Ultrasound of the bladder and urinary tract: decoding of the study results with the determination of the normal volume of residual urine. How is bladder ultrasound done and what does it show? How is ultrasound of the genitourinary system performed?

If a pathology of the bladder and urinary tract of various origins is suspected, for the differential diagnosis of diseases similar to them in symptoms (inflammatory processes of the prostate, kidneys, ovaries, ureters, fallopian tubes), imaging before surgery. Ultrasound of the bladder is performed as the main examination or as an additional one, clarifying the results of the patient's urography, cystography or cystoscopy.

The latest generation scanners, which are equipped with the network's medical centers, allow performing ultrasound of the gallbladder in various ways: traditional abdominal, as well as rectal and vaginal, depending on the indications and the patient's gender. Hardware examination by ultrasound can be performed by both men and women. An ultrasound of the gallbladder is available in our network.

Preparation for ultrasound of the bladder, depending on the method

To make an ultrasound of the gallbladder as informative and reliable as possible, a simple preparation is required, which differs depending on the examination method.

The traditional method - transabdominal - is performed using a transducer that is applied to the anterior abdominal wall lubricated with gel. Such a study is carried out with an empty bowel and a full bladder. To ensure the first condition, it is necessary to refuse food that causes gas formation a few days before the examination, if necessary, as prescribed by a doctor, take adsorbents, and do a cleansing enema on the eve of the procedure. To fulfill the second condition, several hours before the study, you must take a liter of liquid and, as prescribed by the doctor, a diuretic.

A transrectal examination is carried out with an empty rectum, for which appropriate measures are taken before the procedure - taking laxative medications, setting suppositories, enemas - strictly according to the prescription of the doctor who prescribed the ultrasound. During transrectal examination (introduction of an endoscopic probe through the rectum), the gallbladder must be filled; with transvaginal examination, this is not necessary.

A transurethral examination (insertion of a flexible endoscope with a sensor through the urethra) is performed under local anesthesia with a full bladder. Taking liquid before the procedure is necessary to enhance the contrast between the walls of the organ and its contents, which improves the quality of visualization.

Children undergo only transabdominal ultrasound, transvaginal (through the vagina) - only women, other methods are used to scan the urea of adult patients of both sexes.

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

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

What this ultrasound shows:

Bladder tumors.
Stones or sand.
Acute or chronic inflammatory process of the mucous membrane.
Bladder wall diverticula.
Foreign bodies in the bladder.
Abnormalities in the development of the bladder or ureters.
Reflux of urine from the bladder into the ureters.
Blockage of urine outlet by stone.

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

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

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

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

What you need to know to conduct your research

An ultrasound scan is performed on a full bladder... Therefore, preparation for research consists in filling 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 simply wait until this hollow organ fills itself. To do this, you need to not urinate for three to four hours. And if the procedure is scheduled for the morning, you can prepare for the ultrasound if you do not urinate in the morning. If it’s too hard, set yourself an alarm clock for 3 in the morning, go to the toilet, but after you finally wake up, you don’t need to do this.

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

The filled bladder is a kind of "window" that allows ultrasound to "see" the following organs:

a 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 performed

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

Through the abdominal wall (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 clothing so that the stomach is free of it.
So he lies down on the couch facing the sonologist, who applies a special gel to the stomach (it is cold, so unpleasant sensations may arise that quickly pass).
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 an organ pathology, he may ask to empty the bladder, after which he will carry out repeated measurements - ultrasound with determination of residual urine.

Under these conditions:

when a serious pathology needs to be confirmed,
or if external examination is difficult due to obesity, adhesions, tumor processes or free fluid in the abdominal cavity,

the sonologist can immediately carry out internal research, which differs in men and women.

Watch a video on how to prepare for your procedure.
How is the study of the bladder done in women. Most often - externally. 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. In this case, you also need to fill the bladder. Ultrasound of the genitourinary system in men most often it is also carried out through the abdominal wall. But if obesity is expressed, there is ascites (fluid in the abdominal cavity due to cirrhosis of the liver), and also if there is a tumor that originates from the prostate, it is necessary to conduct an internal study.

In this situation, an ultrasound scan in men is done 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 only the rectal wall is located between the sensor and the filled bladder.

The examination is a little uncomfortable. In addition, you must make sure that the rectum is emptied before the procedure. 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 sensor is inserted through the urethra into the bladder.

