Whether it is possible to define or determine a cystitis on uzi. Diagnostic methods for inflammation of the bladder
ultrasound Bladder- an examination based on the properties of an ultrasonic wave reflected from an organ, forming its image on the monitor of the device. This diagnostic is used by people different ages- for 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 inflammatory process mucous.
- 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 quantity 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 (more later dates You don't need to fill your bladder for testing.
- ovaries: their location, size, presence of cystic changes
- in men, the prostate gland.
Read also:
Features of ultrasound of the pelvic organs in women
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 study).
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, which pass quickly).
- 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 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 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 ultrasonic 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 a herbal laxative (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.
Read also:
How normal M-echo affects the fertility of your children
In order to assess the neck of the bladder in more detail, to look at the urethra, to more accurately monitor the flow of urine, an intravesical ultrasound can be performed. 
To identify obstructions in the flow of urine, ultrasound is used to determine the residual urine. To do this, after conducting a study on a full bladder, the patient is asked to urinate.
After that, the procedure is again carried out, assessing how much urine remains inside the organ. Normal should be 50 ml or less. A larger number indicates an inflammatory process or compression by a tumor or stone exiting the bladder.
Ultrasound signs of organ inflammation
Ultrasound for cystitis
Acute cystitis in 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 rear wall bubble, 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 first 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.
Cystitis is a fairly common disease. More common in women. This is due anatomical structure- short and wide urethra. Most often, cystitis occurs due to an ascending infection. About 60 percent of cystitis is due to the ascending pathway of E. coli. E. coli (E. coli) is an opportunistic flora living in the rectum and vagina (in small quantities). Also, cystitis can be caused by staphylococcus aureus (occurs with a febrile temperature), such specific pathogens as chlamydia, mycoplasmas, ureaplasmas. Extremely rarely, cystitis can occur by the hematogenous or lymphogenous route (risk of interstitial cystitis).
On the mucous membrane of the bladder there are special receptors to which Escherichia coli is tropic. The number of these receptors different people varies. genetic predisposition to the inheritance of the number of these receptors has not been identified. It is due to the amount of these receptors that some people often suffer from cystitis, some do not know about this problem at all. However, timely diagnosis and treatment of acute cystitis prevents the occurrence of a chronic process.
The main manifestations of cystitis are:
Pain in the suprapubic region;
Discomfort or pain when urinating;
Possible subfebrile temperature(up to 38 degrees);
change in color or amount of urine;
Frequent or infrequent urination;
Imperative urge (urge to urinate without excretion of urine) with a drop of blood or pus (mainly with cystitis caused by a specific flora).
Cystitis can occur for the following reasons:
Irregular or improper hygiene (in girls);
Hypothermia and wearing synthetic underwear;
Inflammatory diseases vagina (in women), urethritis and prostatitis (in men), defloration (frequent sexual intercourse);
Anatomical anomalies and neoplasms in the bladder (diverticula, polyps, tumors, adhesions);
Metabolic nephropathy (stones and sand in the kidneys and bladder);
Narrowing or inflammation of the urethra;
During pregnancy and after childbirth;
Surgical interventions(transurethral);
Wrong food (spicy, spicy, smoked, salty).
Diagnostics
What studies will the doctor need to make a diagnosis:
Collection of anamnesis and complaints;
General analysis blood. Will show a slight leukocytosis and a slight increase in ESR (except for cystitis caused by staphylococcus aureus);
General urine analysis. It will show an increased number of leukocytes, epithelium, protein, there may be a small amount of erythrocytes, as well as a precipitate in the form of salts;
Urine analysis according to Nechiporenko will show an increase in the number of leukocytes;
Urine bacterial culture and sensitivity to antibiotics (results will be ready in a week, therefore it is rarely prescribed);
(most informative method);
Perhaps the appointment of voiding cystography (for vesicoureteral reflux);
Cystoscopy.
Ultrasound of the bladder with cystitis held after special training sick. The patient should drink 1-1.5 liters of still water or other drink (not milk) 1-1.5 hours before the scheduled procedure. In chronic cystitis, ultrasound shows thickened walls, as well as sediment at the bottom of the bladder.
Health-ua.org - medical portal online consultations of pediatric and adult doctors of all specialties. You can ask a question about ‘ultrasound of the bladder with cystitis’ and get free online consultation doctor.
