Keywords
- Physical Stimulation, Bladder Massage, Paravertebral Massage, Suprapubic Tapping, bladder stimulation
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 124 participants (estimated)
- Lead sponsor
- Istanbul Medeniyet UniversityUniversity, hospital or other
- Study start
- 1 Feb 2026 (actual)
- Primary completion
- 30 Apr 2026 (actual)
- Study completion
- 15 Jun 2026 (estimated)
- First posted
- 17 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this prospective, quasi-experimental study is to evaluate the efficacy of the Bladder Stimulation Technique (BST) compared to the traditional urine collection bag method in non-toilet-trained infants presenting to the Pediatric Emergency Department. The primary objective is to determine whether BST can significantly reduce urine contamination rates and the time required for successful sample collection. By comparing these two non-invasive methods, the study aims to provide a faster, cleaner, and more reliable diagnostic approach to solve the operational challenges of urine collection in acute pediatric care
Detailed description
Diagnosing urinary tract infections (UTIs) in non-toilet-trained infants is a daily and critical challenge in pediatric emergency departments. In this highly vulnerable group, a UTI can rapidly progress to severe complications, making an accurate diagnosis via a sterile or very clean urine sample absolutely essential. Currently, the most common non-invasive method for collecting urine from these infants is the adhesive urine bag. However, this method has significant drawbacks. Bag samples have notoriously high contamination rates-often exceeding 50%-because bacteria from the baby's skin or stool easily mix with the urine.
When a urine sample is contaminated, it frequently leads to false-positive results. This forces physicians to either prescribe unnecessary antibiotics to a very young infant or subject the baby to invasive, painful procedures like urethral catheterization to secure a sterile sample. Furthermore, waiting for an infant to naturally void into a bag is highly unpredictable, often taking hours. This waiting period increases the length of hospital stays, frustrates parents, and creates operational bottlenecks in busy emergency departments.
The Proposed Intervention: Bladder Stimulation Technique (BST) To address these clinical and operational challenges, clinicians are exploring alternative non-invasive methods. The Bladder Stimulation Technique (BST) is a safe, completely non-invasive maneuver that involves gently tapping and massaging the infant's lower abdomen (suprapubic area) and lower back (lumbar region) in a specific sequence. This gentle stimulation triggers the infant's natural reflex to urinate, allowing healthcare providers to catch a midstream urine sample directly into a sterile container.
Study Design and Methodology This is a prospective, quasi-experimental comparative study conducted in a high-volume Pediatric Emergency Department. The study is designed to directly compare the traditional adhesive urine bag method with the Bladder Stimulation Technique.
The study will specifically include infants younger than 6 months of age who present to the emergency department and require a urine sample for clinical evaluation. Eligible infants will be evaluated using one of the two collection methods, and the study will rigorously track and compare the outcomes of both approaches in real-time.
Primary and Secondary Objectives
The study focuses on three main questions regarding this specific age group:
Contamination Rates: Does BST provide a cleaner urine sample compared to the bag method in infants under 6 months, thereby significantly reducing the rate of false-positive cultures?
Time Efficiency: Does BST reduce the time required to successfully collect a urine sample compared to waiting for a bag collection?
