Medical expert of the article
New publications
Ultrasound of the bladder
Last reviewed: 20.11.2021
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Indications for ultrasound of the bladder
- Dysuria or frequent urination.
- Hematuria (wait for the bleeding to stop).
- Recurrent inflammation (cystitis) in adults; acute infection in children.
Indications for ultrasound of the bladder
Preparation of the patient for ultrasound of the bladder is as follows: The bladder should be filled. Give the patient 4 or 5 glasses of fluid and conduct the test an hour after this (do not allow the patient to urinate). If necessary, you can fill the bladder through the catheter with a sterile saline solution: the filling should be stopped when the patient feels uncomfortable. If possible, avoid catheterization due to the risk of infection.
Preparation for ultrasound of the bladder
Begin with transverse sections from symphysis to the navel area. Then go to the longitudinal sections from one side of the abdomen to the other.
Usually this is enough, but with this scanning technique it is difficult to visualize the lateral and anterior wall of the bladder, so it may be necessary to rotate the patient 30-45 ° to obtain an optimal image of these zones.
Methods of ultrasound of the bladder
The filled bladder is visualized as a large anechogenous structure emerging from the small pelvis. At the beginning of the study, determine the state (flatness) of the inner contour and the symmetry on the transverse sections. The thickness of the wall of the bladder varies depending on the degree of filling of the bladder, but it is the same in all departments.
Ultrasound of the urinary bladder is performed by a noninvasive method through the anterior abdominal wall with a filled bladder (at least 150 ml of urine). Normally, on transverse scans, it is visualized as an echo-negative (liquid) formation of a rounded shape (on longitudinal scannograms - ovoid), symmetrical, with clear, even contours and homogeneous contents free of internal echostructures. The distal (relative to the sensor) wall of the bladder is somewhat easier to determine, which is associated with the amplification of reflected ultrasonic waves at its distal boundary, related to the fluid content in the organ.
The thickness of the wall of the unchanged bladder in all its sections is the same and is about 0.3-0.5 cm. Evaluate the changes in the wall of the bladder in more detail allow invasive methods of echography - transrectal and intravesical (transurethral). With transrectal ultrasound (TRUS), only the neck of the bladder and the organs of the small pelvis bordering it are clearly visible. With intravesical echoscanization by special intracavitary sensors conducted through the urethra, it is possible to study in more detail pathological formations and the structure of the wall of the bladder. In addition, the layers can be differentiated in the latter.
Ultrasound of the normal bladder
Poor emptying of the bladder means the presence of an acute inflammatory process, as well as a long-existing or recurrent infection. The prevalence of calcification does not correlate with the activity of schistosomiasis infection, while calcification may decrease in the late stages of the disease. Nevertheless, the wall of the bladder remains thickened and poorly stretched. This may reveal hydronephrosis.
On the echogram of a tumor of the bladder are represented by formations of various sizes, usually extending into the cavity of the organ, with an uneven contour, often a bizarre or rounded shape and a heterogeneous ehostruktury.
Differential diagnosis of the tumor should be carried out with blood clots in the bladder. As a rule, the tumor is characterized by hypervascularization, which allows detecting dopplerography.
In acute inflammation of the bladder, ultrasound usually does not provide the necessary information. However, in individual observations, as well as in chronic cystitis, it is possible to detect thickening of the wall, uneven contour, and sometimes asymmetry of the bladder.
Ultrasound provides a significant help in the diagnosis of diverticula and stones of the bladder, as well as ureterocele.
With the help of echodopplerography, it is possible to visualize urine outflow from ureteral mouths and to conduct a quantitative assessment of it. So. As a result of complete occlusion of the VMP with color Doppler mapping, there is no urine outflow from the corresponding mouth. With a disturbed but partially preserved outflow of urine from the kidney during the bolus discharge, the urine from the corresponding ureteral mouth is determined by a decrease in its flow rate and a change in the spectrum of the latter. Normally, the spectrum of ureteral discharge flow rates is presented in the form of peaks, and the maximum urinary flow rate is on average 14.7 cm / s.
If the bladder is damaged, ultrasound can detect a paravezic urine in an extraperitoneal rupture or fluid in the abdominal cavity with intraperitoneal lesions. However, the final diagnosis can be established only with the help of X-ray methods of investigation.