Ultrasound of the bladder without water load. How is an ultrasound of the bladder performed?

Ultrasound examination (ultrasound) 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 to be used 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 the 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 sensor.

A mandatory requirement for an examination in this way is a filled bladder. Diagnostics allows you to assess the condition of the bladder as a whole: to determine its shape, size, localization, structure and the presence of pathologies.

Transrectal ultrasound of the bladder (TRUS)

performed through the rectum in women with an intact hymen, in patients with contraindications for transabdominal ultrasound, and in men (in order to identify the relationship between prostate disease and the condition of the bladder). For the study, a special rectal sensor is used;

Transvaginal ultrasound of the bladder (TVUS)

is considered by many experts to be the most informative diagnostic method due to the absence of a layer of adipose tissue between the vagina and the 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 probe is inserted into the urethra to identify the relationship between the pathology of the bladder and urethra.

With the help of 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 medical preparation of the patient (the use of anesthesia). In addition, during a transurethral ultrasound, there is a risk of damaging the urethra.

Indications for ultrasound of the bladder

Which doctor prescribes the study and why

A urologist prescribes an ultrasound of the bladder, usually in 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 pulling pains in the lower abdomen.

Real-time imaging with ultrasound is used in the following surgical procedures:

removal of bladder tumors;
cystolithotomy (crushing and extraction of stones);
transurethral resection of the prostate (endoscopic removal of an adenoma through the bladder);
surgery on the ureters and urethra.

For tumors of the bladder, ultrasound is performed in dynamics before and after treatment. Also, regular ultrasound examination is necessary to detect metastases in the bladder with cancerous lesions of neighboring organs (uterus, prostate, kidneys).

An important role is played by ultrasound of the bladder in the differential diagnosis of other diseases that are clinically similar to the pathology of the urinary tract, for example:

prostatitis (inflammation of the prostate);
salpingitis, salpingoophoritis (inflammation of the ovaries and fallopian tubes);
inflammation and abnormal development 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);
overweight (a thick subcutaneous fat layer makes it difficult to scan and reduces the information content of diagnostics);
skin lesions in the lower abdomen (pyoderma, herpes, wounds, burns, infections with syphilis and HIV);
bladder defects (sutures and scars on the bladder wall).

Transrectal method (through the rectum):

inflammatory bowel disease in the acute stage (fissures, hemorrhoids, dysentery, Crohn's disease, etc.);
absence of the rectum (as a result of surgical intervention and replacement of this organ with an artificial anostomy to remove feces);
narrowing (strictures) and obstruction of the rectum;
intolerance to latex (medical rubber).

Transvaginal method (through the vagina):

allergy to latex;
the presence of a hymen;
pregnancy for 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 an ultrasound of the bladder also differs depending on the method of conducting the study.

Transabdominal ultrasound of the bladder is performed with a full bladder and an empty bowel.

Bladder preparation:

2-3 hours before the procedure, you must drink about 1 liter of liquid and do not urinate. Immediately before the examination, the patient is given a diuretic tablet to speed up the production of urine by the kidneys.

Bowel preparation:

People with flatulence and constipation should follow a diet that limits gas-producing foods (raw vegetables and fruits, legumes, dairy products, alcohol, sodas, coffee, sugary baked goods, and black meat) for 1-2 days prior to the examination. bread);
on the eve of the procedure, the intestines must be cleaned by setting microclysters or glycerin suppositories;
to reduce the amount of gases, you can take activated charcoal.

Preparation for transrectal ultrasound of the bladder consists in emptying the rectum, which is carried out on the eve of the procedure by taking laxatives, setting a glycerin suppository or a cleansing enema.

Transvaginal ultrasound of the bladder does not require filling and can be performed on any day of the menstrual cycle. The only recommendation for this type of study is the intestines cleared of feces and gases (in order to increase information content).

