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Ultrasonographic Bladder Parameters for Successful Suprapubic Bladder Aspiration

Korean Journal of Pediatrics 2004;47(2):187-192.
Published online February 15, 2004.
Ultrasonographic Bladder Parameters for Successful Suprapubic Bladder Aspiration
Sung Chul Baek1, Hoe Kyoung Koo1, Cheol Hong Kim1, Kyung Bum Kim1, Hyun Hee Lee1, Byung Min Choi2, Kee Hwan Yoo2, Young Suk Hong2, Dong Gwan Han1
1Department of Pediatrics, College of Medicine, Kwandong University, Goyang, Korea
2Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
성공적인 방광천자를 위한 초음파검사에서 방광 크기의 지표
백성철1, 구희경1, 김철홍1, 김경범1, 이현희1, 최병민2, 유기환2, 홍영숙2, 한동관1
1관동대학교 의과대학 소아과학교실
2고려대학교 의과대학 소아과학교실
Correspondence: 
Byung Min Choi, Email: cbmin@korea.ac.kr
Abstract
Purpose
: Suprapubic bladder aspiration(SBA) is a widely accepted method of obtaining sterile urine for culture in neonates but has a relatively low success rate and a few serious complications during SBA procedure. To improve the chance of obtaining urine, we determined the ultrasonographic bladder parameters(diameters and volume) to confirm that the bladder is adequately distended for successful aspiration of urine.
Methods
: In 94 newborn infants who required sterile collection of urine, ultrasonographic examination and SBA procedure were carried out. On the patient's suprapubic area, the maximal cephalocaudal and anteroposterior diameters were measured by sagittal scanning, and the maximal anteroposterior and transverse diameters by transverse scanning. Bladder volume was calculated using the formula for elliptic volume, and then urine was aspirated to maximum of 10 mL and the amount of urine aspirated was recorded.
Results
: Sufficient urine for culture(>1 mL) was obtained by SBA in 86(91.5%) of 94 infants. In the sagittal view, when the cephalocaudal diameter of the bladder was greater than 20 mm and the anteroposterior diameter was greater than 15 mm, the success rate was 100%. The cephalocaudal diameter of the bladder in sagittal view showed a more significant positive correlation with aspirated urine amount(r=0.65, P<0.001).
Conclusion
: The ultrasonographic sagittal view improved the success rate of SBA in neonates. A SBA was more likely to be successful when the cephalocaudal diameter of the bladder was above 20 mm and the anteroposterior diameter was above 15 mm.
Key Words: Suprapubic bladder aspiration, Ultrasonography, Bladder diameters, Bladder volume, Urinary tract infection, Infant


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