Ultrasound on the bladder. Proper preparation for ultrasound of the kidneys and bladder How the study is carried out
Ultrasonography Bladder is a painless, non-invasive hardware diagnostic method that allows you to quickly obtain information about the presence or absence of pathology. The method is used in case of suspected disease genitourinary system in women and men, while it is possible to simultaneously obtain data on the condition of other organs of the genitourinary system.
Human urinary system
Indications for use
Ultrasound of the bladder in men and women is performed in the presence of the following symptoms and diseases:
- frequent urge to urinate;
- chronic inflammation of the bladder;
- acute infection;
- feeling of incomplete emptying;
- unusual color of urine (for example, traces of blood);
- pain and cramping in the suprapubic area;
- visually detectable sediment in the urine;
- pain when urinating;
- existing neoplasm in the pelvic area;
- with kidney pathology.
Most often, the patient is sent for an ultrasound after complaining of problems with urination or atypical coloration of urine. The method allows for a comprehensive examination of all organs that take part in the removal of fluid from the body, without taking up large quantity time, and also without violating the integrity of the skin.
Preparing for an ultrasound
How to properly prepare for diagnosis? In order for the survey to be informative and the data not to be distorted, certain preparation is required. When performing an ultrasound of the bladder, an important feature of the organ is its ability to significantly decrease in size when emptied. However, the hollow organ must be filled with fluid at the time of diagnosis - this is the only way to obtain reliable information about its size and condition.
Preparing for the study is not difficult. Preparatory measures boil down to the fact that 2 hours before the appointed time you need to drink up to 1.5 liters of water.
An ultrasound of the child’s bladder is also performed when the organ is completely full. To do this, you need to drink liquid at the rate of 5-10 ml per 1 kg of weight. If a child refuses to drink water, it can be replaced with any other liquid that does not increase gas formation in the intestines, such as tea (carbonated drinks and milk should not be used). To perform an ultrasound of the pelvic organs in newborns, such measures are not necessary.
Anatomy of the bladder
If the patient is prone to flatulence and bloating, then 2-3 days before diagnosis, it is necessary to remove foods such as legumes, cabbage, citrus fruits, milk, onions, nuts, and baked goods from the diet.
Is it possible to eat the day before the diagnostic session? You can eat before the ultrasound, but light food in small quantities.
How to fill your bladder quickly? If an ultrasound is required urgently and there is no time for preparation, then to ensure reliable result You need to drink at least 1 liter of liquid and take a diuretic. Such measures will help fill the bladder quickly and thereby ensure the reliability of the result. However, you can follow the recommendations only after coordinating your actions with your doctor.
Carrying out the procedure
Despite the frequent use of this research method in medical practice, patients faced with such an appointment want to know in advance how an ultrasound is done and what to expect at the time of its implementation. First of all, the patient is required to comply with simple preparatory measures, in particular, it is necessary to make sure that the organ is full. An ultrasound diagnostic doctor conducts a transabdominal examination. During the session, the patient lies on the couch in the supine position (sometimes additional measurements are required in the lateral position).
A special gel is applied to the sensor and the area being examined, which improves the conduction of ultrasonic waves and at the same time ensures the sliding of the sensor. The product is hypoallergenic, colorless and odorless, easily washed off the surface without leaving any traces.
The doctor conducts an examination and takes certain measurements according to the protocol, then asks the subject to go to the toilet and repeats the manipulation, examining the already empty organ.
The total procedure time is 10-20 minutes. Often the patient is prescribed a comprehensive examination, including assessment of the condition of the ureters and kidneys.
Transabdominal examination access
Much less often, and in the presence of complex urological pathology, an ultrasound of the bladder in a child or adult is performed through a transrectal approach. The need for such diagnostics is usually decided by a highly specialized specialist monitoring the patient. If the doctor prescribes transrectal diagnostics, then in addition to the tips described, a cleansing enema is also required on the day of the ultrasound examination.
