Ultrasound examination of the bladder. How and why is an ultrasound of the bladder performed? Additional tests before echography
Ultrasound Bladder for cystitis, this is a non-invasive, safest, atraumatic and harmless method that allows you to make an objective assessment of the condition of the bladder organ. As an informative diagnostic search when examining many urological pathologies, ultrasound today is becoming the preferred or even the main method of diagnostic examination.
According to international statistics, more than 10% of healthy people examined by ultrasound were found to have pathologies that had not previously been diagnosed at all.
Oddly enough, the forefathers of modern ultrasound machines are the English military-industrial sonar and radar systems (RADAR and SONAR), which work on the principle of reflecting a pulse of sound waves from certain objects. And the pioneers of scanning human body became American researchers (Hour and Holmes). They placed a “volunteer” in a tank filled with water and passed ultrasound around him.
But the era of real ultrasound diagnostics began in 1949, when the American D. Hauri first created a functioning ultrasound machine.
An important contribution to the modification of this new diagnostic method, allowing to expand its capabilities, was made by the Austrian mathematician and physicist K. Doppler. His developments in comparing and recording impulses and speed of the object of study made it possible to study blood circulation in large vascular beds.
Since 1960, ultrasound examination has been firmly established in medicine. Soon (1964), a group of Japanese researchers proposed using sensors of various modifications when examining the bladder and prostate - rectal, which allows one to obtain an image of the organ in a cross-sectional view, and intracavitary (urethral), which allows one to diagnose various pathological changes in the tissue structure of the cavity of the urinary reservoir.
Today, there are several modes of ultrasound machines - one-dimensional and echography (“M” and “A” modes).
With their help, all anatomical components of the human body are examined, visualized and measured. Mode “B” is called scanning or sonography. It allows you to obtain more effective information - a two-dimensional picture on a monitor with the ability to observe the process in motion (Doppler effect).
Methods of instrumental diagnosis of MP in cystitis
One of the effective methods for examining the reservoir cavity of the bladder during the development of inflammatory processes in it is the CUDI method (urodynamic diagnostics). The urodynamics method itself is a means of assessing the difference in pressure in the urethra and bladder in order to identify functional viability lower sections urethra.
Diagnosis of CUD includes several methods:
- uroflowmetry, which allows you to determine the volume of urine and measure its speed;
- , which is used to determine the presence of detruser hyperactivity (involuntary muscle contractions of the bladder walls), pressure during the period of hyperactivity and during urination, and the volume of the bladder cavity;
- flow-pressure ratio test - shows the relationship between the pressure required for urination in relation to the rate of urine flow;
- electromyography, used for suspected damage to nerve or muscle tissue and their effect on urination processes;
- multichannel urodynamics – synchronous recording of pressure in the cavity and outside the bladder, urine flow and pressure in the urethra, ensuring its retention (profilometry);
- videourodynamics, which allows for video observation and recording of functional parameters of the urinary tract.
Types of ultrasound examination
Diagnosing cystitis these days is not difficult, since urologists have in their “arsenal” different kinds diagnostic search. First of all, this is ultrasound diagnostics. Ultrasound of the bladder in women and men is performed various methods, which are determined by the doctor by analyzing the clinical picture of the disease and the individual characteristics of a particular patient.
Transabdominal ultrasound method is the most common type instrumental diagnostics.
The organ is examined by moving an abdominal sensor along the anterior wall of the peritoneum. This method makes it possible to clarify the size, structure and shape of the organ, but is not effective if the patient is clearly obese or is unable to hold urine. Since a mandatory condition for the procedure is a filled bladder.
Transabdominal ultrasound method.
"TVUS" method (transvaginal). An ultrasound probe is placed in the vagina (vagina). It is considered the most informative diagnostic method, allowing to accurately and correctly detect various pathological processes. It is carried out with an empty urinary reservoir.
Transvaginal method - TVUS.
"TUUS" (transurethral method). Diagnosis is carried out by inserting a sensor into the urethral cavity, thus providing excellent visualization. It is carried out using anesthesia. This method allows you to assess the condition of the urethral wall, the severity of its damage and possible pathological processes in nearby organs. It is used in exceptional cases, since there is a high probability of damage to the walls of the urethra by the sensor and the development of complications.
TRUS technique (transrectal method). The sensor is inserted rectally (into the rectum). It is mainly used when it is necessary to perform an ultrasound of the bladder in men. This method reveals the pathological connection between the bladder and prostate organs. It is sometimes used when examining girls for whom the transabdominal method is contraindicated, but the presence of a hymen is an obstacle to another method.
Transrectal method - TRUS.
Doppler diagnostics. Allows you to identify changes in structural tissues bladder walls and study the residual volume of urine in the bladder reservoir. Diagnostics consists of two stages - scanning the organ when it is completely full and when it is empty.
Examination of pregnant women and children
In case of inflammatory processes in the bladder, any instrumental diagnostic methods that can harm the development of the fetus or injure the female organs are not used. This applies to cystoscopy, CT, x-ray examination, or the use of contrast agents during angiography. The safest option for examining pregnant women is ultrasound scanning, which cannot harm either the fetus or the expectant mother.
Ultrasound diagnostics does not carry any radiation exposure and is completely safe. Therefore I received wide application and for examination of various ages children. The study is carried out only in a transabdominal way (through the peritoneal wall). Prescribed for signs painful urination and the presence of pathogenic flora in urine sterility tests.
But if a child has problems with bladder filling (examination is possible only if the bladder is full), the doctor can prescribe appropriate treatment based on the severity clinical picture. An important indicator of the disease is sediment in the bladder and the possible volume of its filling with urine. To prevent false analysis conclusions, it is necessary to comply with certain conditions for preparing for the examination.
Preparation stages
Each method of diagnostic examination has its own algorithm of preparatory measures.
How to properly prepare for a transabdominal examination
Preparation for ultrasound of the bladder in women, men and children is similar.
If patients suffer from constipation or flatulence (accumulation of intestinal gases), they must follow a diet for 2 days before the examination. The diet should not include:
- dishes made from legumes that cause bloating;
- baked goods and dairy products;
- coffee and drinks based on it;
- sparkling water and alcohol.
Shortly before diagnosis, you should cleanse the intestines - give a cleansing enema.
To properly prepare the bladder organ for examination, you must:
- 3 hours before the procedure, consume from 0.5 to 1.5 liters. Water;
- refrain from urinating;
- if the process of filling the bladder is delayed, take diuretics to speed up urine formation.
The amount of fluid required to fill the bladder in children should correspond to the age of the child. Children can be offered various herbal teas, fruit drinks, non-carbonated mineral water or compotes. All necessary recommendations To prepare a child for examination, parents should obtain information from a doctor.
Preparation for examination using the transrectal method
Preparation for this procedure consists, first of all, of observing hygienic measures. It is necessary to carefully prepare the rectum. It needs to be cleaned. The procedure is due to the use of cleansing microenemas and the introduction of glycerin rectal suppositories. You can use laxatives (if urgently needed).
Transvaginal diagnosis: preparation
When performing a transvaginal examination, filling the bladder organ with urine is not required. The effectiveness and reliability of the result is affected by insufficient cleanliness of the intestines, flatulence, or the presence of leukoplakia (hardening of mucous tissues) in a woman.
On the eve of diagnosis, you should take all measures to cleanse the intestines, prevent gas formation and warn the doctor about the existing pathology.
The presence of menstruation at the time of ultrasound does not affect the diagnostic results, but the very fact of their presence is unpleasant even for the woman herself, not to mention the doctor. Therefore, if the manipulation is not vital at the moment, it is better to postpone it to another time.
