Bladder ultrasound is a scan of the bladder by acoustic waves propagating during ultrasound radiation. It is indicated for suspected inflammation, stones, foreign bodies, diverticula or neoplasms, to study the patency of the ureters. A full bladder is needed for examination. Examination of the bladder is usually performed through the front wall of the abdomen in the supine position. There is a method of examination through the wall of the rectum, in which an ultrasound sensor is inserted into the anus.
The diagnostic arsenal of clinical urology includes transabdominal, transvaginal, transurethral and transrectal methods.
Transabdominal ultrasound through the lower abdominal wall is performed most often. Transrectal ultrasound using a sensor inserted into the rectum is usually used in the examination of men. Transvaginal bladder ultrasound in women is performed through the vagina. With transurethral bladder ultrasound, the sensor is inserted into the urethra. Transurethral, transvaginal and transrectal ultrasound are used when it is necessary to detail serious changes detected during abdominal examination.
Bladder ultrasound is indicated for pathology of the urinary tract (cystitis, pelvic organ prolapse, urinary incontinence, etc.), injuries and injuries, detection of micro- and macrohematuria, suspected urolithiasis, tumor and cystic formations of the bladder, developmental abnormalities (diverticula, urachus cyst, ureterocele, etc.), varicose veins of the bladder. In men, examination of the bladder is often carried out in combination with ultrasound of the prostate. Contraindications to bladder ultrasound were not revealed. However, the presence of open wounds, sutures, and a catheter in the scanning area can complicate the study or distort the diagnostic results.
A special diet and preliminary intestinal cleansing before transabdominal ultrasound are not required. The specifics 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 with abstinence from urination for 4-6 hours. In case of urinary incontinence, preliminary catheterization is performed and the solution is injected into the bladder immediately before ultrasound. Before a transrectal bladder ultrasound, a cleansing enema is performed.
Methodology of conducting
During ultrasound, the sensor emits acoustic waves, which, reflecting, return to the transducer again, forming an echoscopic image. The ultrasonic sensor is placed on the suprapubic region; first, the transverse sections (from the pubic to the umbilical region) are scanned, then the longitudinal ones. 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. This ultrasound method 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 examined simultaneously, in men – the prostate.
Interpretation of results
When performing ultrasound, the capacity of the bladder and the volume of residual urine are evaluated, the thickness of the walls is measured, the contours and surrounding tissues are examined, the locking function is detected, urinary stones, foreign bodies, additional formations, urine leaks into the parapubic space are detected. The echographically unchanged bladder has smooth and clear contours of the walls; the thickness of the walls is not more than 2 mm, echonegative contents. Following ultrasound scanning of the filled bladder, the study is repeated after emptying it, while assessing the volume of residual urine (normally about 20 ml). At the time of urination, urofluometry can be performed.