Collecting uncontaminated urine specimens from infants is difficult. Commonly, an adhesive urinecollecting bag is used, which is uncomfortable. This study determined bacterial contamination rates using three methods of urine collection sequentially on the same infant (without known urinary tract infection)-clean-catch, cotton wool (sanitary) pad and urine bag. The study was undertaken in children under 3 years of age in the Institute of Maternal and Child Health of Pernambuco (IMIP), Recife, Brazil. Urine samples were analysed using phase contrast microscopy and routine culture. Culture of bacteria at any level was interpreted as a contaminated urine specimen. Cultures with > 10(5) colony-forming units/ml of one species by all three collection methods were regarded as true urinary tract infection and these children were excluded. Altogether, 534 urine samples from 191 patients were analysed. Median age was 2 months (1 day-36 months) and 124 (65%) were boys. Twelve children (6.3%) were considered to have true urinary tract infection, three were indeterminate and in 16 one or more samples were missing and all were excluded from analysis. There were more missing samples using the clean-catch method (12%) than when using the bag (4%) or pad (4%). Seventy-six of 160 (47.5%) children had evidence of bacterial contamination. Clean-catch specimens showed the least contamination (14.7%) and rates were similar between pads (29%) and bags (26.6%) (kappa = 0.40). Urine contamination rates were similar for sanitary pads and urine bags and significantly higher than for clean-catch (p<0.01). However, pads were a simple, non-invasive and comfortable alternative to bags.

Objective: To evaluate the efficacy of modified-release doxazosin 4 mg in the treatment of patients with acute urinary retention (AUR) due to benign prostate gland hyperplasia (BPH). An evaluation is made of the number of patients recovering spontaneous micturition after catheter removal, micturition quality, and the number of patients suffering new AUR episodes or who require surgery in the 2 years following the first episode. Patients and Methods: A randomized, controlled study in males with AUR secondary to BPH. Two groups are formed, administering modified-release doxazosin 4 mg to patients born in even-numbered years, once a day in the morning. Those born in odd-numbered years receive no medication. The catheter is withdrawn 1 month later. Flowmetry is performed, with determination of ultrasonographic postmicturition retention at withdrawal, and after 6, 12 and 24 months. Results: Of the 65 patients included, 47 proved evaluable, and 46 complied with treatment (with exclusion of 1 case due to hypotension). Of the 22 patients treated with doxazosin, 15 (68.86%) presented AUR after 2 years, while 7 (31.2%) showed spontaneous micturition. Of the 24 patients treated with bladder catheterization in the absence of medication, 16 (66.6%) presented AUR after the same period of time, while 8 (33.3%) showed spontaneous micturition. There were no statistically significant differences between the treated and untreated subjects in terms of drug efficacy. Residual flow parameters are described in the population with spontaneous micturition in each stage of the study. Conclusion: In our series, treatment with the α-blocker doxazosin (4 mg, modified-release formulation), added to bladder catheterization, showed no increased efficacy in AUR treatment versus catheterization alone. Two years after the urinary retention episode, 31.2% of the patients treated with modified-release doxazosin 4 mg, and 33.3% of those with a bladder catheter only were seen to maintain spontaneous micturition.

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