How to properly prepare for TUUS
This diagnosis is carried out in men, so preparing the bladder for ultrasound concerns them specifically. Since the examination involves the use of local anesthesia, it is necessary to ensure its good tolerance. For this:
- Limit yourself to a light diet on the day of the examination;
- the day before the procedure, avoid alcohol;
- refrain from smoking 2 hours before the procedure.
Failure to comply with these measures may result in unwanted reactions with an anesthetic and cause nausea or vomiting during examination.
What can an ultrasound show for cystitis?
By comparing the results of sonography with established standards, taking into account the patient’s symptoms and his complaints, the doctor can establish an accurate diagnosis - either an inflammatory process (cystitis).
- At acute process sonography shows signs of increased echogenicity, indicating the presence inflammatory reactions. Sediment in the urine of the bladder cavity appears in the form of various cells and salt crystals. On initial stage development of cystitis, the structure of the walls of the organ remains smooth. The progression of the process causes the development of their asymmetrical shape.
- A chronic process on ultrasound is indicated by thickening of the walls of the bladder and the presence of sedimentary flakes. With a protracted, chronic course of the process, the presence of blood clots attached to the internal walls of the organ is diagnosed. At the stage of the process of liquefying hemorrhagic clots, their coagulation creates the appearance of uneven borders of the bladder. the opportunity to use the service of conducting an examination at home.
Prices for ultrasound examinations in private clinics vary from 800 rubles.
Cost of ultrasound in one of the Moscow clinics.
Despite the constant updating of diagnostic techniques, ultrasound continues to be the most informative method for assessing the condition of the bladder. Each patient has his own examination method, which the attending physician can easily recommend. Compliance with all the basic rules for preparing for an ultrasound and the doctor’s recommendations is a guarantee of a reliable diagnosis for adult patients and children.
Ultrasound of the bladder is one of the most common diagnostic methods. Its popularity is based on the fact that a full bladder serves as a “window” for.
Ultrasound of the bladder shows pathological changes, and deciphering the results of the study helps to carry out differential diagnosis emergency conditions.
Indications for the study
Ultrasound of the bladder is performed for a number of indications, including:
- dysuric disorders (impaired urination);
- frequent urge to urinate;
- impurities in the excreted urine (blood, flakes);
- difficulty urinating, accompanied by pain;
- inability to urinate independently;
- pain in the suprapubic region.
The indication for an ultrasound of the bladder is not only the patient’s complaints, but also control over therapy. Using diagnostics, the dynamics of the disease after surgery are monitored. Surgical interventions controlled by ultrasound of the bladder are as follows:
- oncology treatment (prostate cancer);
- cystolithotripsy (crushing stones) or removing stones;
- resection of prostate adenoma;
- surgeries on the ureters.
Ultrasound of the bladder allows the doctor not only to detect pathological conditions, but also to exercise control over the therapy Often, the cause of the patient’s complaints is pathology of other pelvic organs. The explanation for this is the close anatomical location of the ureters, and. By interpreting the results of an ultrasound scan of the bladder, a diagnosis can be made.
Methods for diagnosing the bladder
There are several examination methods:
- Transabdominal examination. It is done in a supine position, diagnosis is carried out through the abdominal wall. The condition for the study is that the bladder is full. Abdominal ultrasound allows you to determine the volume, size, and structure of the organ. Used in men and women.
- Transrectal examination. It is done in a lateral position, and the organ is examined by inserting a sensor into the rectum. The technique is intended for men and girls. The method is highly informative compared to the transabdominal method.
- Transvaginal examination. The method is applicable to women. It is carried out in a supine position, the sensor is inserted into the vagina. Advantages of the method: high information content and no need for preliminary preparation. The transvaginal method helps to identify diseases reproductive organs among women.
- Transurethral examination. The examination is carried out in the supine position, with the sensor inserted into the urethra. The advantages of the method are the ability to assess the degree of damage to the urethra and visualize the urethra. Disadvantages of transurethral ultrasound of the bladder: pain relief and risk of complications (damage urinary tract sensor). The method is rarely used due to the above disadvantages.
Transrectal ultrasound is intended to examine the bladder in men and girls (transvaginal examination is prescribed only to those women who have already had sexual intercourse) What does the study show?
Normally, an ultrasound of the bladder (together with determination of residual urine) shows:
- shape: pear-shaped when the bladder is full and saucer-shaped after urination;
- structure: echo-negative (on the monitor screen it is presented in the form of dark shades);
- volume: from 250 to 550 ml. in women and from 350 to 750 ml. in men;
- wall thickness: from 2 to 4 mm;
- filling: normal, filling rate is 50 ml. at one o'clock;
- volume of residual urine: no more than 50 ml.
Signs of pathology on an ultrasound picture
The data obtained from an ultrasound examination represent only preliminary information on the basis of which a diagnosis is made. The final analysis of diagnostic data may vary depending on the quality of the equipment, the method of scanning, and the qualifications of the specialist. Let's look at some ultrasound signs of pathological conditions.
Increase normal sizes bladder may be accompanied by an increased volume of residual urine. The main reason for the increase in the size of the organ is overstretching of its walls with urine. This symptom observed when an obstacle to its outflow occurs.
Possible causes of difficulty in urine flow:
- prostatic hyperplasia (pathological growth: due to anatomical features, the prostate compresses the urethra and impedes the outflow of urine);
- pathology of organ innervation;
- calculi in the bladder (stones and sediment);
- urinary tract valves (more often - pathology in newborns).
A decrease in the normal size of the organ is observed due to congenital anomalies or in the last stages of nonspecific bladder diseases. The main indicator is a reduced volume of residual urine. Possible reasons for a decrease in organ size:
Sediment (flakes) in the bladder is observed with cystitis. The flakes are a mass of inflammatory cells (epithelial cells and leukocytes). Often, the sediment is formed by salts (phosphates), which is a prerequisite for the development of urolithiasis. Upon examination, flakes are identified as hyperechoic formations (i.e., in the form of light spots on a dark background).
Formations of increased echogenicity on ultrasound of the bladder:
- stones;
- cysts or polyps;
- narrowing of the lumen of the ureter;
These formations can be immobile (for example, polyps, tumors) or, on the contrary, mobile (stones, flakes). When interpreting the results, it is taken into account that the degree of echogenicity depends on the density of the tissue: the denser it is, the lighter the areas on the ultrasound picture. For example, stones will appear as light spots, while cysts are less echogenic (and therefore less light).
Reverse reflux of urine from the bladder into the ureters, which can even reach the renal pelvis. Conditions leading to urine reflux:
- urinary tract abnormalities;
- stones and flakes (sediment) in the bladder cavity;
- neoplasms of the urinary tract.
With this type of pathology, an ultrasound of the bladder is performed, which allows one to determine the quantitative volume of residual and thrown urine, the direction of its flow, and also allows one to assess the severity of the disease. The scope of the diagnosis is determined by the doctor. For an accurate diagnosis, not only ultrasound is used, but also laboratory and invasive methods for diagnosing the urinary tract.
Ultrasound examination (US) of the bladder is widely used in the diagnosis of diseases of the urinary system. This examination method is quite informative, has no contraindications and is completely safe, therefore it is allowed for use even in children.
Types of ultrasound diagnostics of the bladder
There are several ways to perform an ultrasound examination of the bladder. The choice of method is determined by the attending physician depending on the preliminary diagnosis and individual characteristics of the patient.
Transabdominal ultrasound of the bladder
this is the most popular way. It is suitable for both men, women (including pregnant women), and children.
Transabdominal ultrasound of the bladder is performed through the anterior abdominal wall using an external probe.