(ixodid tick-borne borreliosis)»> Leukocyturia and Lyme disease
(ixodid tick-borne borreliosis)
The most common manifestation of kidney disease is leukocyturia, the presence of which, as a rule, doctors associate with urinary tract infection. Indeed, there is no cystitis or pyelonephritis without neutrophilic leukocyturia, accompanied by ...
climacteric syndrome
CS is a kind of symptom complex that aggravates natural flow menopause. It is characterized by neuropsychic, vasomotor disorders that occur against the background of age-related changes in the body (I group). The frequency of CS is from 26 to 48%.
Hereditary degenerative diseases of the nervous system
The transition from January 1, 2007 to new standards for registering the birth of newborns from 22 weeks imposes special requirements not only on obstetrician-gynecologists and neonatologists, but also on doctors of other specialties, significantly increases the role of medical genetic ...
2016-09-27 19:08:37
Valeria asks:
Hello! I had such a problem. I’ll start from the very beginning. In July of this year I lost my virginity. After a couple of weeks, I began to feel pain when urinating in the clitoris area. I thought it was cystitis, I bought a powder for its treatment, I drank it and the next day the symptoms disappeared .After some time, I began to feel like a needle in my bladder, I especially felt it when I lay down on my stomach. I went to the therapist, he sent me for an ultrasound of the bladder and for urinalysis. No. The last couple of days I feel pain when urinating. Help, what could it be?
Zhosan Dmitry Alexandrovich answers:
Hello. I advise to address for survey to the urologist and the gynecologist. Before a visit to the urologist, I advise you to perform a urine culture tank.
2012-10-16 10:56:24
Olga asks:
Hello! My name is Olga, I’m 26 years old, I’ve been suffering from cystitis for 3 years, at first there was cystitis in the usual form, the urologist prescribed antimicrobials, then it turned into a chronic form. determined the sensitivity to antibiotics. chlamydia, candida, gardinella and virus herpes simplex., because believes that Kalpit may be the cause of Cystitis. Why antibiotics did not help, because the microorganism was discovered and prescribed proper treatment? And can cystitis appear due to Kalpit? How effective will these tests be? It seems to me that there is a relationship here. If something is found during the scraping, will this be considered the cause of Cystitis? Please help(((Thanks.
Brezitsky Yuri Iosifovich answers:
Only by examining you, having carried out a complete laboratory examination By conducting a detailed analysis of previous appointments and failures from previous therapies, you can find the right solution.
2010-05-22 20:37:36
Ramsia asks:
Hello dear consultants.
I am 48 years old. 10 months ago, due to CIN 3 st, an extirpation of the uterus with ovaries was made. and distension in the rectum, constant pain in the lower abdomen, a feeling of incomplete emptying of the bladder and with a slight tension of the body, running, coughing, the desire to urinate. Rezey, pains of a blood at an urination are not present.
Complete blood count is normal, general urinalysis, urine according to Nechiporenko and flora - no pathology.
Sigmoidoscopy - the intestines were examined at 25 cm. There is no tumor pathology.
Irrigography-Sigma with an additional bend, sagging of the transverse colon to the entrance to the small pelvis. Without organic changes - dyskinesia of the right sections of the hypomator type.
Ultrasound of the kidneys - with clear, even contours, the right one is located lower than usual.
Right-102-43mm parenchyma-16
left-100-47, perenchyma 19.
The ratio of the parenchyma and the renal sinus is preserved.
the cavities of the kidneys are not dilated.
In the projection of the renal sinus of both kidneys, hypoechoic structures with a diameter of 2-3 mm are visualized.
vaginal examination
in the pelvis adhesive process.
Ultrasound of the bladder - the walls are thickened by 7 mm. There is an echogenic sediment along the posterior-lower wall.
I visited a urologist, he says that it is chronic cystitis, it needs to be treated, but because of him such constant severe pain can not be.
Was at the surgeon - says - the stomach is calm, so what, that adhesions because of them, too, there can not be constant severe pain and problems with urination.
Pain in the lower abdomen in the midline and heaviness (feeling as if I were carrying a large boil the size of a brick)
I don’t know what to do and which doctor to go to. Maybe it’s because I don’t take HRT.