How to understand research results

Deciphering an ultrasound of the bladder should be carried out by the attending urologist on the basis of not only comparing the figures obtained as a result of your research with the norms. The symptomatology that made the person seek medical help is also assessed.

Bladder norm according to ultrasound

It 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 thickness of the organ wall along its entire length 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 prone position, it will be localized near the back wall of the bladder, but if the person is asked to stand, then closer to the front wall.

Until the disease has reached an advanced stage, the thickening of the wall will not be noticeable, its contour will be even. With the progression of pathology, the wall becomes thicker, its outline 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 have formed during inflammation, they will initially look like hyper- or hypoechoic formations, which can even be adhered 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:

stones soldered to the mucous membrane
polyps
ureterocele
hypertrophy of the prostate.

4. Echogenic formations with mobility in the bladder:

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

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

hyperplasia of the prostate
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 training, but is generally simple, painless and safe.

As you know, due to anatomical features, women are most susceptible to genitourinary diseases. As a result, not the last place in the diagnosis of pathologies is given to ultrasound examination. This method can be used for patients of different ages. Our article will tell you about the features of the ultrasound of the bladder in women, how the preparation for the study is made, which is shown by the ultrasound.

Who is doing the research

Most often, ultrasound of the bladder is done in women with clear signs of impaired genitourinary function. These include:

frequent urge to go to the toilet;
difficulty urinating;
the presence of bloody discharge in the urine;
the presence of calculi;
vesicoureteral reflux;
pyelonephritis;
cystitis;
pain over the pubis.

Ultrasound of the bladder is used as an adjunct to a gynecological examination, to assess the patient's condition after undergoing surgery on the genitourinary system, to monitor the functioning of the kidneys.

Training

Many women have the question of how to prepare for an ultrasound examination in order to obtain the most accurate results. Preparation for an ultrasound of the bladder is based on a good fullness of the organ. This is the basic rule that applies to patients of any age. The highlights are:

two hours before the procedure, you should drink at least 2 liters of liquid. It can be pure water, weak tea, dried fruit compote;
you must refrain from going to the toilet 2 hours before the study;
people who do not suffer from cardiovascular pathologies can take diuretics.

The basis of preparation is filling the bladder with water.

The above activities will help the doctor conduct a high-quality study. If the diagnosis is done transvaginally or transrectally, filling of the bladder is also required. In addition, for the diagnosis of the last type, it is necessary to make cleansing with an enema. You can get unreliable results if there is increased gas production in the intestine. Therefore, 3 days before the study, it is necessary to exclude the use of a diet that increases the number of gases.

To do this, you need to adhere to a special diet that excludes the use of:

legumes;
tomato;
cabbage;
carbonated drinks;
alcohol;
dairy products.

If a woman has difficulty in abstaining from urinating, this often happens during pregnancy, then you can visit the toilet. Next, you should drink 1 liter of water so that during the study the bladder is well filled. Examination of women is done on any day of the menstrual cycle.

How the research is done

Most often, the diagnosis is carried out transabdominally, through the abdominal wall. During the procedure, the patient lies on the couch on her back. The doctor performs the procedure with an ultrasonic transducer with a special gel applied to it. If, during the diagnosis, an assumption is made about the presence of stones, sand, a tumor process, then a request may be made to the patient to conduct a study while standing.

To assess the condition of the bladder mucosa, it is recommended to conduct an examination on the side.

Diagnostics usually lasts no more than 15 minutes. It may be necessary to assess how fully the organ is emptied. To do this, the woman may be asked to visit the toilet and then re-examine the bladder. If the patient is obese or there is an assumption about the presence of a tumor, then an ultrasound scan can be performed using the following methods:

Transvaginally... The sensor is then inserted into the vaginal opening. The study can only be conducted for women who are sexually active.
Transrectally. With the help of a special probe inserted into the rectal opening. Diagnostics can be carried out for both women who are sexually active and for virgins.

Transvaginal diagnosis allows simultaneous gynecological examination

Contraindications

Contraindications for ultrasound examination of the bladder include in the abdominal form: urinary incontinence, since the diagnosis is carried out exclusively on a full bladder, the presence of excess weight (since with an excess amount of subcutaneous fat, there is a decrease in information content), skin lesions on the investigated area, the presence of scars on bladder.