A mandatory requirement for conducting an examination using this method is a full bladder. Diagnostics allows you to assess the condition of the bladder as a whole: determine its shape, size, location, structure and the presence of pathologies.
Transrectal ultrasound of the bladder (TRUS)
performed through the rectum for women with an intact hymen, patients who have contraindications for transabdominal ultrasound and men (to identify the connection between prostate disease and the condition of the bladder). A special rectal sensor is used for the study;
Transvaginal ultrasound of the bladder (TVUS)
It is considered by many experts to be the most informative diagnostic method due to the absence of a layer of fatty tissue between the vagina and bladder.
In addition, TVUS is used as an alternative method (if there are contraindications to transabdominal ultrasound) and is performed on an empty bladder using a vaginal probe;
Transurethral ultrasound of the bladder (TUUS)
a type of diagnosis in which a sensor is inserted into the urethra to identify the connection between the pathology of the bladder and urethra.
Using TUUS, specialists determine the degree of damage to the urethra and surrounding tissues. This method is highly informative, but rarely used, as it requires special drug preparation of the patient (use of anesthesia). In addition, during transurethral ultrasound there is a risk of damaging the urethra.
Indications for ultrasound of the bladder
Which doctor prescribes the test and why?
A urologist usually prescribes an ultrasound of the bladder as part of a comprehensive examination of the pelvic organs. Indications for diagnosis are:
- frequent and/or painful urination;
- various impurities in the urine (sediment, blood);
- acute urinary retention;
- suspicion of urolithiasis;
- sharp nagging pain in the lower abdomen.
Real-time ultrasound imaging is used in the following surgical procedures:
- removal of bladder tumors;
- cystolithotomy (crushing and removal of stones);
- transurethral resection of the prostate ( endoscopic removal adenomas through the bladder);
- surgical intervention on the ureters and urethra.
For bladder tumors, ultrasound is performed dynamically before and after treatment. Also regular ultrasound examination necessary to detect metastases in the bladder due to cancerous lesions of neighboring organs (uterus, prostate, kidneys).
Ultrasound of the bladder plays an important role in the differential diagnosis of other diseases that are clinically similar to pathology of the urinary tract, for example:
- prostatitis (inflammation of the prostate);
- salpingitis, salpingoophoritis (inflammation of the ovaries and fallopian tubes);
- inflammation and developmental abnormalities of the ureters;
- renal pathology (pyelonephritis, glomerulonephritis), etc.
Contraindications
Contraindications to ultrasound of the bladder depend on the method of diagnosis.
Transabdominal method (through the abdominal wall):
- urinary incontinence (ultrasound is performed only on a full bladder);
- excess weight (a thick subcutaneous fat layer makes scanning difficult and reduces the diagnostic information);
- skin lesions in the lower abdomen (pyoderma, herpes, wounds, burns, infectious lesions for syphilis and HIV);
- bladder defects (sutures and scars on the bladder wall).
Transrectal method (through the rectum):
- inflammatory bowel diseases in the acute stage (fissures, hemorrhoids, dysentery, Crohn's disease, etc.);
- absence of the rectum (as a result of surgery and replacement of this organ with an artificial anostomy to remove feces);
- narrowing (stricture) and obstruction of the rectum;
- intolerance to latex (medical rubber).
Transvaginal method (through the vagina):
- allergy to latex;
- the presence of a hymen;
- pregnancy more than 12 weeks;
- genital infections.
Transurethral method (through the urethra)
- intolerance to medicinal painkillers;
- inflammatory diseases of the urethra.
Preparing for an ultrasound
Preparation for a bladder ultrasound also varies depending on the method of examination.
Transabdominal ultrasound of the bladder is performed with a full bladder and empty bowel.
Bladder preparation:
- 2-3 hours before the procedure you need to drink about 1 liter of liquid and not urinate. Immediately before the test, the patient is given a diuretic tablet to speed up the formation of urine by the kidneys.
Bowel preparation:
- for 1-2 days before the examination, people suffering from flatulence and constipation must follow a diet that limits foods that stimulate gas formation in the intestines (raw vegetables and fruits, legumes, dairy products, alcohol, carbonated drinks, coffee, sweets). bakery products and black bread);
- on the eve of the procedure, the intestines need to be cleansed by administering microenemas or glycerin suppositories;
- To reduce the amount of gases, you can take activated carbon.
Preparation for transrectal ultrasound of the bladder involves emptying the rectum, which is carried out on the eve of the procedure by taking laxatives, administering a glycerin suppository or a cleansing enema.
Transvaginal ultrasound of the bladder does not require filling and can be performed on any day menstrual cycle. The only recommendation for this type of study is that the intestines be cleared of feces and gases (in order to increase information content).
Transurethral ultrasound of the bladder is performed under local anesthesia, so to avoid negative reactions the body on the drug should:
- during the day before the procedure, completely eliminate alcohol intake, since its interaction with medications is unpredictable;
- on the day of the study, in the morning, limit light breakfast and do not smoke 1-2 hours before the ultrasound, because food and nicotine during the action of the anesthetic can cause nausea;
- inform the doctor about the presence of cardiovascular and renal pathologies and diseases respiratory system, allergies to medications, alcohol abuse, constant use of vital medications.
On a note: filling the bladder is not required only in one case - when performing transvaginal ultrasound in women. For all other research methods, the bubble must be full.
Methodology
The most common of all types of bladder ultrasound is the transabdominal (external) method. The doctor treats the head of the sensor with a special gel (to improve the transmission of ultrasonic waves) and scans the abdominal area above the pubis and below the navel. Other methods are used to clarify the results of an external examination.
In any case, the diagnostic method is determined by the attending physician, taking into account gender and individual characteristics patient, age, diagnosis, accompanying illnesses and other factors.
Ultrasound of the bladder in women
In women, an ultrasound of the bladder can also be performed transvaginally or transrectally (for virgins) in which the condition of the uterus and its appendages is additionally examined.
These types of studies allow us to obtain the most complete picture of the condition of the female genitourinary organs.
Ultrasound of the bladder in men
In addition to standard external ultrasound in men, pathologies of the bladder and prostate can be diagnosed using the transrectal method. If there is a suspicion of problems with the prostate, then during an ultrasound of the bladder in men, residual urine is calculated. For this procedure, the patient is asked to urinate and then undergoes an examination that measures the remaining amount of fluid in the bladder.
Transurethral ultrasound is carried out equally for both men and women.
Ultrasound of the bladder in a child
For children, ultrasound diagnostics are performed only transabdominally. The procedure is no different from an adult ultrasound.
Ultrasound of the bladder during pregnancy
Pregnant women up to 12 weeks can be examined using ultrasound using the vaginal and rectal method. In the 2nd and 3rd trimester of pregnancy, ultrasound is performed only transabdominally.
Ultrasound results
The bladder is a hollow muscular organ that can be easily diagnosed by ultrasound if it is full.
The main parameters of the bladder, bearing important information for specialists are:
- form;
- size (volume);
- structure;
- wall thickness and smoothness;
- degree of filling and emptying;
- the nature of the contents of the bubble;
- amount of residual urine.
Decoding these indicators allows the doctor to assess the condition of the bladder and, with a careful analysis of the clinical picture, make the correct diagnosis.
Norms for ultrasound of the bladder
- depends on the level of its fullness and the condition of the surrounding organs. On transverse photographs it is a rounded organ, on longitudinal photographs it is ovoid. The contours of the bubble are clear and even. In women, the shape of the bladder is influenced by the presence of pregnancy and the number of births. Unlike the male bladder, the female one is more compressed at the top and expanded at the sides. These factors must be taken into account when interpreting the ultrasound.