Transurethral ultrasound of the bladder is performed under local anesthesia, therefore, in order to avoid negative reactions of the body to the drug, you should:

during the day before the procedure, completely exclude the intake of alcohol, since its interaction with pharmacological preparations is unpredictable;
on the day of the study, limit yourself to a light breakfast in the morning and do not smoke 1-2 hours before the ultrasound, because food and nicotine against the background of the action of the anesthetic can provoke nausea;
inform the doctor about the presence of cardiovascular and renal pathologies, diseases of the respiratory system, allergies to drugs, alcohol abuse, constant intake of vital medicines.

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 ultrasound of the bladder is the transabdominal (external) method. The doctor treats the transducer head with a special gel (to improve the transmission of ultrasonic waves) and scans the abdomen above the pubis and below the navel with it. 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 the gender and individual characteristics of the patient, age, diagnosis, concomitant diseases and other factors.

Ultrasound of the bladder in women

In women, an ultrasound of the bladder can also be performed by a transvaginal or transrectal (in virgins) method, in which the condition of the uterus and its appendages is additionally examined.

These types of studies allow you to get the most complete picture of the state of the female genitourinary organs.

Bladder ultrasound in men

In addition to the standard external ultrasound in men, pathologies of the bladder and prostate can be diagnosed by the transrectal method. If there is a suspicion of problems with the prostate, then with an ultrasound of the bladder in men, a residual urine count is performed. For this patient, the patient is asked to urinate during the procedure, and then the examination continues, during which the remaining amount of fluid in the bladder is measured.

Transurethral ultrasound performed equally for both men and women.

Ultrasound of the bladder in a child

For children, ultrasound diagnostics is performed only by the transabdominal method. The technique of 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 by the vaginal and rectal methods. In the 2nd and 3rd trimester of pregnancy, ultrasound is performed only transabdominally.

Ultrasound results

The bladder is a hollow muscular organ that is well diagnosed by ultrasound if it is filled.

The main parameters of the bladder, which carry 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.

Deciphering these indicators allows the doctor to assess the condition of the bladder and, with a thorough 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 pictures it is a rounded organ, on longitudinal pictures it is ovoid. The contours of the bubble are clear and even. In women, the shape of the bladder is affected by the presence of pregnancy and the number of births. Unlike the male bladder, the female one is more squeezed from above and expanded on the sides. These factors must be taken into account when decoding ultrasound.

Structure

echo-negative is normal. The older the patient, the higher the echogenicity (due to chronic inflammatory diseases).

the average bladder capacity in women is 250-550 ml,
in men - 350-750 ml.

Bladder walls

they must be of the same thickness over the entire surface: from 2 to 4 mm (depending on the degree of fullness). If in one or more areas there is a local thickening / thinning of the wall, then this phenomenon is considered as a pathology.

Residual urine

with ultrasound of the bladder is measured necessarily. Normally, the amount of residual urine should not exceed 50 ml.

Deciphering 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;
stones in the bladder (urolithiasis);
the presence of foreign bodies;
various vascular pathologies;
vesicoureteral reflux (reflux of urine from the bladder into the ureters);
inflammatory processes;
congenital anomalies in the development of the bladder in children and acquired in adults;
hyperactivity (increased functionality) of the bladder;
enuresis (urinary incontinence);
diverticula of the bladder (protrusion of the wall with the formation of a bag-shaped reservoir for urine).

Where is an ultrasound of the bladder done?

It is possible to undergo an ultrasound diagnosis of the bladder in any medical institution, but it is best in a specialized one that specializes in the diagnosis and treatment of urological diseases.

Ultrasound of the bladder is an examination based on the properties of an ultrasonic wave reflected from an organ, forming its image on the monitor of the apparatus. This diagnostic is used for people of all ages - newborns, pregnant women, and the elderly. It has a wide range of indications, has no contraindications, requires preparation.

urine color change
discomfort or pain in urination
frequent urge to urinate, even if it is painless
small portions of urine
pain in the suprapubic region
air in urine
sediment in the urine or flakes visible "by eye"
the presence of blood in the urine.