Examination of women is also carried out with a full bladder and, if there are certain indications, can be performed transvaginally. Transvaginal access is applicable in case of existing concomitant pathology of the uterus, ovaries and fallopian tubes that need to be inspected as part of comprehensive examination genitourinary system.
A fairly new transurethral or intravesical diagnostic method used in andrology is carried out by penetrating the hollow organ through the urethra with a special thin sensor. This method allows you to obtain accurate data if necessary:
- find a connection or distinguish pathological processes in the area of the bladder or urethra(often before or after prostate surgery);
- determine the degree of involvement in pathological process walls of the canal and neck of the bladder;
- identify the presence of damage to neighboring organs.
There is a technique that combines ultrasound of the bladder with Doppler ultrasound. It is used, if necessary, to evaluate blood flow parameters and the condition of the walls of blood vessels supplying the pelvic organs. Ultrasound in Doppler mode is prescribed for differential diagnosis for the presence of a neoplasm (tumor), as well as for the development of vesicoureteral reflux (a pathology in which urine is thrown back from the bladder into the ureters).
Research results
Deciphering an ultrasound of the bladder based on the results of the examination sometimes requires the additional involvement of a specialist in order to compare the ultrasound picture and the medical history.
What does the diagnosis show? Ultrasound examination of a hollow organ allows you to evaluate and measure the following indicators:
- volume and shape;
- filling speed;
- amount of residual urine;
- wall thickness;
- structure.
The bladder on ultrasound is defined as an anechoic cavity protruding from the pelvic cavity in a filled state. If the indicators are normal, the boundaries of the organ will be smooth, with symmetrical cross sections. The thickness of the walls varies depending on the level of filling (about 4 mm), but should be uniform and the same in all zones.
After urination, the organ is examined again for the presence of residual urine - normally its amount should not exceed 50 ml, so if there is any, the doctor records its volume. After this, the examination protocol includes examination of the ureters and kidneys.
What pathologies can be identified?
Ultrasound of the bladder allows you to identify indirect or direct signs of the disease:
- increased trabecularity;
- change in wall thickness;
- asymmetrical walls;
- internal cysts;
- neoplasms in the cavity of an organ or at its base.
Tumor localization options
Let's consider common diagnoses detected on ultrasound of the bladder.
Thickening of the walls of the organ over the entire area in men most often occurs due to blockage at the level of the prostate. Such changes require examination of the kidneys and urinary tract, exclusion of hydronephrosis. In case of increased density of the walls of the organ, it is also necessary to make sure that there are no diverticula (protruding formations). They can be visualized if the size of the diverticulum exceeds 1 cm in diameter. Such formations are echogenic and conduct ultrasound.
A highly compacted trabecular wall is fixed with such changes as:
- Neurogenic bladder (in combination with urethrohydronephrosis).
- External obstruction by the posterior urethral valve (or urogenital diaphragm in pediatrics).
Local compaction of the walls can be interpreted in different ways and lead the doctor to think about such conditions and diseases as:
Your doctor will help you interpret the results correctly.
Identified lumps or neoplasms in the bladder area may have different origins and therefore require qualified differential diagnosis with diseases such as:
- pedunculated polyp;
- urethrocele (cystic formation);
- stones fused to the surface of the mucous membrane;
- enlarged uterus in women;
- enlarged prostate in men.
Also, ultrasound can detect moving echogenic objects not emanating from the organ. These include:
- blood clots (thrombi);
- foreign bodies;
- stones;
- air.
An overly distended and enlarged bladder indicates problems associated with:
- prostate enlargement; stones or the presence of urethral strictures in men;
- trauma to the urethra in women;
If a small bubble is visualized, this may indicate a pathology such as:
- cystitis;
- injury;
- rebirth muscle tissue in fibrotic or oncopathology.
In case of detected pathology, the conclusion form, as a rule, is accompanied by an image in which deviations from the norm are clearly visible (if the device has such a function).
Examination through the rectum in men
Features of the technique in different groups of patients
The widespread use of ultrasound examination is explained not only by its accessibility and information content, but also by the absence of contraindications to its implementation - the method is applicable to everyone, regardless of age and gender.