Structure
- Normally echo negative. The older the patient, the higher the echogenicity (due to chronic inflammatory diseases).
- the average bladder capacity in women is 250-550 ml,
- for men - 350-750 ml.
Bladder walls
- they should be the same thickness over the entire surface: from 2 to 4 mm (depending on the degree of fullness). If local thickening/thinning of the wall is observed in one or more areas, then this phenomenon is considered a pathology.
Residual urine
- It is mandatory to measure it during ultrasound of the bladder. Normally, the amount of residual urine should not be more than 50 ml.
Interpretation of an ultrasound of the bladder can reveal serious pathologies, the treatment of which should be immediate:
- cystitis (inflammation of the bladder);
- neoplasms, including cancerous tumors;
- bladder stones ( urolithiasis disease);
- presence of foreign bodies;
- various vascular pathologies;
- vesicoureteral reflux (backflow of urine from the bladder into the ureters);
- inflammatory processes;
- congenital anomalies of bladder development in children and acquired ones in adults;
- hyperactivity (increased functionality) of the bladder;
- enuresis (urinary incontinence);
- diverticula of the bladder (protrusion of the wall with the formation of a sac-like reservoir for urine).
Where is an ultrasound of the bladder performed?
You can undergo a bladder diagnosis using ultrasound examination in any medical institution, but it is best to go to a specialized one that specializes in the diagnosis and treatment of urological diseases.
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How to do an ultrasound of the bladder in women
How and why is an ultrasound of the bladder performed?
Ultrasound is modern method diagnostics of a huge number of diseases of various organs. It is considered to be absolutely safe, so this procedure indicated for people of any age, including newborns, and gender.
Very often, ultrasound is performed to assess the condition of the urinary system. But in order for the study to provide the most accurate information, some kind of preparation for an ultrasound of the bladder is required.
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Indications and features of the procedure
Patients may be referred for an ultrasound examination of the bladder if they have:
- changes in urine color;
- frequent urge to urinate;
- pain when urinating;
- pain in the suprapubic region;
- sediment in the urine visible to the naked eye;
- blood in urine, etc.
In addition to diagnosing various diseases, this procedure is carried out to evaluate the effectiveness of treatment by the presence or absence of positive dynamics. Most often this is necessary when undergoing a course of chemotherapy or after surgery.
Features of preparation
The procedure is performed on a full bladder, so the main preparation for an ultrasound of the bladder is to fill it. This can be achieved by drinking approximately 1 liter of still water an hour before the procedure. In cases where the study is scheduled for the morning, you can go to the clinic immediately after waking up, without visiting the toilet. If it is impossible to refrain from urinating in the morning, it is recommended to set the alarm clock 2-3 hours earlier than the scheduled wake-up time, visit the restroom and go back to sleep. Moreover, after the final rise, the intensity of the urge will not be too great, which will allow you to reach medical institution with a full bladder, ready for examination.
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Important: water can be replaced with tea, compote or other non-carbonated drink, but not with milk or fermented milk products. If a patient is diagnosed with kidney pathologies, he may be advised to take diuretic medications.
In addition to filling the bladder, patients need to take care of the condition of the intestines before the study, since its overcrowding with gases can interfere with the procedure. Therefore, within a couple of days before the appointed date, it is recommended to take activated carbon or its analogue, as well as follow a diet that helps reduce gas formation. That is, on these days you should not consume:
- fresh vegetables and fruits;
- legumes;
- carbonated drinks;
- baked goods;
- dairy and fermented milk products;
- alcohol.
If, even before the study is carried out, it is known that it will be carried out through the rectum, then, among other things, a cleansing enema or a glycerin suppository must be done a few hours before the procedure.
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How is the procedure performed?
How an ultrasound of the bladder is done depends on its condition, degree of fullness, the presence of concomitant pathologies and some other factors. In general, the examination is usually performed using the transabdominal (through the abdomen) method. With this approach, the patient is placed on the couch on his back. He is asked to remove clothing from his lower abdomen, to which the doctor applies a special gel. After this, the doctor applies the sensor to the place where the gel was applied and, with slight pressure, moves it along the surface of the abdomen to different sides, examining the bladder and nearby organs.
Important: in certain cases, to clarify the situation, the specialist may ask the patient to visit the toilet and return to the ultrasound room to assess the condition of the bladder after emptying it. This is usually required to diagnose prostate pathologies.
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As a rule, the procedure lasts no more than 20 minutes, after which the patient immediately receives a form with the examination results and is sent to his attending physician. But in some cases it may be necessary to conduct an examination through:
- Rectum. This type of examination is indicated when an ultrasound of the prostate and bladder is necessary, but it can also be used if the patient has fluid in the abdominal cavity, obesity, or other factors that make examination through the abdominal wall difficult. In addition, the indication for transrectal ultrasound (TRUS) is the need to examine girls who have not lost their hymen, for whom transabdominal examination is difficult.
- Vagina. Ultrasound of the bladder in women is performed using the transvaginal method in the presence of obesity, adhesions, tumor formation, etc.
In such cases, a condom is placed on a special sensor, a small amount of conductive gel is applied and it is inserted shallowly into the natural openings.
Sometimes patients are prescribed an ultrasound with Doppler ultrasound. It is carried out if it is necessary to evaluate the parameters of urine flow through the ureters and the state of blood flow in the organs being studied. This is required if there is a suspicion of vesicoureteral reflux, in which urine, for one reason or another, is thrown back from the bladder into the ureters. Doppler ultrasound is also indispensable in diagnosing tumor formations.
Another variation of this diagnostic method is intravesical or transurethral ultrasound. To carry it out, a special, thinnest sensor is used, which is inserted into the patient’s body through the urethra. It is prescribed if necessary:
- determine the degree of damage to the walls of the urethra and the neck of the bladder;
- differentiate or find the relationship between diseases of the bladder and urethra;
- assess the degree of damage to neighboring organs.
Decoding the results
During the study, the specialist evaluates bladder parameters such as:
- structure;
- form;
- clarity of contours;
- Wall thickness;
- volume;
- filling speed;
- amount of residual urine (if necessary).
Normally, the bladder is a symmetrical, completely echo-negative organ, that is, it looks like a black spot without inclusions on the device screen. In different projections it can be round or ovoid. Its edges are clear and smooth, and the thickness of the walls is 0.3–0.5 cm. If the amount of residual urine is assessed, then normally its volume should not exceed 50 ml.
At the end of the examination, the ultrasound doctor gives the patient a completed form with the diagnostic results, which indicates the conclusion of this specialist, but the interpretation of the bladder ultrasound is performed by the attending doctor. He also makes the final diagnosis, since for this it is necessary not only to compare the obtained indicators with normal ones, but also to take into account the entire complex of symptoms that are present in the patient.
Thus, using ultrasound you can diagnose:
- tumors of the bladder and nearby organs;
- presence of stones or sand;
- wall diverticula;
- acute and chronic inflammation of the mucous membrane;
- presence of foreign bodies;
- anomalies of development and structure;
- backflow of urine into the ureters;
- blockage of the urethra with a stone, etc.
The procedure is completely safe even for pregnant women and newborns Quite often, patients are prescribed an ultrasound of the bladder with cystitis to assess the extent of organ damage. In the case of the development of acute cystitis, sediment is found in the cavity of the bladder, that is, small echogenic particles, the number of which may vary. Thus, ultrasound reflects accumulations of various cells, for example, leukocytes, erythrocytes, epithelium, as well as salt crystals. In this case, the location of such sediment will change depending on the position of the patient’s body. But when acute cystitis the walls of the bladder usually retain normal thickness and clear contour. Thickening of its walls and the appearance of irregularities is a sign of neglected chronic process.