Success Rate: What is the overall success rate of obtaining a viable urine sample using BST versus the bag method within a standard emergency room timeframe? The findings of this study have the potential to immediately change clinical guidelines and daily practices in acute pediatric care. If the Bladder Stimulation Technique proves to be faster and less prone to contamination than the traditional bag method, it will serve as a crucial "diagnostic firewall." For parents, this means less time waiting in the emergency room, protection from unnecessary antibiotic treatments, and avoiding the pain and trauma of invasive catheterization for their babies. For healthcare systems, it offers a cost-effective, evidence-based solution to resolve diagnostic dilemmas and operational bottlenecks in emergency departments.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Interventional, Quasi-experimental
| Arm | Type | Receives |
|---|---|---|
| Arm 1: Bladder Stimulation Technique | Experimental | Procedure: Bladder Stimulation TechniqueInfants in this arm will undergo the Bladder Stimulation Technique. This completely non-invasive method involves a specific sequence of paravertebral (lower back) massage and suprapubic (lower abdomen) tapping to trigger the infant's natural voiding reflex, allowing for a midstream urine sample to be collected directly into a sterile container. |
| Arm 2: Traditional Urine Bag Method | Active comparator | Procedure: Traditional Urine Bag ApplicationInfants in this arm will undergo the current standard of care. A standard, sterile adhesive urine collection bag will be applied to the infant's perineal area. The patient will be monitored until natural voiding occurs into the bag |
Who may qualify
- Ages
- 0 days to 6 months
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (4 listed)
- Infants strictly under 6 months of age.
- Patients presenting to the pediatric emergency department who require a urine sample collection for any clinical indication (e.g., fever without a source, suspected urinary tract infection).
- Infants who are able to be fed orally or enterally (as the protocol requires the procedure to be performed 20 minutes after feeding to ensure bladder volume).
- Presence of informed written consent from a parent or legal guardian.
Key exclusion criteria (7 listed)
- Infants aged 6 months or older.
- Patients requiring immediate life-saving resuscitation or those who are hemodynamically unstable.
- Patients with known congenital anomalies of the genitourinary tract.
- Patients with known neurological disorders that may affect normal bladder function or voiding reflexes (e.g., neural tube defects, spina bifida).
- Presence of skin lesions, active infections, trauma, or surgical incisions in the paravertebral (lower back) or suprapubic (lower abdomen) areas that would contraindicate physical massage and tapping.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Bladder Stimulation TechniqueIn the intervention group, the Bladder Stimulation Technique (BST) was performed. The infant was held safely suspended in the air by their armpits by a researcher to relax the abdominal muscles. The physician then initiated a stimulation cycle consisting of 30 seconds of gentle paravertebral (lower back) massage, followed immediately by 30 seconds of light suprapubic (lower abdomen) tapping. This 1-minute cycle was repeated continuously for a maximum of 5 minutes. The moment the natural voiding reflex was triggered and the infant began to urinate, a midstream urine sample was directly caught into a sterile specimen container | Procedure or surgery | Arm 1: Bladder Stimulation Technique |
| Traditional Urine Bag ApplicationThe current standard care method for urine collection in non-toilet-trained infants. The infant's perineal area is cleaned, and a standard, sterile pediatric adhesive urine collection bag is attached. The infant is then closely monitored in the emergency department until spontaneous natural voiding occurs into the bag. | Procedure or surgery | Arm 2: Traditional Urine Bag Method |
Primary outcome
Success Rate of the Bladder Stimulation Technique and Influencing Factors
Time frame: From the start of the stimulation maneuver until at least 1 cc of urine is obtained (maximum of 5 minutes)
The primary objective is to evaluate the percentage of successful urine collections, strictly defined as obtaining at least 1 cc (mL) of clean-catch midstream urine, achieved specifically by using bladder stimulation maneuvers (paravertebral massage and suprapubic tapping). Additionally, this outcome evaluates the clinical and demographic factors (e.g., patient age, gender, weight) that influence the success of this specific maneuver.
1 secondary outcome
Effect on Emergency Department Waiting Time
Time frame: Up to 5 minutes for the bladder stimulation group, and until at least 1 cc of urine is obtained for the traditional bag group
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Jun 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Bladder Stimulation Technique and Traditional Urine Bag Application in people with Urinary Tract Infections in Children and Diagnostic Techniques, Urological, run by Istanbul Medeniyet University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 22 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Success Rate of the Bladder Stimulation Technique and Influencing Factors (time frame: From the start of the stimulation maneuver until at least 1 cc of urine is obtained (maximum of 5 minutes)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jun 2026.