Help, tell me what to do.
thanks in advance.
A big request to duplicate the answer to my e-mail address.
Zheleznaya Anna Alexandrovna answers:
Obstetrician-gynecologist the highest category, Candidate of Medical Sciences, Associate Professor of the Department of Obstetrics, Gynecology and Perinatology
All consultant answers
I would advise you to take FSH estradiol TSH T4 free and, depending on the results, discuss HRT taking into account mastopathy.
Try the course rectal suppositories Distreptase or Biostrepta, Serata 2 tablets 3 times a day for 10 days, absorbable preparations.
And most importantly, is there any indication of endometriosis in your histological response after the operation, if there is, then it is imperative to treat it.
2009-12-08 13:04:39
Maria asks:
Hello. I've been suffering from cystitis for 4 years already, but maybe it's not cystitis, because the treatment does not bring results. At the first attack of cystitis, she was treated on her own on the advice of her friends, which I now regret very much. She was treated with furadonin, furagin, herbs, and a heating pad. At that time it helped, and exacerbations were 1-2 times a year. In the future, I tried other drugs: cephalexin, urolesan, cystone, cystenal, amoxicillin, monural, I don’t remember everything. For the last year and a half, the symptoms have haunted me almost constantly, there are sharp attacks, and the rest of the time constant feeling discomfort when urinating, burning, urging to the toilet is not so frequent, as well as pain during intercourse. In the fall of 2008, she turned to a urologist at a local hospital, they took urine, a culture tank and found Sf epidermidis, E. coli 1000 in 1 liter. detrid - bol., mucus - bol., prescribed Nolitsin + Phytolysin (10 days). It helped for a while, then the symptoms reappeared. In the winter of 2009, she went to the gynecologist with the same problem, passed the tests for the UGI, nothing was found. Discharged for the prevention of suppositories Viferon and drink diuretic fees. The symptoms never went away. In September, she turned to a “quality” clinic on the advice of friends, to a gynecologist. A PCR diagnosis was made for Micoplasma Genitalius, Chlamydia trachomatis, Ureaplasma urealyticum, Ureaplasma parvum, Gardnerella vaginalis, Neisseria gonorrhoeae, Trichomonas vaginalis, candida albicans, HPV in.s.(6,11), HPVs.s.(16), HPVs.s.(18). It is found out only Candida (could and itself tell). Smear: leukocytes - uretra 1-3, Vagina 5-10, Canalis Cervicalls - 5-10. Epithelium - Uretra, Vagina, Canalis Cervicalls - flat in a large number. Flora - Uretra, Vagina, Canalis Cervicalls - moderately rod. Elements of the fungus - Vagina - detected, Uretra, Canalis Cervicalls - absent.
Cytological examination (scraping from the cervix): Among single neutrophilic leukocytes, cells squamous epithelium, elements of the fungus. Cytogram without features.
Tank. Analysis of vaginal discharge: Staphylococcus epidermidis, Candida albicans with sensitivity to antibiotics. Tank urinalysis of Escherichia coli with the determination of sensitivity.
Ultrasound of the bladder and kidneys: signs of chronic cystitis.
Treatment was prescribed: clotrimazole, Augmentin, Linex, magnetic laser procedures on the bladder area. Candida was treated successfully, but the cystitis did not go away. Biseptol, a diuretic collection and laser-magnetic procedures were prescribed. After treatment, the symptoms did not go away and continue to this day: burning and pain in the urethra during urination, pain during intercourse. Furamag was prescribed 1 tab per day for 4 months and baths with chamomile for 10 days, Clotrimazole ointment for 10 days.
Already disappointed, I don’t know where to turn for help, the treatment does not bring results. Thanks in advance
Alexey Chernikov answers:
Hello Maria. You should have turned not to a gynecologist long ago, but to a urologist. Till now to you the tsistoskopiya and full-fledged inspection is not made. I'm sorry you weren't redirected to the right specialist. Treatment by a gynecologist, therapist or doctor general practice justified only in uncomplicated and uncomplicated cases. You need to contact a urologist or nephrologist and be examined. As it is valid, probably it and not a cystitis. Be healthy.