But perhaps it would be more correct to treat not the effect, but the cause?
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Ultrasound of the bladder
Often, according to doctor's indications, an ultrasound of the bladder is performed in women and men, thanks to which many diseases are diagnosed. It is done at any age and condition (newborns or people old age, pregnant or after surgery). It is important to prepare properly before the procedure, then you can get an accurate result. And the correctness of diagnosis and treatment depends on this. An ultrasound of the urinary tract (UU) is performed to check the result of surgery on the organs. genitourinary system. This is often how complications can be identified.
An ultrasound examination of the bladder provides a good basis for analyzing the state of health or the course of diseases in this organ. Indications for use
All indications are related to problems in the genitourinary system (GUS).
This study can be very informative. It is carried out in order to determine diseases of the kidneys and genitourinary system. Indications include:
- pain in the lower abdomen;
- frequent urination;
- problems with urination;
- blood in urine;
- symptoms of urolithiasis.
In addition, it is carried out in men if there is a suspicion of prostate disease. This is how an adenoma or inflammation of this organ is detected. Ultrasound of the genitourinary system may show the presence of cystitis or chronic pyelonephritis. In women it is carried out because it detects diseases of the genital organs located in the pelvis. Sometimes an ultrasound examination of the genitourinary system may include examination of the uterus and appendages. Sharp pain in the lower abdomen, accompanied by a strong increase in temperature, is also an indication for research. It is worth doing this procedure for preventive reasons.
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Preparing for the study
It is imperative to prepare for the procedure, especially since the algorithm is simple: stick to a diet and drink a lot. A bladder examination involves a full bladder. Preparing a patient for a study is sometimes carried out according to the following scenario: a person should not go to the toilet for 5-6 hours before the procedure. This method is suitable for people who have severe swelling. If you can’t bear it, you can let out a little urine, but then quickly fill the bladder again. When the bladder is empty, its contours are poorly visible, the same applies to the prostate and appendages. The doctor should explain how a prostate ultrasound is performed. It is necessary to prepare not only the patient, but also the equipment: gel is generously applied to sensitive areas of the device. This will give a clear image. During transvaginal examination, a special disposable condom is put on it.
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How to fill your bladder? How much fluid for ultrasound?
Preparing for an ultrasound of the bladder during menstruation requires drinking a lot of fluids. Approximately 2 liters of still water (water, compote, tea - it doesn’t matter). The amount of fluid may depend on approximately how much water a person drinks. In children this dose is much less. Carbonated drinks are not allowed because they cause increased gas formation, which closes the internal organs. It is also undesirable to drink alcohol before an ultrasound scan of organs. It is important to take a responsible approach to the preparation process. Otherwise the result will be inaccurate.
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How is the procedure done?
The ultrasound technique and algorithm depend on its type. It is important that the patient knows in advance what awaits him and how the study will proceed. The following types are distinguished:
Return to contentsTransabdominal
Transabdominal ultrasound of the bladder is suitable for everyone (children, men, women). Requires patient preparation. It consists of eliminating all foods that cause increased gas formation a few days before the procedure (baked goods, legumes, dairy and fermented milk products, coffee, mineral water). For prevention, these days you need to drink 2 tablets “ Activated carbon"(not recommended for children). This is necessary so that gases do not block the view. In the evening, it is advisable to give a cleansing enema. Immediately before the procedure, you need to fill your bladder. During the procedure, the patient lies on his back. It is worth noting that this type is less accurate, but more common.
Transrectal ultrasound of the bladder is more suitable for people with low sexual activity. Return to contents Transrectal (TRUS)
TRUS is used to diagnose diseases in women who do not sex life, and men. During the procedure, the patient lies on his side with his back to the doctor (preferably on the left) with his legs pressed to himself. TRUS includes ultrasound of the prostate and bladder. TRUS of the prostate is performed. Going through this examination can be painful. It is necessary to prepare for the study in a special way. To do this, you must select one of the methods:
- drink a laxative;
- give a microenema;
- put a glycerin suppository.
TRUS shows a clearer picture than transabdominal ultrasound.
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Transvaginal
Transvaginal ultrasound of the bladder is suitable only for women who are sexually active. The procedure is allowed during menstruation and pregnancy. It is important to inform the doctor about your piquant situation. This method is carried out when the bladder is empty. But preparation for the procedure is mandatory: diet and cleansing the body of gases. During menstruation, an ultrasound of the uterus may show abnormalities.
Transurethral ultrasound of the bladder is performed through the urethra of the male penis. Return to contents Transurethral
This method is used very rarely. For this study we use local anesthesia, this is due to the fact that insertion of the device into the urethra can be painful. This method is used only in men. Before the procedure, you should not eat heavily, smoke, or drink alcohol. In addition, it is important to tell the doctor what drugs you are allergic to and whether you have chronic liver or kidney diseases. Transurethral examination of the bladder and urethra can detect bladder tumors.
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Peculiarities of implementation in different groups of patients
Ultrasound in women
Everyone without exception undergoes research. Ultrasound of the genitourinary system in women is performed using both transabdominal and transvaginal methods. In the first case, sometimes an ultrasound of the abdominal cavity is also performed at the same time. Using ultrasound, you can detect many inflammatory diseases, as well as neoplasms, and determine whether they are benign or malignant. Before an ultrasound of the bladder, you need to make sure that the woman has no problems with the central circulation (especially during menstruation). An ultrasound of the kidneys clearly shows the neoplasm.
Ultrasound of the bladder during pregnancy does not have any special restrictions or prohibitions, because does not provide negative influence for fruit.Return to contents During pregnancy
There is an opinion that pelvic ultrasound is contraindicated. This is wrong. Ultrasound does not have a negative effect on the fetus, the same applies to the placenta. Thus, this procedure is completely safe for a woman in an interesting position. But telling your doctor about pregnancy is very important. In this case (depending on the age and size of the fetus), he will be able to select the correct research method. This is important because later or if there is a threat of miscarriage, transvaginal ultrasound is prohibited. This may lead to undesirable consequences. Sometimes the test can detect the presence of a fetus.
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Ultrasound in men
An ultrasound of the bladder is performed in men to show a full bladder. There is no need to do an ultrasound of the prostate and bladder separately; both organs are clearly visible in this study. In addition, you can look at the condition of the prostate gland. The most common type of this study is transabdominal. It is ideal for men. It is used to check for bladder tumors.
It is important that the doctor knows about everyone chronic diseases internal organs.
Ultrasound of the bladder can also be performed on children if problems arise with the urinary system. Return to contents Ultrasound in children
Most often, ultrasound is performed on a full bladder in older children. With the advent of diapers, cystitis is becoming more common in infants. This may be due to wearing a filled diaper for a long time. Ultrasound examination can determine the presence of this disease. In addition, diseases of the genitourinary system in infants may be associated with abnormal development of the kidneys, bladder and ureters. The pathology in this situation is congenital. Girls are more likely to suffer from this disease. Preparation for an ultrasound of the kidneys and bladder is impossible in this situation. You can suspect a problem if the baby cries when urinating. The size of the bladder in children is smaller than in adults. Ultrasound does not harm the baby.
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Ultrasound with determination of residual urine
If residual urine is detected by ultrasound of the prostate gland, then sometimes this is considered normal if the amount of urine does not exceed 40 ml (approximately 10% of the total amount). If there is more urine, this indicates the presence of diseases of the bladder and prostate gland. This problem may be expressed by severe spasms or muscle strain of the bladder wall. Most often seen in children and older men. Preparing for the study involves having a bowel movement in a normal position if desired (you cannot wait long before doing this).