Female patients
How is an ultrasound of the bladder done in women? There are two methods in the doctor’s arsenal - transvaginal and transabdominal. Both methods allow simultaneous diagnosis of not only the bladder, but also the kidneys, ureters and organs reproductive system. Lactation and pregnancy do not interfere with the procedure.
When examining the pelvic organs in pregnant women, it is important to consult with a specialist; in some cases, it is not recommended to examine the woman transvaginally. Contraindications for the use of this type of ultrasound include late date pregnancy (there is a possibility of provoking contractions) and the threat of termination of pregnancy.
For male patients
Ultrasound of the genitourinary system in men is performed transabdominal or transrectal. They allow you to simultaneously evaluate the anatomy and condition prostate gland, thereby identifying foci of altered tissue, compaction and neoplasms.
Use in pediatrics
An ultrasound of the bladder can be performed on a child at any age - there are no contraindications for the study, it can be used from birth. In preparation for diagnosis, it is necessary to take measures to fill the bladder only in older children. For infants who do not control the process of urination on their own, such measures are not applied.
Child examination
The examination will help identify the inflammatory process and abnormalities in the development of the genitourinary system.
Ultrasound of the bladder in children is performed transabdominally - this method is absolutely painless and does not cause discomfort.
Only a specialist who has thoroughly studied the medical history and has all the information about the patient’s health status can determine what type of ultrasound of the genitourinary system is necessary in a particular case.
Ultrasound of the pelvic organs is one of the first diagnostic appointments that a person receives when complaining of pain when urinating, or a change in the color of urine. The examination allows you to find out all the physical indicators of the bladder, identify abnormal changes in it, and also obtain information about other pelvic organs - the ureters, kidneys, prostate (in men), ovaries and uterus (in women).
To diagnose diseases of the urinary organs in men, including the bladder, use different techniques research. Ultrasound is considered one of the most informative. It occupies one of the first places among diagnostic methods. In men, the procedure is prescribed if pathologies of the urinary and andrological organs are suspected.
This diagnostic technique makes it possible to determine the volume of the bladder, the condition of its walls, and urine retention. Before the procedure, men need to prepare so that the ultrasound result is more effective and truthful.
Types of research
In men, research can be carried out in several ways:
- Transabdominal- carried out through the anterior wall of the peritoneum using a sensor. Before the procedure, you must fill your bladder with fluid.
- Transrectal- carried out using a special rectal sensor in order to identify the connection between prostate disease and bladder. The method helps to identify the volume of residual urine.
Sometimes they carry out ultrasonography with Dopplerography. This method is appropriate if you need to evaluate the flow of urine through the ureters and blood flow in the urinary organs. Doppler ultrasound is recommended if tumors or bladder reflux are suspected. Rarely do they resort to ultrasound through the urethra. The procedure is quite uncomfortable and painful.
Indications for use
The doctor may prescribe an ultrasound of the bladder based on laboratory tests and the presence of such manifestations:
- frequent urge to urinate;
- difficulties in the process of urine separation, pain;
- stones in the bladder;
- sensation of partial emptying of the bladder;
- cloudy urine, presence of sediment.
An ultrasound may be prescribed if cystitis, prostatitis, prostate adenoma, tumors, or other pathologies are suspected.
Ultrasound is used as a visualization method during operations:
- removal of tumors;
- prostate resection;
- interventions on the ureter and urethra.
Contraindications
Depending on the ultrasound method, there may be some contraindications to the procedure.
Transabdominal:
- urinary incontinence;
- obesity (scanning is difficult due to a thick layer of fat);
- scars or stitches on the bladder;
- violation of the integrity of the skin in the lower abdomen (burns, pyoderma).
Transrectal:
- acute inflammatory processes in the intestines (hemorrhoids, fissures);
- rectal strictures;
- allergy to latex.