2009-06-29 23:52:09
Kate asks:
Hello! I suffer from pain before (not often), during and after urination in the urethra. At the age of 17 (three years ago) I was diagnosed chronic pyelonephritis. Exacerbations occur regularly, mostly before menstruation. cutting during and stabbing pains or burning after urination. Sometimes the left side of the back hurts. Helps reduce symptoms a large number of water. According to gynecology, no abnormalities and diseases were found. Tests for all kinds of sexual infections are negative. The only thing that bothers me with particular regularity is thrush. But some of the gynecologists claim that this is vaginal dysbacteriosis, since thrush was sometimes not confirmed by tests. She treated both, and still every month everything repeats ((. According to urine tests, there is an increased content of leukocytes, but in recent times the same symptoms are observed normal analysis! They did a cystoscopy and there were no significant changes. By ultrasound of the bladder put signs of cervical cystitis. Kidney ultrasound: RD-15? RS-19 mm. Its echogenicity is increased.
Tell me what to do?? What else could it look like? I can’t suffer anymore… Thank you in advance!
Good afternoon. Do a urine culture tank. With the greatest probability you constantly do not recover. In such cases, long-term prophylaxis with small doses of an antibiotic sensitive to the identified pathogen (up to 3 months in the evening) or cranberry juice up to 300 ml / day is recommended.
2008-01-23 10:31:19
Victoria asks:
hello. I was diagnosed with chronic cystitis. I underwent a course of treatment with collargol, I think the instillation of the bladder. But after a month wellness the attack recurred after hypothermia. The whole story: I have been suffering for 2 years. Pain when urinating, cramps. When passing urine, there is a significant amount of bacteria. Ultrasound Bladder increased to 6 mm. According to gynecology, everything is normal. But 2 months ago they discovered uroplasma, and ultrasound showed colitis. Prompt, whether the cystitis in my situation is treated. Thanks in advance.
Manzhura Alexander Ivanovich answers:
Good afternoon. First you need to make a tank. urine culture, then, if necessary, treat the infection in the urinary tract, then restore the intestinal microflora and not hypothermia.
2015-02-01 16:32:05
Irina asks:
Hello
A week ago, some kind of discomfort in the vagina began - burning and itching, frequent urination. I myself bought fluomizin suppositories and started putting them on, but after 3 days I started to get very sore in the groin in the area of \u200b\u200bthe left ovary for four days. On the 5th day in the morning, my ovary ached quite a bit, but I still went to the gynecologist, when I examined it, when she pressed hard on the ovaries, I felt pain. After taking a smear, 40-50 leukocytes and nithymycelia were detected. As the doctor explained that this is a beginning thrush or, on the contrary, ending, since I put fluomizin suppositories before the smear and she cannot say what exactly could cause inflammation of the ovaries, since putting fluomizin suppositories could kill the first true infection.
A smear from the urethra is clean everything
General analysis of urine - 1-3 leukocytes and mucus, no protein, no bacteria, said that the problem is not in the bladder
Poisoned me on the ultrasound. By ultrasound
24 day of the cycle (my usual cycle is 31-34 days)
uterus anteflexsio, even, clear, 61/36/65mm, bicornuate
the structure of the myometrium is homogeneous
Cervix 43/25
Endocervix 8
Endometrium 13 corresponds to the phase of the menst.cycle
Homogeneous
Right ovary 31/26
Contours are clear, contains 15 antral follicles up to 6 mm
Left ovary 47/30
Contains corpus luteum and the number of antral follicles is not yet clearly written, like 23
Prescribed Azitrox 500 drink 3 days 1 time per day
And candles revitaks 10 days
Fluzak 200 1st, 3rd, 5th, 7th days once
And since I have relapses of cystitis urolesan in drops and furamag
I started taking antibiotics on the same day and until the next morning the ovary almost disappeared, but for some reason after a couple of hours I woke up and started to hurt a lot more than it used to. I can’t understand why, on the contrary, pain worsened during treatment and antibiotics do not help.