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Decoding: what is the norm
The data that the study provides is very useful for making a diagnosis. According to the MP standard, it has the following indicators:
The doctor calculates the norm or deviation after an ultrasound of the bladder using several indicators. Normally, the bladder wall is smooth and uniform. It is important to examine the ureters and make sure there are no tumors there. The remainder of the urine is checked for an empty MP. If it is not visualized, it means that the patient was not prepared in good faith and the ultrasound must be done again. If the result repeats, this indicates the presence of the disease. The concept of normal may vary depending on the individual indicators of a person. The volume and size may vary depending on the amount of liquid a person drinks daily. Ultrasound of the bladder can reveal inflammatory diseases.
Interpretation of the results is the prerogative of the attending physician.
Inflammation of the bladder on ultrasound is shown by formations at the bottom of the organ. Return to contents Signs of inflammation
Inflammation is clearly shown by ultrasound of the bladder. In the presence of cystine in the bladder, a clot is formed consisting of epithelium, leukocytes, and erythrocytes. It settles at the bottom of the MP. In this case, the conclusion will write “sediment in the bladder.” If inflammation progresses, the walls begin to thicken and the contours become uneven. The sediment begins to look more like flakes. Ultrasound picks it all up. In this case, in the conclusion you can see the entry “flakes in the bladder.”
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Other pathologies
Using this method, it is possible to see the formation of the bladder (both inside the bladder and on its walls). Foreign bodies and air are visible. Hypertension or prostate hypertrophy, urolithiasis, urethral trauma and other diseases are determined. To exclude the occurrence of complications, once every 2 years you need to undergo an examination and a urine test (for men over 40 - once a year). Then you can be sure that everything is in order with your health.
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Ultrasound of the bladder in women and men - how to prepare for the procedure
This examination method, such as ultrasound of the kidneys and bladder, is based on the special properties of the ultrasound wave, which consists in its ability to be reflected from organ tissues with the formation of their image on the viewing monitor of a special apparatus. Method ultrasound diagnostics does not cause inconvenience or discomfort and is suitable for people of any age category, including pregnant women.
When is an ultrasound performed?
There are a lot of indications for this study, but there are no contraindications at all. But each patient on the day when he will have an ultrasound scan must follow certain rules, which we will talk about a little later.
This diagnostic method is used for cystitis and suspected cystitis, for changes in urine tests, for pyelonephritis, and so on.
Ultrasound helps identify:
- Tumor formations
- Diverticula
- Sand, stones
- Foreign bodies
- Developmental pathologies
- Vesicoureteral reflux
- Inflammation of the mucous membrane
And also, with the help of ultrasound diagnostics, you can quite accurately determine the size of the organ itself (wall thickness, volume) and other structures.
Ultrasound examination with Dopplerography makes it possible to assess the patency of the ureters, their location and the symmetry of the processes occurring in them, and assess the blood flow in tumor vessels in comparison with normal ones. Dopplerography is also used to study reflux.
There are a lot of indications for ultrasound, but there are no contraindications at all. Preparation
Many patients do not know how to prepare for a bladder ultrasound. There is nothing complicated here. Preparing for an ultrasound of the bladder is just about filling it. To prepare for the study, one to one and a half hours before the procedure, the patient drinks at least a liter of still water, compote or tea. Milk is not suitable for these purposes. You will need to refrain from urinating until the end of the study. With cystitis and some other diseases, this can be especially difficult, and the patient feels acute discomfort. In such cases, you can go to the toilet, but after that drink two or three glasses of water again.
Preparing for a bladder ultrasound is just about filling it If the ultrasound is not scheduled for a specific time, then you can not drink a large amount of liquid at one time, waiting for the bladder to fill naturally. This usually happens within three to four hours.
Note! Correct visualization on the monitor of an ultrasound machine during ultrasound of the kidneys and bladder may be hindered by the intestines when they are filled with gases and feces. If you are prone to constipation and flatulence, two days before the test the patient should exclude legumes, fresh fruits and vegetables, carbonated drinks, and alcohol from the diet.
If you are prone to constipation and flatulence, two days before the test the patient should exclude legumes, fresh fruits and vegetables, carbonated drinks, and alcohol from the diet. Through a bladder filled with fluid, you can view the uterus before and during the first trimester of pregnancy, the ovaries, and in men, identify cysts and other formations in the prostate gland.
Study
Let's figure out how an ultrasound of the bladder is done, what the “norm” is in this case, and how to decipher ultrasound data.
Ultrasound diagnostics of the abdominal organs is generally carried out in two ways, it all depends on what and from whom we are looking:
- Through the abdominal wall;
- Through the rectum, urethra or vagina in women.
With both methods, a video image of the organs being examined is received from a scanning sensor and transmitted to the monitor screen; the procedure lasts about twenty minutes.
The video image of the organs being examined with both methods comes from a scanning sensor and is transmitted to the monitor screen If the doctor suspects a pathology of the bladder, the doctor asks the patient to empty the organ and takes control measurements of it with the remainder of the urine.
A sonologist may perform a transvaginal or rectal ultrasound examination if:
- extensive adhesive process,
- to confirm the identified pathology,
- for obesity and difficult visualization,
- with tumors and large amounts of effusion in the abdominal cavity.
The way an ultrasound of the bladder is performed in females differs from conducting the same study in men due to the anatomical and physiological differences in their bodies. In women, the examination is more often performed externally, in some cases resorting to transvaginal examination.
Note! In this case, the bladder should also be full.
Ultrasound of the genitourinary system in the male population is also often performed through the abdominal wall. However, in case of significant obesity, as well as with ascites and prostate tumors, the patient undergoes a transrectal ultrasound.
Ultrasound of the genitourinary system in the male population is also often performed through the abdominal wall Naturally, before performing an ultrasound, the intestine must be free (microlax enemas, laxatives (sodium picosulfate, senade) or glycerin suppositories.
In some situations, intracavitary examination is recommended for both men and women, in which a thin sensor is inserted through the urethra into the bladder cavity.
How are ultrasound data interpreted?
Deciphering the ultrasound of the bladder, coupled with the anamnestic data obtained from the patient and the history of his illness, makes it possible to most accurately make a diagnosis and, if necessary, prescribe adequate therapy to the patient.
The normal bladder has an echo-negative structure - The normal bladder has an echo-negative structure; it is a round-shaped organ in the transverse projection and ovoid in the longitudinal projection. The contours of the bladder are normally smooth and clearly visualized. The cavity should be free from foreign inclusions, the wall thickness should be uniform throughout its entire length and be 0.3-0.5 cm. The maximum speed of urine outflow is normally approximately 14.5 cm/s. To evaluate it, as well as to give a more detailed description of the urethra and bladder neck, an intravesical examination is performed, which was already mentioned above. The normal level of residual urine in an adult is approximately 50 ml or less.
- If its amount is increased, this may indicate a tumor or inflammatory process, and possibly also compression of the urinary tract by a stone.
- The acute phase of cystitis gives an ultrasound picture of small areas of positive echogenicity. This is what sediment looks like on the monitor - accumulations of epithelial cells, erythro- and leukocytes, as well as salt crystals. In a lying patient, it is localized along the posterior wall of the bladder, and when the person gets up, it moves to the front. At the initial stage of the disease, the contours of the walls remain clear and the thickness remains normal.
The acute phase of cystitis gives an ultrasound picture of small areas of positive echogenicity As the process becomes chronic, the wall thickens, the contour ceases to be smooth, and the sediment looks like flocculent structures. When blood clots form, a picture of hyperechoic formations (sometimes hypo-echoic) is first observed, and then they liquefy and acquire uneven contours and, in places, an anechoic structure.