Before an ultrasound, the patient must first prepare, taking into account the method of the procedure. For the transabdominal method, you need to empty your bowels and fill your bladder. 2-3 hours before the ultrasound, a man should drink 1 liter of liquid (preferably clean water). A filled organ makes it possible to better visualize the anatomical formations located behind it. To speed up the formation of urine, you need to take a diuretic tablet right before the procedure.
To prepare the intestines, men suffering from constipation and flatulence need to follow a diet for 1-2 days. Avoid eating foods that cause gas.(beans, raw vegetables, soda, coffee, brown bread). You need to cleanse the intestines with a microenema, you can put glycerin suppositories.
Before transrectal ultrasound, clean the rectum, take a laxative (for example, Microlax, Fitolax, Agiolax), or do a cleansing enema. Laxatives for plant based They act slowly, so it is better to take them the evening before the procedure. TRUS is performed using local anesthesia. To avoid undesirable consequences, you must not drink alcohol for at least a day, and not smoke several hours before the procedure. Nicotine, when interacting with a painkiller, can cause nausea.
Important! If a man has kidney, heart diseases, pathologies respiratory system, you must inform your doctor about any existing pathologies.
How is the procedure performed?
The doctor chooses the ultrasound method based on the condition of the bladder, its fullness, concomitant diseases. More often they resort to the transabdominal method, as the safest and most informative.
How is an ultrasound of the bladder performed? The patient needs to lie on the couch with his back down. The stomach must be freed from clothing and a special gel must be applied. The doctor places a sensor on the abdomen and runs it over the surface with slight pressure, examining the condition of the bladder and surrounding organs. The examination area is from the pubis to the navel.
In some cases, a man may need to go to the toilet, urinate, and then continue with an ultrasound to assess the condition of the organ after bowel movement. This may be required to diagnose prostate diseases.
The study usually lasts no more than 15-20 minutes. The results of the study are immediately available. The patient goes with them to the attending physician.
With transrectal ultrasound, a probe is inserted into the rectum. Body position may change during the procedure. A condom is put on the sensor, treated with a small amount of special gel, and shallowly inserted into the anus. At internal ultrasound the distance between the sensor and the bladder is reduced, which makes it possible to examine the organ in more detail.
What does an ultrasound of the bladder show?
During an ultrasound examination in men, a specialist must evaluate the following parameters of the bladder:
- shape;
- volume;
- condition of external and internal circuits;
- thickness of the walls of the organ;
- nature of the content;
- fullness;
- volume of residual urine.
Decoding the results
The results enable the doctor to give a correct assessment of the condition of the bladder, and taking into account all clinical manifestations make an accurate diagnosis.
The bladder is normal if:
- Transverse scanning shows a round and even shape. Longitudinal scanning determines the ovoid shape of the organ.
- The contours are smooth and clear.
- The average volume of the bladder is 350-700 ml.
- The walls are 2-4 mm thick over the entire surface of the organ (depending on fullness). The walls will be thinner if the bladder is filled with fluid.
- The speed of urine flow is 14 cm per second.
- Residual urine is not more than 50 ml.
Deviations from these parameters indicate the presence of pathologies. The shape becomes asymmetrical with tumor formations. A decrease in the size of the organ can be due to schistosomiasis, an increase - in the presence of prostate adenoma, strictures. With inflammation, thickening of its walls is visible, uneven contours. Increase
To date in the best possible way research internal organs is an ultrasound. It is prescribed by a doctor if diseases of these organs are suspected, as well as for preventive examination. The procedure is absolutely painless and does not cause any discomfort to the person. Therefore, if you have been given a referral, then do not be afraid and feel free to go for an ultrasound of your kidneys.
Preparation for the procedure is an important stage, without which manipulation can give a distorted result. Today we will find out what a person should do before performing an ultrasound so that the doctor sees on the monitor true information about the condition of these organs. How to properly prepare for such a study, read below.
What is the procedure?
This is an analysis carried out using a special apparatus using sound waves to create images of the organs being tested. Another name for this procedure is echography. During the manipulation, sound waves record the image of the organs and show it on the monitor. A specialist performs this procedure to make an accurate diagnosis.