What this ultrasound shows:

Bladder tumors.
Stones or sand.
Acute or chronic inflammation of the mucosa.
Diverticula of the walls of the bladder.
Foreign bodies in the bladder.
Anomalies in the development of the bladder or ureters.
Throwing (reflux) of urine from the bladder into the ureters.
Blockage by a stone in the exit of urine.

Doppler ultrasound helps to assess the passage of urine through the ureters: in which direction is its flow directed, what form of this flow is, how symmetrical the process is on both sides.

Based on this analysis, it is concluded how much the ureter is blocked (by a stone, edema, tumor). This study is also indispensable for the diagnosis of Vesicoureteral Reflux, when urine in some amount is thrown against its current - from the bladder into the ureter.

Dopplerography also allows you to make a conclusion about the number of ureters and where they open.

It is this study that will more accurately help to detect tumor formations based on the assessment of blood flow, since the vessels of the tumor look and behave somewhat differently.

What you need to know to conduct research

Ultrasound performed on a full bladder. Therefore, preparation for the study is to fill it. This can be done in two ways:

An hour or a little more before the procedure, you need to drink about a liter of water without gas, tea or compote (but not milk), then do not urinate. If it is impossible to endure the urge to urinate, it is allowed to empty the bladder, then drink 2-3 glasses of water again.
You can not drink water, but just wait until this hollow organ fills itself. To do this, do not urinate for three to four hours. And if the procedure is scheduled for the morning, you can prepare for an ultrasound if you do not urinate in the morning. If this is too hard, set yourself an alarm clock for 3 in the morning, go to the toilet, but after the final awakening, this is no longer necessary.

In addition, a gas-filled intestine can prevent a correct diagnosis of the bladder. So, if you suffer from flatulence or constipation, try a day or two before the appointed time to follow a diet with the exception of fresh vegetables, fruits, legumes, carbonated drinks and alcohol.

The filled bladder is a kind of “window” that allows ultrasound to “see” such organs:

non-pregnant uterus or when examining it in the first trimester (at a later date, it is not necessary to fill the bladder for the study)
ovaries: their location, size, presence of cystic changes
in men, the prostate gland.

How is the procedure carried out

How is an ultrasound done? Diagnostics can be carried out using the following methods:

Through the wall of the abdomen (external examination).
Through the vagina, rectum, or urethra (internal examination).

If an ultrasound is done through the abdomen, then the procedure looks like this.

The patient undresses to the waist or lifts the clothes so that the stomach is free from it.
So he lies down on the couch facing the sonologist, who applies a special gel to the stomach (it is cold, so there may be discomfort that quickly passes).
Moving along the gel, the sensor scans the image of the bladder and nearby organs, sends their images to the screen.

The examination is painless and lasts about 20 minutes. If the doctor suspects a pathology of the organ, he may ask to empty the bladder, after which he will take repeated measurements - an ultrasound with the determination of residual urine.

Under such conditions:

when it is necessary to confirm a serious pathology,
or if external examination is difficult due to obesity, adhesions, tumor processes or free fluid in the abdominal cavity,

the sonologist can immediately conduct an internal study, which differs for men and women.

Watch the video on how to prepare for the procedure.
How is the study of the bladder in women. Most often - the external way. But sometimes you have to resort to transvaginal research. In this case, a special sensor is used, which is inserted into the vagina in a special disposable condom. At the same time, you also need to fill your bladder. Ultrasound of the genitourinary system in men most often it is also carried out through the wall of the abdomen. But if obesity is pronounced, there is ascites (fluid in the abdominal cavity due to cirrhosis of the liver), and also if there is a tumor that comes from the prostate, an internal study is necessary.