- Thickening over the entire surface of the bladder wall with characteristic trabecularity in pediatric patients may indicate obstruction of the urethra by its own valve.
- If thickening of the bladder wall is combined with ureterohydronephrosis, then we will talk about the so-called neurogenic bladder.
- Echogenic structures, visually fused to the wall of the organ, can be polyps, stones, signs of urethrocele and prostatic hypertrophy.
- Mobile echogenic formations can be stones, air bubbles, foreign bodies and blood clots.
- An enlarged organ, depending on the history and laboratory test data, may be the result of hypertrophy, edema, inflammation, injury and other pathological processes.
Ultrasound examination of the bladder is highly informative method, making it possible to identify a fairly wide range of pathologies of this organ and the anatomical structures closest to it.
This method is safe, painless and requires minimal preparation from the patient.
Home » Diagnostics » Ultrasound of the bladder in women and men - how to prepare for the procedure
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Indications and norms of ultrasound of the bladder
Ultrasound of the bladder is considered important diagnostic method in urology and related fields of medicine (gynecology, andrology, etc.). Typically, this procedure is performed in conjunction with an ultrasound of the abdominal cavity and pelvis. This is necessary for the differential diagnosis of bladder disorders from other diseases with similar symptoms.
Why is an ultrasound examination of the bladder necessary?
Ultrasound of the bladder is indispensable for diagnosing inflammatory diseases of the kidneys and urinary system, cystitis (inflammation of the mucous membrane of the organ), and urinary incontinence. And also with enlarged prostate gland in men and other disorders. The scan shows the size of the organ, its shape, volume, wall thickness, and the volume of residual urine (with a double procedure).
As a result of an ultrasound scan, the doctor can detect the following pathologies:
- urinary tumors (benign and malignant);
- stones, sand and foreign bodies in the organ cavity;
- degree of inflammation of the mucous membrane (with cystitis);
- wall diverticula;
- congenital developmental anomalies;
- reflux of urine from the bladder back into the ureters;
- blockage of the urethra (stone or tumor).
Ultrasound with Doppler (Doppler) is also often used. This procedure allows you to evaluate not only the size of the organ, but also see how freely urine moves through the ureters. In addition, Doppler ultrasound makes it possible to trace the direction of urine flow, its shape and symmetry.
Indications for the study
Ultrasound of the bladder is usually done as part of comprehensive survey patient. The doctor may prescribe a referral for an ultrasound if characteristic symptoms, and also when monitoring of recovery after surgery or chemotherapy is necessary. Portable ultrasound machines are also used at home if daily monitoring is required to analyze the function of the urinary system.
The main indications for ultrasound diagnostics are:
- change in color or noticeable blood in the urine;
- sediment or flakes;
- pulling or sharp pain when urinating;
- an unnaturally frequent urge to urinate (even if there is no pain);
- urine volume is too small;
- discomfort or pain in the bladder area (above the pubis).
A control ultrasound of the bladder is always prescribed after tumor removal, regardless of whether it was organ resection or endoscopic surgery. Removal of stones from the urinary tract, surgery on the ureters and urethra, transurethral resection of the prostate also require a final ultrasound scan.
The doctor may also send the patient for such an ultrasound if there is a suspicion of inflammation of the prostate (in men) or the uterine appendages (in women). IN mandatory this procedure is prescribed for the diagnosis of inflammation and congenital anomalies of the ureters, kidney diseases.
Types of ultrasound
How is an ultrasound of the bladder performed? For cystitis, the doctor usually recommends one of two methods: transabdominal or transvaginal. But modern medicine knows and applies 4 options for ultrasound diagnostics of this organ.
- Transabdominal (through the external abdominal wall).
External ultrasound of the bladder is used most often; the main condition is a full bladder. This method does not bring any discomfort to the patient, but with urinary incontinence and obesity such ultrasound is impossible.
Helps to spend more accurate diagnosis patients compared with the previous method. The procedure is performed with an empty bladder.
The method is suitable for men and girls who are not sexually active. This procedure is also considered more informative than external ultrasound. In men, this makes it possible to assess the relationship between prostate damage and diseases of the urinary system.
This type of ultrasound is used least often - inserting a sensor into the urethra can lead to damage and requires mandatory anesthesia. However, this procedure is indispensable for inflammation of the urethra. Transurethral scanning shows the extent of damage to the canal walls and allows you to assess the condition of neighboring organs.
Ultrasound of the bladder may include an assessment of the volume of the organ with determination of residual urine and examination of its wall.
Measuring the volume of the organ itself and residual urine takes place in 2 stages. First scanned full bubble, then the patient is sent to the toilet and a second ultrasound is performed. Fluid volume is measured before and after urination. This procedure is necessary when identifying the causes of urinary outflow problems. For cystitis and other disorders of the urinary system, scanning of the bladder wall is also performed - transverse and longitudinal.
Preparing for a bladder ultrasound
Proper preparation for an ultrasound of the bladder is a guarantee that the results will be accurate and the diagnosis will be error-free. Each type of ultrasound requires special preparation, so you need to ask your doctor in advance which diagnostic method is right for you.
For a transabdominal procedure for cystitis and other disorders, you need to go with your intestines prepared. To do this, in 3-4 days you will have to exclude from the diet all dishes that provoke flatulence and bloating. This is cabbage, peas and beans, fresh apples, milk and baked goods. You can take Espumisan. It is advisable to do a cleansing enema or just go to the toilet the day before the procedure.
External ultrasound is the only one that requires a full bladder. This condition can be ensured in two ways: either do not go to the toilet in the morning before the procedure (4-5 hours), or drink 1.5 liters of liquid an hour and a half before the ultrasound. It can be water without gas, Herb tea, fruit drink or compote.
For transrectal ultrasound, it is necessary to thoroughly cleanse the intestines the day before. Microenemas, mild laxatives or anal suppositories are suitable. Transvaginal ultrasound is performed with an empty bowel and an empty bladder. And if transurethral ultrasound is prescribed, it is enough to give up a hearty breakfast and cigarettes a few hours before the procedure. The latter two varieties also require careful hygiene procedures before analysis.
Norms of ultrasound results
Interpretation of the results of an ultrasound scan of the bladder includes several parameters, on the basis of which the attending physician makes a final diagnosis. These indicators include:
- bladder shape and volume;
- residual urine (volume);
- organ structure;
- wall thickness;
- filling and emptying.
The shape of the organ differs between men and women; in the latter, the position of the uterus, pregnancy, and the number of births have a significant influence on the appearance of the bladder. Normally, a full organ is shaped like a pear, while an empty organ is shaped like a saucer. In women it is wider on the sides and compressed at the top.
The volume also varies depending on the gender of the patient. For women – 250-550 ml, for men – 350-750. Residual urine should not exceed 50 ml (in healthy person it shouldn't exist at all). Normal wall thickness is in the range of 2-4 mm, and the average emptying rate is 50 ml/h.
Ultrasound of the bladder is one of the most informative methods diagnosis of urinary system disorders. And the variety of methods of this study allows us to take into account the individual characteristics of the patient and make the most accurate diagnosis.
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Ultrasound examination of the bladder is a type of instrumental diagnostics of this body, based on obtaining images of various tissues from ultrasonic waves.Ultrasound of the bladder - the essence and principles of the diagnostic method
Ultrasonography Bladder, as the name of the method implies, is based on the possibility of obtaining an image of an organ on a monitor by passing ultrasonic waves through it. That is, a special sensor emits ultrasonic waves with a high vibration frequency that are not detected by the human ear. These waves pass through various tissues, are partially absorbed by them, partially reflected and refracted. The reflected ultrasonic waves return back and are picked up by the same sensor that emits them. Next, the captured reflected ultrasound waves are amplified by the device, automatically processed, and an image of the internal organs and tissues appears on the monitor of the ultrasound machine.Depending on the properties of the biological structure, it absorbs more or less ultrasonic waves, causing different numbers of waves to be reflected back to the sensor. It is the unevenness of the absorbing and reflective ability of tissues that allows you to create images of various objects on the monitor.