Transrectal examination is not done for intestinal inflammation, anal fissures, bowel obstruction, or latex allergy. The transvaginal method is not indicated for allergic manifestations to latex, the presence of a virgin pleura, the presence of pregnancy in the 2nd trimester, and infectious diseases of the genital organs.

results

During the study, the doctor, evaluating the parameters of the bladder, can assess the following parameters:

what form of the bladder, deformation can indicate the presence of neoplasms;
size. A reduced organ speaks of fibrosis, frequent cystitis, an enlarged organ - hyperplasia, narrowing of the urethra, the presence of calculi;
contours;
what content the organ has. It can be clots of pus, blood, hematoma, urine;
the presence of neoplasms and their size, shape, mobility;
the integrity of the organ or the presence of damage.

If a woman has cystitis, then ultrasound can show uneven contours, enlarged walls. Ultrasound examination allows you to determine various neoplasms, which include polyps, cysts, tumor processes. As a result of the study, it is possible to diagnose the presence of patency of the urethral canals, foreign neoplasms, sediment, inflammation, increased tone, atony, prolapse of the bladder, diverticulosis and pathology in the genitals.

The attending physician is engaged in decoding the picture of the study.

Norm

After receiving a picture of the study, the doctor evaluates the results with indicators of norms. A healthy woman is diagnosed with the following parameters:

the bladder should be pear-shaped with a full organ, after urination - saucer-shaped;
the normal structure looks like dark spots on the screen of the device;
the volume of urine varies between 250-550 ml;
walls with a thickness of 2 to 4 mm;
filling speed of about 50 ml per hour;
residual urine should have a volume of no more than 40 ml.

What problems are detected on ultrasound

Diagnosis of flake sediment occurs in cystitis. Often, the sediment is formed from leukocytes, epithelial cells, phosphates and is a prerequisite for the development of ICD. In the course of diagnosis, the flakes appear to be hyperechoic formations. Formations characterized by increased echogenicity include the presence of stones, cysts, polyps, a narrowed lumen in the urethra, and neoplasms.

The tumor in the ultrasound picture does not have an acoustic shadow, such as calculi

Formations with increased echogenicity are mobile, for example, stones, and immobile, polyps. On the screen of ultrasound equipment, light areas are stones, cysts are darker. Often, the study determines the presence of a reflux of urine, which reaches the renal pelvis. This phenomenon occurs due to pathologies of the urinary tract, stones, flakes, formations.

In this case, ultrasound diagnostics are performed simultaneously with a Doppler. This type of study evaluates how much urine is thrown and remains, what is its direction, and is used to determine the severity of the disease. Ultrasound diagnosis of the bladder refers to an effective method of detecting pathologies at the very beginning of their development.

Content

In determining diseases of the bladder, ultrasound examination is not the last place. This diagnostic method is prescribed when there are symptoms indicative of the pathology of the genitourinary system. To obtain reliable results, an ultrasound of the bladder should be taken seriously and prepared. All instructions regarding preparation for the examination are given by the doctor and it is very important to follow them. This method has no contraindications, it is allowed even for a child.

Indications for the appointment of an ultrasound study

This method of examination is distinguished by its simplicity, the absence of contraindications, complications, and the speed of obtaining results. A study is prescribed for the following symptoms:

frequent or difficult urination;
incontinence;
suspicion of the presence of kidney stones;
with cystitis;
outflow of urine mixed with blood;
the assumption of vesicoureteral reflux.

Additionally, the study is prescribed to assess the work of the kidneys, diagnose cystitis (both chronic and acute), pyelonephritis. If there is a suspicion of adenoma or inflammation in men, prostate examinations are carried out at the same time. For a complete assessment of the state of the genitourinary system, women may be prescribed additional examinations of the uterus and appendages.

How to properly prepare for an ultrasound of the bladder

Preparation for ultrasound of the bladder plays a very important role. By the time of the procedure, the organ must be filled - this will help determine the thickness of the walls, the shape of the organ and its contour. To do this, about 1.5 - 2 hours before the ultrasound, you need to drink about 2 liters of liquid in the form of teas, compotes, still water. There is another way - do not empty the bladder for 5 - 6 hours before the procedure.

If the ultrasound will be performed transrectally, it is necessary to do a cleansing enema on the eve of the procedure and a few hours before it. After such preparation, patients do not have questions about whether it is possible to eat before the ultrasound of the bladder. After all, it is clear that it is better to conduct an examination after an enema on an empty stomach or following a diet (with other types of examination: external and transvaginal or trans urethral).

