Suprapubic Bladder Aspiration or Urethral Catheterization: Which is More Painful in Uncircumcised Male Newborns?

BACKGROUND The aim was to compare the intensity of pain caused by suprapubic aspiration (SPA) and urethral catheterization for urine sampling in premature infants. METHODS A prospective randomized controlled design with 80 premature infants in Alzahra University Hospital, Isfahan, Iran was conducted. Premature newborns who needed urine samples for microbiologic analysis were randomly assigned into two groups: SPA group and urethral catheterization group. Newborn faces and upper parts of the body were videotaped during the study and the pain was assessed during urine collection using Premature Infant Pain Profile (PIPP) score. Furthermore, crying time compared between groups. RESULTS The mean crying time was significantly higher in SPA than urethral catheterization group (77 vs. 34.4 s) (P < 0.001). The PIPP score was significantly lower in urethral catheterization group (13.4) than SPA group (11.5) P < 0.001. The success rate of SPA was 53% compared with 71% success rate of urethral catheterization. CONCLUSIONS SPA is more painful than urethral catheterization in premature male infants as assessed by PIPP score and is more likely leads to procedure failure.