Transabdominal access for ultrasound of the bladder is the simplest, most convenient and safest, as a result of which the lion's share of organ studies is currently carried out in this way. Transvaginal and transrectal approaches provide more information about the bladder, but are used less frequently, only when it is necessary to obtain comprehensive and as detailed data as possible. Transrectal access is also often used in men when it is necessary to evaluate the condition of not only the bladder, but also the prostate gland, seminal vesicles and other genital organs. Transvaginal access for ultrasound of the bladder is used only for women, and transrectal is used mainly for men and young girls (virgins). Transrectal ultrasound of the bladder in adult women is rarely performed, preferring transvaginal access when necessary to obtain detailed data on the condition of the organ. Transurethral access for ultrasound examination of the bladder is rarely used, since it requires special expensive equipment and the need for pain relief. Let's look at how an ultrasound of the bladder is performed using transabdominal, transvaginal and transrectal methods.
To perform an ultrasound using transabdominal access, the patient needs to lie on his back on a couch and expose the lower abdomen (the area from the pubis to the navel). The doctor will apply a special gel to the abdomen, which is necessary to improve the quality of the image obtained on the monitor. The gel is usually cold, so in the first few seconds after its application you may experience discomfort, however, they will pass quickly. After this, the doctor will press the ultrasound machine probe firmly against the abdomen and move it over the surface of the skin with light pressure, obtaining images of the bladder on the screen from different angles. The procedure is completely painless and usually lasts from 5 to 15 minutes. After the ultrasound is completed, the doctor will remove the transducer from the abdomen, and the patient will need to clean the skin and get dressed.
In some cases, when an ultrasound of the bladder through transabdominal access is prescribed to determine the volume of residual urine, after the main study, the doctor asks the patient to urinate, after which he again places the sensor on the stomach, measures the necessary parameters and determines how many milliliters of urine remain in the organ after urination.
To perform an ultrasound of the bladder through transvaginal access, the woman is positioned on a couch lying on her back with her knees bent and her legs spread apart. It will be necessary to remove clothing from the lower half of the body, including underwear. Next, the doctor lubricates the sensor with a special gel, puts a condom or sterilized rubber cap on it and inserts the device into the vagina. Rotating the sensor into the vagina under different angles, the doctor sees on the monitor an image of the bladder from different angles, which allows him to diagnose various pathologies. After the test is completed, the doctor removes the sensor from the vagina, and the woman can get dressed and leave.
To perform an ultrasound of the bladder via transrectal access, the patient should lie on the couch on his side, pull his legs bent at the knees towards his stomach, after removing clothes from the lower abdomen. The doctor lubricates the sensor with gel, puts a special sterile cap or condom on it and inserts the instrument into the rectum 5–6 cm. Then, by changing the position of the sensor, the doctor receives images of the bladder on the monitor from different angles. After completing the examination, the doctor removes the instrument from the rectum, after which the patient can get dressed and leave.
Ultrasound of the bladder in women and men
There are no fundamental differences in performing ultrasound of the bladder in men and women, but there are a number of features that should be mentioned. Thus, men are usually prescribed an ultrasound of the bladder to determine the volume of residual urine, which is due, firstly, to the need to diagnose the pathology of not only the bladder, but also the genital organs located next to it (prostate, seminal vesicles). And secondly, in men a simple ultrasound of the bladder is less informative than in women, therefore for quality diagnostics it is necessary to determine a larger number of parameters, one of the most important of which is the volume of residual urine. If a man is suspected of having pathology only of the urinary system, then a transabdominal ultrasound is usually prescribed. But if a man is suspected of having a pathology not only of the urinary system, but also of the reproductive system, or if it is necessary to distinguish between diseases of the bladder and prostate/seminal vesicles, then a transrectal ultrasound is prescribed. Since men often have situations when the doctor needs to accurately determine whether the existing symptoms are due to pathology of the urinary or reproductive system, in practice, representatives of the stronger sex are usually prescribed transrectal ultrasound of the bladder. Women are usually prescribed a transabdominal ultrasound of the bladder without determining the volume of residual urine, since this study is quite sufficient for diagnosis. If the doctor needs the most accurate data, then women are usually prescribed a transvaginal ultrasound of the bladder, which allows not only to increase the information content of the diagnosis of bladder diseases, but also to distinguish them from possible pathologies of the genital organs (adnexitis, salpingitis, etc.).
There are no other fundamental differences in ultrasound of the bladder in women and men.
What parameters are assessed by ultrasound of the bladder?
When performing an ultrasound, the following parameters must be assessed:- The location of the bladder relative to neighboring organs and tissues;
- Condition of Lieto's triangle and bladder neck;
- Bladder size (three dimensions are measured - width, length and depth);
- Bladder shape (normally round, oval or slightly triangular, always symmetrical);
- Contours of the bladder (smooth, uneven, scalloped, etc.);
- Condition and thickness of the bladder wall;
- Bladder capacity;
- Release from the ureters and the rate of bladder filling with urine;
- The presence of neoplasms in the bladder (if they are detected, their shape, size, and growth pattern are determined);
- The presence of suspension (pus, blood, sand, etc.) and stones in the contents of the bladder;
- Condition of the ureters.
Interpretation of ultrasound of the bladder
Normally, the bladder should be round, oval or slightly triangular shape, clear, even contours. The thickness of the bladder wall is normally 2–5 mm, and the inside of the organ should be hollow (echo-negative) without suspension, pinpoint inclusions (stones, blood clots), etc. The doctor also evaluates the release from the ureters into the bladder, which is normally visible on the monitor, and its speed is up to 14.5 cm/s. The rate of filling of the bladder with urine is normally 50 ml per hour, and the volume of the organ in women ranges from 250 to 550 ml, and in men from 350 to 750 ml. A sign of pathology is a thickening of the bladder wall of more than 5 mm, which may indicate an inflammatory process, closure of the organ lumen with a stone or tumor.
If the contour of the bladder is scalloped, cysts or a bifurcated wall are visualized around it, then this indicates diverticula, ureterocele, etc.
If the volume of the bladder is larger than normal, then this may be a sign of narrowing, stone or injury to the urethra, enlarged prostate in men, cystocele, or neurogenic bladder. If the volume of the bladder is less than normal, this may indicate cystitis, schistosomiasis or a tumor.
Small multiple hyperechoic/hypoechoic formations in the bladder cavity may indicate cystitis or sand. If the hyperechoic/hypoechoic formations are larger, then this may be a sign of stones, cysts, polyps or bladder tumors. Polyps, cysts and tumors usually look like immobile hyperechoic inclusions in the cavity of the bladder, and stones and sand look like mobile ones.
If the doctor detects the backflow of urine from the bladder into the ureters, this may indicate neoplasms, stones, sand, or abnormalities in the structure of the urinary organs.
The volume of residual urine is normally less than 50 ml, and if it is more, then this may be a sign of an inflammatory process, stones, tumors (and in men, also pathology of the prostate gland, seminal vesicles).
We have indicated the main ultrasound signs of normal and pathological bladder, on the basis of which we can only roughly orient ourselves regarding general condition organ. But a full interpretation of ultrasound data can only be carried out by a doctor, taking into account the person’s clinical symptoms and data from other examinations (tests, palpation, etc.).