Can you tell me if this treatment is effective? It seems to me that revitax does not cure inflammation of the ovaries? And the treatment is not enough. And according to the ultrasound, is this inflammation of the ovaries or not? And why did I feel worse during treatment than before treatment. I am very afraid of complications, since I have not yet given birth and my husband and I are very worried
Please help
Bosyak Julia Vasilievna answers:
Hello Irina! Your left ovary is enlarged, due to which it is difficult to say. I understand that 23 antral follicles are visualized in it? If yes, then the cause of pain in the ovaries is most likely associated with multifollicular ovaries or polycystic. Monthly cycle do you have a regular one? Did you donate blood for sex hormones? To make a diagnosis, it is necessary to donate blood for AMH. If you have PCOS, then antibiotics are not required.
2014-09-23 16:00:33
Katerina asks:
Hello! I have been seeing a psychiatrist since 2003. Neurotic depression with insomnia (I sleep badly, the quantity and quality of sleep is poor). Long time drank azaleptol and amitriptyline. In January of this year, day hospital offered sonapax and quetiron. But in the summer, side effects from drugs began to appear, urinary retention began. At first, she could not cure cystitis for a long time, only from the 4th course of antibiotics she fell. Then came the strong urge to urinate. She turned to the Institute of Urology: they did an ultrasound with the determination of residual urine - much higher than the norm, they did uroflometry - showed a delay in urination in the work of the bladder. The urologist explained to me that this happens to me from taking psychotropic drugs.
Please advise what to do and where can I turn for qualified help, where would they help me choose the right drugs that will not cause urinary retention and promote sleep?
The urologists have done everything in their power. I'm still drinking tamsulide, so that urine would pass more easily (sometimes no-shpu with spasm).
One psychiatrist said that it's rare for anyone to experience these side effects from psychosis. drugs, in particular from azaleptol, etc. Although drugs with anticholinergic side effects lead to neurovegetative disorders such as urinary retention, disrupting the normal contractions of the sphincters. (Especially so affect tricyclic antidepressants). So far, a miaser has been prescribed and, in addition to it, sonovan and gidazepam.
But how much it will help me and for how long, I do not know! Advise how to be, and to sleep and there were no side effects from drugs?
Andrey Gusak answers:
2014-07-19 07:05:10
Olga asks:
when conducting ultrasound of the small pelvis, an increase in the kidneys was revealed: the right 106/48, the left 108/47 structure of the renal sinuses of increased echogenicity. Urinary bladder-walls are thickened up to 5.5 mm in the lumen of 1/2 bladder floating echo sound. OOM-20 cm3 (said mucus and bacteria). Conclusion: chronic cholecystitis with signs of sluggish pyelonephritis, chronic cystitis. I did a urine culture tank and an antibiogram: Streptococcus agalactiae 10 ^ 5 CFU was detected. all quinols, all cephalosporins. Resistant only to doxycycline and tetracycline. Prompt, please, what antibiotic to be treated. Thank you.
Velichko Marina Borisovna answers:
You need to know how many leukocytes are in the general urine test.
The cause of cystitis is the entry of pathogenic bacteria into the cavity of the bladder. This body has enough high degree protection against these microorganisms. Therefore, in order to create a focus of infection, additional factors are needed:
- Hypothermia.
- Sexual infections.
- Failure to comply with the requirements of personal and sexual hygiene.
- Reduced immunity.
- Regular consumption of alcohol, smoked, spicy food, etc.
Diagnosis of cystitis
Diagnosis of cystitis allows the study of blood and urine tests. The decoding evaluates the level of leukocytes, erythrocytes, the presence of infections that are sexually transmitted. With the help of urine culture, the causative bacterium is detected.Ultrasound of the bladder with cystitis is prescribed in case of difficulties in diagnosis, the need to obtain a more accurate picture of the state of the organ. The procedure can also be carried out in preventive purposes. This type of research is absolutely safe. Therefore, it can be used for children, pregnant women.
Ultrasound for cystitis
There are three methods of ultrasound of the bladder for cystitis:- Examination through the abdominal wall.
- Examination through the urethra.
- Examination through the rectum.
In any case, the bladder must be full. You can drink two liters of water 1.5-2 hours before the procedure, hold urination until the examination. If there are no contraindications, you can drink a diuretic. Transrectal methods are used for suspected organ pathologies. In other cases, with cystitis, an ultrasound of the bladder is performed through the abdominal wall. An infection that develops in the bladder can travel up the ureters to the kidneys. This provokes the appearance of pyelonephritis, inflammation of these organs. Therefore, if the patient has back pain, an ultrasound of the kidneys is additionally performed for cystitis. This makes it possible to carry out a treatment that will completely destroy the infectious focus in the body.