In this situation, ultrasound is done in men in this way: a special thin ultrasound transducer is inserted into the rectum, which helps to obtain an image of the bladder and other structures. In this position, it turns out that between the sensor and the filled bladder is only the wall of the rectum.

The study causes little discomfort. In addition, before the procedure, it is imperative to ensure that the rectum is emptied. This is achieved with the help of microclysters, glycerin suppositories or herbal laxatives (Senade, Picolax).

In some cases, both men and women need an intracavitary ultrasound, when a thin probe is inserted through the urethra into the bladder.

How to understand the results of the study

The interpretation of the ultrasound of the bladder should be carried out by the attending urologist on the basis of not only a comparison of the numbers obtained as a result of your study with the norms. The symptoms that caused the person to seek medical help are also evaluated.

The norm of the bladder according to ultrasound

This is an organ with an echo-negative structure. It has a rounded shape on transverse scans, ovoid on longitudinal images. The organ is symmetrical, its contours are even and clear. There should be nothing inside the bubble. The wall thickness of the organ throughout should be about 0.3-0.5 cm. The maximum urine flow rate is about 14.5 cm / s.

Ultrasound signs of organ inflammation

Ultrasound for cystitis

Acute cystitis in its early stage has such an echo picture: small echogenic particles are determined in it in various quantities. This is an accumulation of various cells (epithelium, leukocytes, erythrocytes) or salt crystals. This is described by the words "bladder sediment". On ultrasound in the supine position, it will be localized near the back wall of the bladder, but if a person is asked to stand up, then closer to the front wall.

Until the disease has reached an advanced stage, wall thickening will not be noticeable, its contour will be even. With the progression of the pathology, the wall becomes thicker, its contour is uneven.

Chronic cystitis looks like a thickening of the organ wall, while sediment will also be determined in the lumen (they also write - “flakes in the bladder”). If blood clots form during inflammation, they will initially look like hyper- or hypoechoic formations, which can even be glued to the mucous membrane. When, after three days, the clot begins to liquefy, this is defined as a formation in which anechoic areas with uneven contours have appeared.

Other pathology on ultrasound

1. Thickening of the entire wall of this organ and its trabecularity in children may mean obstruction of the urethra by its valve.

2. A rather thick bladder wall in combination with ureterohydronephrosis may indicate a neurogenic bladder.

3. Echogenic formations in the bladder associated with its wall can be:

soldered to the mucous stones
polyps
ureterocele
prostate hypertrophy.

4. Echogenic formations that have mobility in the bladder:

stones
foreign body
air: it enters the bladder or from the fistula, or during inflammation, or when placing a urinary catheter
blood clot.

5. An increase in the size of an organ may be due to:

prostate hyperplasia
stones or swelling in the urethra in men
neurogenic bladder
urethral injury in women
valves or diaphragm of the urethra in newborns.

The price of this ultrasound is from 300 to 1200 rubles on average in our country.

Thus, ultrasound of the bladder is a very useful study that allows you to identify a wide range of pathologies of this organ and nearby structures. It requires preparation, but is generally simple, painless, and safe.

Thanks to ultrasound examination of the urinary system, a lot of urological diseases can be detected. The examination does not harm the body and can be carried out by absolutely everyone: men, women and children, regardless of age. Experts say that various pathological processes of the urinary system are much easier to completely eliminate in the first stages of development. In order to prevent complications, as a preventive measure, it is recommended to do an ultrasound examination of the organs of the urinary system once a year.

What is included in the survey

The urinary system includes the kidneys, bladder, ureters, and adrenal glands. All these organs are examined during an ultrasound examination. If you do not want to wait in line for an examination at a municipal clinic, ultrasounds can be done at private diagnostic clinics for a fee.

Indications

As a rule, a comprehensive diagnosis of the urinary system is prescribed in the following cases:

Urinary retention
Urinary incontinence
Injuries
Pain in the lower abdomen
Having stones in the kidney or ureter
Inflammatory or infectious diseases
Pain while urinating
Blood or pus in the urine

The child is prescribed a diagnostic procedure in the presence of a poor urine test of unclear etiology. Often this procedure is carried out for pregnant women in the first trimester in order to exclude diseases of the urinary system.