Many patients find it difficult to refrain from urinating before the procedure and the question arises how to prepare then. In this case, it is recommended to empty partially, but at the same time you will need to drink 1.5 - 2 liters of liquid so that by the time of ultrasound the organ is refilled. The accuracy of the results after the examination depends on the correct preparation of the patient, because only for a full bladder it is possible to determine the state of the organ.

How is the procedure performed

Ultrasound of the bladder is performed in 3 ways:

Abdominal - with it, the examination is carried out from the side of the anterior abdominal cavity. This is an external type of research.
Transurethral - diagnosis occurs through the urinary canal.
Transrectally - the organ is examined through the rectum.

The most used is the first survey method. The other two are needed to confirm or refute the problems that were identified during the external examination. Ultimately, the method of conducting ultrasound is determined by the attending physician, who prescribes this procedure. The position of the patient is determined during the diagnosis, you will be offered to lie on your back or side, in some cases, you are asked to stand up so that you can examine the organ for the presence of formations inside it.

How is an ultrasound of the bladder done in women

Diagnosis sometimes differs depending on the gender of the patient. For women, the uterus and ovaries are additionally examined. The procedure provides an opportunity to measure these organs, to determine their structure, location, shape. In some cases, women undergo transvaginal ultrasound. This helps to clearly see the picture of the state of organs inside and accurately diagnose the existence of certain diseases. Pregnancy and menstruation are not an obstacle for diagnosis, it is only important to warn the doctor so that he chooses the right examination method.

Ultrasound of the genitourinary system in men

Examination of male patients has some of its own characteristics, for example, during an ultrasound of the bladder, sometimes there is a need to diagnose the prostate gland. If you suspect a disease associated with the prostate, ultrasound of the bladder with the determination of residual urine. To do this, a man is asked to go to the toilet, and then the amount of fluid that is stored in the organ is measured. Otherwise, the diagnosis of the bladder in men and women is no different.

What ultrasound can show

Organ diagnostics helps to see:

Passage through the urethral canals.
The presence of foreign formations, tumors, stones.
Sediment in the bladder on ultrasound can be seen in the form of salts, crystalline formations, epithelium, erythrocytes and leukocytes.
Inflammation (acute or chronic).
Increased tone.
Atony.
Diverticulosis of the walls.
The omission of the organ.
Existence of problems with the prostate (in men).
Diseases of the ovaries, appendages, uterus (in women).

Decoding ultrasound of the bladder

Deciphering the ultrasound results helps the doctor to adequately assess the condition of the bladder, and together with the patient's complaints, make an accurate diagnosis and prescribe treatment if necessary. After all, not always a normal echo pattern indicates the absence of problems with the bubble. In this case, it is very important for the doctor to know the acceptable indicators for the correct examination. A round or oval shape of the organ is considered normal, smooth edges and a volume ranging from 350 to 750 ml in men and 250-550 ml in women.

Estimated cost of ultrasound

In Moscow and St. Petersburg, the price of such a service depends on the clinic where it is performed and the qualifications of the specialist. At the time of this writing, the cost varies between:

Minimum - 600 rubles. in the multidisciplinary medical center "Prima Medica", located on the street. Academician Chalomey, 10B (near the Kaluzhskaya metro station).
Maximum - 2500 rubles. at the Center for Endosurgery and Lithotripsy, which is located at 62 Enthusiasts Highway (near the Entuziastov Highway station).

Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can diagnose and give recommendations for treatment, based on the individual characteristics of a particular patient.

Found a mistake in the text? Select it, press Ctrl + Enter and we'll fix it!

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

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

Indications

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

Training

A special diet and preliminary bowel cleansing are not required before transabdominal ultrasound. Features of 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 abstaining 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 an ultrasound scan. 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 image. An ultrasound probe is placed on the suprapubic area; first, transverse sections (from the pubic to the umbilical region) are scanned, then longitudinal. The bladder is usually well visualized 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. An ultrasound of the bladder lasts from 5 to 15 minutes; during the procedure, discomfort may occur due to the pressure of the ultrasound sensor on the filled bladder. In women, during an ultrasound scan, the uterus and ovaries can be examined at the same time, in men - the prostate.

Interpretation of results

When performing an ultrasound scan, the capacity of the bladder and the volume of residual urine are assessed, the thickness of the walls is measured, the contours and surrounding tissues, the obturator function are examined, urinary stones, foreign bodies, additional formations, urine leaks into the paravesical space are identified. 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 its emptying, while assessing the volume of residual urine (normally about 20 ml). At the time of urination can be performed