In what cases is echography needed?
Ultrasound examination is an excellent alternative to palpation and catheter insertion. Echography gives more exact information about the condition of these organs. Indications for prescribing ultrasound of the kidneys and bladder are:
Suspicion of kidney or bladder stones.
Tumors.
Cysts in the bladder.
Kidney injuries.
It is in these cases that the doctor can give a referral for echography. What is important for a person who is about to undergo a study to know? Proper preparation Ultrasound of the kidneys and bladder is necessary to ensure that the ultrasound results are clear and reliable. Therefore, below we will find out how to prepare for such a diagnosis.
Nutrition before the procedure
Preparation for ultrasound of the kidneys and urinary tract should begin with proper diet which should be followed 3 days before the study. At this time, it is necessary to consume only those foods that do not allow increased gas formation. This is perhaps the main preparation for an ultrasound of the kidneys. What can you eat? What specific foods are advisable to consume before the procedure?
Ideal daily diet 3 days before the ultrasound should consist of the following delicious products:
Porridge cooked in water. It could be buckwheat, oatmeal, barley.
Boiled meat, preferably chicken or veal.
Steamed cutlets made from lean minced meat.
Boiled sea fish.
Unsalted and low-fat hard cheese.
Hard boiled egg.
Dried or yesterday's white bread.
For people who do not have problems with digestion, it is enough to follow such a diet for 3 days before performing an ultrasound of the kidneys. Preparing for the test for patients who have problems with gastrointestinal tract, must be carried out 7 days before the procedure. There are also people who are prone to flatulence. In this case, they need to take sorbents 3 days before the ultrasound.
What foods should you exclude?
2-3 days before the procedure you need to refuse:
From whole milk;
Legumes;
Potatoes, cabbage, any raw vegetables;
Rye bread;
Fresh fruits, and especially apples;
Sweet products;
Carbonated drinks;
Fat, fried meat, as well as fish;
Rich meat broths;
Smoked meats.
Bowel cleansing before echography
Preparation for an ultrasound of the kidneys and bladder also involves maximizing bowel movements. In this case, it is recommended to give an enema, but you can do without it. It is allowed to use a glycerin suppository, laxatives "Pikolaks" or "Guttalax".
2 days before the manipulation, it is necessary to use sorbents between meals, such as activated carbon, Smecta, Sorbex preparations. If for some reason this did not work out, then you need to take 6 tablets of Espumisan 3 hours before the procedure.
Additional tests before echography
Preparation for an ultrasound of the kidneys and bladder should begin several days before the procedure. Moreover, the doctor can additionally write out a referral for the patient to donate blood and urine. It is the results of these tests that will then help to more thoroughly identify the presence of diseases in the kidneys or bladder. A person should already come to an ultrasound with the results of the studies performed. And the doctor, after an ultrasound scan together with blood and urine tests, will be able to accurately describe the problem.
Preparation for the procedure scheduled for the first or second half of the day
If a person has been given a referral to morning time, then it is most convenient to come to the hospital on an empty stomach. In this case, the last meal should be before 18.00. Dishes should be light and easily digestible. This rule is mandatory for both men and women. Therefore, it is important to follow these recommendations so that the ultrasound scan is successful and the doctor is able to identify the problem. It is necessary to come to the procedure only after the person has drunk about 1 liter of water.
Preparing for an ultrasound of the kidneys in women and men in the afternoon involves an early breakfast. One hour after breakfast you need to take activated or any other sorbent. And do not forget that before coming to the procedure (1 hour before it), you need to drink about 1 liter of liquid.
Differences between performing urinary ultrasound in women and men
Typically, examination of this organ is done through the anterior abdominal wall. But in some cases it may be necessary to perform manipulation through the rectum or vagina. The first method is an ultrasound of the bladder in men. Preparation for the study is already known to everyone: come on an empty stomach, solve problems with stool, and, if necessary, take special drugs, drink about 1 liter of water, have a bowel movement. Men should also stop smoking at least 3 hours before the ultrasound. An examination of the bladder through the rectum is necessary if the specialist will also check the prostate.