Contraindications and possible risks

Side effects are completely excluded, there is no negative effect on the body. Of the contraindications, it is worth noting only injuries, injuries, deep abrasions or severe burns of the area under study. Ultrasound is not recommended until complete healing of the skin.

How to prepare for an ultrasound

A comprehensive examination of the urinary system requires special preparation. Only in this case, you can find out the exact diagnosis and find out detailed information about the organs. Despite the fact that the urinary system is in no way connected with the digestive organs, it is necessary to follow a dietary diet in order to prevent increased gas formation, which can interfere with the study.

For two days, you need to stop eating black bread, whole milk, cabbage, fresh vegetables and fruits, pickled foods.
Drink enough water every day, up to 2.5 liters, if there are no contraindications.
In the evening, before the ultrasound, have a light dinner around 19-20 hours.
If there are problems with the stool, you need to do a cleansing enema. If the study is carried out through the rectum - this item is mandatory.
With flatulence, drink carminative preparations for a couple of days.
Come for an ultrasound on an empty stomach.
Take a bottle of clean water with you. Drink about 700 ml of water in about 30 minutes and do not empty your bladder until the specialist requires it.
Strictly avoid alcoholic beverages.

The doctor who ordered the study will tell you more about the preparation. Don't forget to bring your passport and specialist referral. If there are pictures from the last ultrasound, it is also desirable to have them with you.

How is an ultrasound of the urinary system performed?

Let us consider in more detail how ultrasound of the urinary system is performed.

Ultrasound of the kidneys

Depending on the patient's complaints and specific diagnoses, the examination of the kidneys can be carried out in various positions. Up to 40 years of age, a routine ultrasound examination is performed; older people are shown an additional examination with a Doppler, which evaluates blood flow and possible problems with blood vessels in the kidney area.

A special gel is applied to the lumbar region for better glide of the sensor. The study takes no more than 20 minutes.

Ultrasound of the ureters

Separate ultrasound of the ureter is not performed, only in combination with other organs of the urinary system. This is due to the fact that using this diagnostic method it is practically impossible to detect the patency of the ureter.

Note that ultrasound is not entirely informative in this case, since the ureters are poorly visualized by ultrasound. For a more detailed study of the organ, other methods of examining the ureter are used.

Inspection is also carried out with a full bladder. The sensor is installed in the area of the anterior abdominal wall, on average, the study takes 10-15 minutes.

bladder ultrasound

The diagnostic procedure can be determined in various ways, most often through the abdominal wall. In women, a transvaginal ultrasound is possible, and in men, through the rectum. Note that this is practiced extremely rarely, for example, with an extreme degree of obesity.

For an adequate diagnosis, the organ is examined in two states: full and empty. First, before the ultrasound, the patient drinks a liter of water. The specialist conducts research in a standard way. Then it is necessary to empty the bladder, after which the condition of the bladder is re-evaluated.

Due to the good mobility of the organ, the study of the bladder is as informative as possible. With the help of such an examination, it is possible to identify various diseases, even oncological ailments at the earliest stages.

Kidneys not visible on ultrasound

It often happens that on ultrasound, the doctor cannot “see” the kidneys. What is it? According to statistics, this happens in 20% of cases. Sometimes this is associated with increased echogenicity. In this case, it is necessary to replace ultrasound with magnetic resonance imaging. Also, the following ailments can serve as a cause:

Ectopia - non-standard localization of the body.
Atrophy - in this case we are talking about a reduced size of the kidney compared to normal.
Lack of one organ - sometimes children are born with only one kidney.