The role of ultrasound in diagnosis
During the study, the doctor receives a lot of important data. During the procedure, it is determined:- The size.
- The form.
- Content.
- Integrity.
The presence of hyperechoic structures allows you to determine the contents of pus, blood clots. Based on the data from the decoding of the tests, ultrasound of the kidneys and urinary cystitis, the doctor can prescribe an effective treatment.
Initially, antimicrobial antibacterial drugs to destroy pathogens. Required simultaneous reception anti-inflammatory medicines. These can be tablets, suppositories or injections. Using herbal preparations, such as Urolesan or Canephron, you need to drink tablets for a month.
If you need to improve blood microcirculation in the tissues of the bladder, Pentoxifylline is prescribed. Support the body, give it strength to fight the disease helps reception vitamin complexes. In the treatment of chronic cystitis, it is necessary to include a course of physiotherapy.
Cystitis is a fairly common disease. More common in women. This is due to the anatomical structure - a short and wide urethra. Most often, cystitis occurs due to an ascending infection. About 60 percent of cystitis is due to the ascending pathway of E. coli. E. coli (E. coli) is an opportunistic flora living in the rectum and vagina (in small quantities). Also cystitis can cause staphylococcus aureus (occurs with a febrile temperature), such specific pathogens as chlamydia, mycoplasmas, ureaplasmas. Extremely rarely, cystitis can occur by the hematogenous or lymphogenous route (risk of interstitial cystitis).
On the mucous membrane of the bladder there are special receptors to which Escherichia coli is tropic. The number of these receptors varies from person to person. No genetic predisposition to inheriting the amount of these receptors has been identified. It is due to the amount of these receptors that some people often suffer from cystitis, some do not know about this problem at all. However, timely diagnosis and treatment of acute cystitis prevents the occurrence of a chronic process.
Symptoms
The main manifestations of cystitis are:
Pain in the suprapubic region;
Discomfort or pain when urinating;
Possible subfebrile temperature (up to 38 degrees);
change in color or amount of urine;
Frequent or infrequent urination;
Imperative urge (urge to urinate without excretion of urine) with a drop of blood or pus (mainly with cystitis caused by a specific flora).
Cystitis can occur for the following reasons:
Irregular or improper hygiene (in girls);
Hypothermia and wearing synthetic underwear;
Inflammatory diseases of the vagina (in women), urethritis and prostatitis (in men), defloration (frequent sexual intercourse);
Anatomical anomalies and neoplasms in the bladder (diverticula, polyps, tumors, adhesions);
Metabolic nephropathy (stones and sand in the kidneys and bladder);
Narrowing or inflammation of the urethra;
During pregnancy and after childbirth;
Surgical interventions (transurethral);
Wrong food (spicy, spicy, smoked, salty).
Diagnostics
What studies will the doctor need to make a diagnosis:
Collection of anamnesis and complaints;
Inspection;
General blood analysis. Will show a slight leukocytosis and a slight increase in ESR (except for cystitis caused by staphylococcus aureus);
General urine analysis. It will show an increased number of leukocytes, epithelium, protein, there may be a small amount of erythrocytes, as well as a precipitate in the form of salts;
Urine analysis according to Nechiporenko will show an increase in the number of leukocytes;
Urine bacterial culture and sensitivity to antibiotics (results will be ready in a week, therefore it is rarely prescribed);
(the most informative method);
Perhaps the appointment of voiding cystography (for vesicoureteral reflux);
Cystoscopy.
Ultrasound of the bladder with cystitis carried out after special preparation of the patient. The patient should drink 1-1.5 liters of still water or other drink (not milk) 1-1.5 hours before the scheduled procedure. In chronic cystitis, ultrasound shows thickened walls, as well as sediment at the bottom of the bladder.
A doctor can diagnose cystitis based on the results of urine and blood tests. But often the specialist has difficulty in accurately determining the pathology, so he directs the patient for an ultrasound examination of the urinary organs.
Indications for the procedure
A number of symptoms from the urinary system are indications for ultrasound in cystitis. Among them:
- the appearance in the urine of bloody impurities or pus;
- frequent urge to urinate or acute urinary retention;
- a small amount of urine;
- pain in the suprapubic region, which appear periodically.
