Urine collections

Timed urine collections are sometimes needed at various times during your child’s
treatment. Such collections are useful in evaluating your child’s kidney function prior
to receiving chemotherapy drugs that can cause damage to the kidneys or to measure
certain substances in the urine. If your child is toilet trained, the collection is done
by saving all the urine your child produces in a defined period of hours. If your child
is not yet toilet trained, a Foley catheter (catheter that goes up the urethra into the
bladder) will need to be placed for a period of time.
Urine specimens
Chemotherapy requires frequent urine specimens. One way to help obtain a sample
is to encourage lots of drinking the hour before or ask the nurse to increase the drip
rate on the IV. Explain to the child why the test is necessary. Ask the nurse to show
how the dip sticks work. (They change color, so they are quite popular with the
preschoolers.) Use a “hat” under the toilet seat. This is a shallow plastic bucket that
fits under the seat and catches the urine.
Turn on the water while the child sits on the toilet. I don’t know why it
works, but it does.
As all parents learn, eating and elimination are areas that the child controls. If she
just can’t or won’t urinate in the hat, go out, buy her the largest drink you can find,
and wait.
If infection is suspected, then a clean catch specimen for culture will be ordered.
Your child’s perineal area will need to be gently cleansed with soap or an antiseptic
towelette, and she will need to urinate in a small sterile container. Urinary tract
infections are much more common in girls than boys, because the female urethra is
much shorter.
Occasionally, your physician will order a urinary catheterization if a clean specimen
can’t be obtained or your child is unable to urinate. This procedure can be quite
stressful because it involves placing a sterile rubber tube up the urethra and into the
bladder. It is quite appropriate to ask for a mild sedative or muscle relaxant before
the procedure if your child is anxious. It is also perfectly acceptable to request that the
most skilled person available perform the procedure. In skilled nursing hands, the
procedure takes less than five minutes to perform.