Deciphering the results

The result is interpreted by a nephrologist or urologist. The specialist evaluates the size of the kidneys and bladder, the structure and the presence of defects. Depending on the diagnosis, the patient is prescribed appropriate treatment. Please note that most pathologies are treated with medication. Only with critical diagnoses can surgery be prescribed.

Norms of the urinary system by ultrasound

Each body has its own indicators of the norm:

Length up to 13 centimeters
Width no more than 6 centimeters
Thickness should not exceed 5 centimeters
Parenchyma wall thickness up to 25 mm

Bladder

The shape is round
Localized symmetrically
Wall thickness from 0.3 to 0.5 centimeters
Urine flow rate not more than 14.5 cm/s
The residual amount of urine is not more than 40 ml

Ureters:

Fabrics are homogeneous
No defects or anomalies
Permeability is normal

As a rule, diseases of the urinary system are accompanied by acute pain, which is difficult to miss. It is very important to perform diagnostic manipulation in a timely manner so as not to start the pathological process and avoid serious complications. Thanks to early diagnosis, you will get rid of unpleasant symptoms and eliminate the risk of the disease becoming chronic.

There are transabdominal, transvaginal, transurethral and transrectal methods of bladder ultrasound.

Transabdominal ultrasound through the lower abdominal wall is performed most frequently. Transrectal ultrasound, using a transducer inserted into the rectum, is commonly used to examine men. Transvaginal ultrasound of the bladder in women is performed through the vagina. In a transurethral ultrasound of the bladder, a transducer is inserted into the urethra. Transurethral, transvaginal and transrectal ultrasound are used when it is necessary to detail serious changes found during abdominal examination.

Indications

Ultrasound of the bladder is indicated for pathology of the urinary tract (cystitis, pelvic organ prolapse, urinary incontinence, etc.), injuries and injuries, detection of micro- and macrohematuria, suspicion of urolithiasis, tumor and cystic formations of the bladder, developmental anomalies (diverticulum, urachus cyst, ureterocele, etc.), varicose veins of the bladder. In men, an examination of the bladder is often carried out in combination with ultrasound of the prostate. There were no contraindications to ultrasound of the bladder. However, the presence of open wounds, sutures, a catheter in the area of the scan may complicate the study or distort the diagnostic results.

Preparation

A special diet and preliminary cleansing of the intestine before transabdominal ultrasound is not required. Features of the preparation are the need to fill the bladder. This can be achieved by drinking 1 liter of liquid 1.5-2 hours before the examination, taking diuretics, by physiological filling while refraining from urinating for 4-6 hours. In case of urinary incontinence, preliminary catheterization and the introduction of a solution into the bladder immediately before the ultrasound are performed. Before transrectal ultrasound of the bladder, a cleansing enema is performed.

Methodology

During ultrasound, the sensor emits acoustic waves, which, being reflected, return to the transducer again, forming an echoscopic picture. The ultrasonic sensor is placed on the suprapubic area; First, transverse sections are scanned (from the pubic to the umbilical region), then longitudinal. The bladder is usually visualized well due to the high contrast between its walls and contents. For a better examination of the walls of the bladder, the patient is asked to turn 35-40 °. Any suspicious areas are scanned polypositionally. Ultrasound of the bladder lasts from 5 to 15 minutes, during the procedure there may be discomfort associated with the pressure of the ultrasound sensor on the filled bladder. In women, during ultrasound, the uterus and ovaries can be simultaneously examined, in men - the prostate.

Interpretation of results

When performing an ultrasound, an assessment is made of the capacity of the bladder and the volume of residual urine, measurement of wall thickness, examination of the contours and surrounding tissues, obturator function, detection of urinary stones, foreign bodies, additional formations, urine leakage into the paravesical space. An echographically unchanged bladder has smooth and clear contours of the walls; wall thickness no more than 2 mm, echo-negative content. Following an ultrasound scan of a filled bladder, the study is repeated after it has been emptied, while assessing the volume of residual urine (normally about 20 ml). Can be performed at the time of urination

Ultrasound of the bladder is one of the most common diagnostic methods. The popularity is justified by the fact that a filled bladder serves as a "window" for.