Training
The person who received the referral for the procedure must prepare for its implementation. An ultrasound examination is performed with a filled urea, so 1.5-2 hours before the ultrasound, you need to drink about 2 liters of still water or other liquid. If this fails, then it is recommended not to defecate for 5-6 hours.
The procedure may interfere with the intestines filled with gases. Those who suffer from flatulence should follow a diet for 2-3 days before the ultrasound. From the diet, it is necessary to exclude products that promote gas formation - vegetables, fruits, legumes, carbonated and alcohol-containing drinks.
If the study will be carried out by the transrectal method, then a cleansing enema should be done a few hours before the procedure.
Types of ultrasound
The study of the bladder using ultrasound is carried out in several ways:
- Transabdominal. The most common method instrumental diagnostics and less invasive for the patient. Passed through the anterior abdominal wall with full urinary organ. With urinary incontinence and obesity, transabdominal ultrasound is not prescribed.
- Transrectal. It is carried out through the rectum in patients of both sexes.
- Transurethral is a rare diagnostic method that requires mandatory anesthesia. It is carried out through the urethra using a special tip. The procedure causes discomfort to a person, possibly injuring the urination canal.
- Transvaginal. Women are examined using this method. The urinary organ must be completely emptied. Transvaginal examination allows for a detailed analysis, but gives the patient some inconvenience.
Pathogenic microorganisms that caused cystitis are able to rise through the urogenital canals to the kidneys, provoking pyelonephritis. If the patient complains of back pain, then with ultrasound for cystitis, a kidney test is performed.
Differences in men and women
Depending on the gender of the patient, the examination is carried out in different ways. If a woman came to the appointment, then the doctor ultrasound diagnostics additionally analyzes the state of the uterus and ovaries: the organs are measured, their location, shape and structure are determined. Ultrasound can be performed during menstruation and during pregnancy, but the doctor should be warned so that he selects the correct procedure for the procedure.
During the examination of a man, the doctor can analyze the condition prostate. If a pathology of the prostate is suspected, then the remainder of the urine is determined. The patient is asked to go to the toilet to empty the bladder, and then the amount of urine remaining in the organ is measured.
Cystitis: symptoms, treatment. How to treat cystitis
results
In the results ultrasound the bladder indicates several parameters that help make the final diagnosis:
- bubble shape;
- its volume;
- amount of residual urine;
- bubble structure;
- Wall thickness;
- bladder emptying rate.
Ultrasound allows you to determine whether an inflammatory process develops in the urinary organ.
On the echo picture of a patient with acute cystitis, clusters of cells are visible - epithelium, erythrocytes and leukocytes, which are described by the term "sediment" in the results of the study. If the patient lies during the ultrasound, then the sediment is localized near the posterior wall of the bladder. When the patient gets up, the sediment will move to the anterior wall.
At chronic form pathology or with the progression of acute cystitis, the results of the study will show that the organ uneven contour and the walls are thickened. Availability blood clots in the bladder cavity is shown in the echo picture.
The results of the study conducted using ultrasound should be deciphered by the urologist who referred the patient for the procedure. If necessary, the doctor selects a treatment course.
Norms
The results of the study of the bladder are normal:
- The form. In the transverse projection, the bubble should be rounded, in the longitudinal projection - ovoid. On the form female organ affected by the number of pregnancies and births.
- Structure. Normally, it is echo-negative, but the parameter depends on the age of the person: the older, the higher the echogenicity should be.
- Volume. The average indicators for women are 250-550 ml, for men - 350-750 ml.
- Walls. The same thickness over the entire surface - 2-4 mm. If thickening or thinning is shown in any area, then this indicates the presence of pathology in the organ.
- Residual urine. Its amount should not exceed 50 ml. When conducting a study, it is measured without fail.
What is the price
Ultrasound prices depend on various factors: the city of the study, the clinic (in the commercial medical center the cost of the service can be 2-3 times higher than in a specialized hospital of a municipal hospital), the level of qualification of the specialist conducting the procedure.
In Moscow and St. Petersburg, the average cost of an ultrasound of the urinary tract is from 600 to 2,500 rubles.