Ultrasound of the bladder shows pathological changes, and deciphering the results of the study helps to make a differential diagnosis of emergency conditions.

Indications for research

Ultrasound of the bladder is performed for a number of indications, including:

dysuric disorders (urination disorders);
frequent urge to urinate;
impurities in excreted urine (blood, flakes);
difficulty urinating accompanied by pain;
inability to urinate independently;
pain in the suprapubic region.

An indication for an ultrasound of the bladder is not only the patient's complaints, but also control over therapy. With the help of diagnostics, the dynamics of the course of the disease after surgery is monitored. Surgical interventions controlled by ultrasound of the bladder are as follows:

oncology treatment (prostate cancer);
cystolithotripsy (crushing of stones) or removal of stones;
resection of prostate adenoma;
operations on the ureters.

Ultrasound of the bladder allows the doctor not only to detect pathological conditions, but also to control the therapy.

Often, the cause of the patient's complaints is the pathology of other organs of the small pelvis. The explanation for this is the close anatomical location of the ureters, and. By deciphering the results of an ultrasound of the bladder, a diagnosis can be made.

Methods for diagnosing the bladder

It distinguishes several methods of examination:

transabdominal examination. Do in the supine position, the diagnosis is carried out through the abdominal wall. The condition for the study is the fullness of the bladder. Abdominal ultrasound allows you to determine the volume, size, structure of the organ. Applied to men and women.
transrectal examination. It is done in a position on its side, 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 with transabdominal.
transvaginal examination. The method is applicable in women. It is carried out in the 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 of the reproductive organs in women.
transurethral examination. The examination is carried out in the supine position, with the introduction of the probe into the urethra. The advantages of the method is the ability to assess the degree of damage to the urethra, visualization of the urethra. Disadvantages of transurethral ultrasound of the bladder: pain relief and risk of complications (damage to the urinary tract by the probe). The method is rarely used due to the above disadvantages.

Transrectal ultrasound is designed to examine the bladder in men and girls (transvaginal examination is prescribed only for women who have already had sexual intercourse)

What does the study show?

Normally, an ultrasound of the bladder (together with the determination of residual urine) shows:

shape: pear-shaped with a filled bladder 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;
residual urine volume: no more than 50 ml.

Signs of pathology on the ultrasound picture

The data obtained from the ultrasound examination are only preliminary information on the basis of which the diagnosis is based. 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. Consider some ultrasound signs of pathological conditions.

An increase in the normal size of the bladder may be accompanied by an increased volume of residual urine. The main reason for the increase in the size of the organ is the overstretching of its walls by urine. This symptom is observed when there is an obstacle to its outflow.

Possible causes of obstruction of the outflow of urine:

prostatic hyperplasia (pathological growth: due to anatomical features, the prostate compresses the urethra and makes it difficult to drain urine);
pathology of the innervation of the organ;
stones 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 diseases of the bladder. The main indicator is a reduced volume of residual urine. Possible reasons for the reduction in the size of the organ:

Sediment (flakes) in the bladder is observed with cystitis. Flakes are a mass of inflammatory cells (epithelial cells and white blood cells). Often, the sediment is formed by salts (phosphates), which is a prerequisite for the development of urolithiasis. On examination, the flakes are defined 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 deciphering the results, it is taken into account that the degree of echogenicity depends on the density of the tissues: the denser it is, the lighter the areas on the ultrasound picture. For example, stones will be displayed as brightest spots, and cysts are less echogenic (and therefore less light).

Backflow (reflux) of urine from the bladder into the ureters, which can even reach the renal pelvis. Conditions leading to reflux of urine:

urinary tract anomalies;
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 you to determine the quantitative volume of residual and thrown urine, the direction of its current, and also allows you to assess the severity of the disease. The volume of 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.