Ultrasound examination through the vagina is indicated when women are obese, adhesions, tumor formation and some other problems.
Why is it so important to drink a lot of water for echography?
Preparing for an ultrasound of the kidneys and bladder necessarily involves drinking 1 liter of water the day before. Why is this being done? It turns out that if the urinary bladder is poorly filled, then it will be difficult for the doctor to see what problems the patient has with the organs being examined. In this case, there is a high risk of errors. It even happens that the doctor can see a tumor that actually isn’t there. It turns out that if the bladder is poorly filled, its folds are not completely straightened, and it is they that can show a false tumor, misleading the doctor. But when a person drinks 1 liter of water, the specialist will be clearly visible necessary organs. Therefore, the patient’s preparation consists of filling the bladder before the procedure.
Preparation for the study of pregnant girls
You may ask, why should pregnant women have an ultrasound of their kidneys? The fact is that pregnant girls experience a threefold load on this organ. Often, expectant mothers develop late toxicosis. And it is precisely because of this that the kidneys suffer first, which can later lead to gestosis. To understand whether these organs were affected during this period or not, it is necessary to conduct an ultrasound examination. This is the only one safe method diagnostics of pregnant girls.
Preparation for ultrasound of the bladder in pregnant women is special. If to an ordinary person the day before you can do a cleansing enema, take laxatives and adsorbents, but during pregnancy all this is contraindicated. The fact is that such measures to cleanse the body can harm the development of the fetus. Preparing for an ultrasound examination of pregnant girls involves following a diet that will prevent gas formation. The doctor may also prescribe special medications approved for this category of people to eliminate flatulence or constipation, if these symptoms occur.
It is advisable to refrain from eating 4-5 hours before the examination of internal organs. And 1 hour before the start of the procedure, you need to urinate and then drink about 0.7-1 liters of clean water.
What to take with you to the study?
A person should know what he needs to bring to an event such as a kidney ultrasound. Preparation for the procedure includes not only diet, bowel movements, and drinking plenty of water. Here it is also important to know what you need to take with you for research. So, below is a list of things that a person who comes for an ultrasound of the kidneys and bladder should have:
Results of previous analyses.
Passport, medical card.
Referral for research.
A sheet or towel.
Paper napkins to wipe the body after the procedure.
Water so you can drink it to fill your bladder.
Now you know what a kidney ultrasound is. Preparation for the study, differences in ultrasound scanning in men and women, features of the procedure in relation to pregnant women - all this is also known to you. We have determined what a person must do before this manipulation, namely: stick to a diet, drink 1 liter of water, empty the intestines, collect all the necessary things.
Thank you
The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!
Ultrasound examination of the bladder is a type of instrumental diagnostics of this organ, based on obtaining images of various tissues from ultrasonic waves.Ultrasound of the bladder - the essence and principles of the diagnostic method
Ultrasonography Bladder, as the name of the method implies, is based on the possibility of obtaining an image of an organ on a monitor by passing ultrasonic waves through it. That is, a special sensor emits ultrasonic waves with a high vibration frequency that are not detected by the human ear. These waves pass through various tissues, are partially absorbed by them, partially reflected and refracted. The reflected ultrasonic waves return back and are picked up by the same sensor that emits them. Next, the captured reflected ultrasound waves are amplified by the device, automatically processed, and an image of the internal organs and tissues appears on the monitor of the ultrasound machine.Depending on the properties of the biological structure, it absorbs more or less ultrasonic waves, causing different numbers of waves to be reflected back to the sensor. It is the unevenness of the absorbing and reflective ability of tissues that allows you to create images of various objects on the monitor.
Transabdominal access for ultrasound of the bladder is the simplest, most convenient and safest, as a result of which the lion's share of organ studies is currently carried out in this way. Transvaginal and transrectal approaches provide more information about the bladder, but are used less frequently, only when it is necessary to obtain comprehensive and as detailed data as possible. Transrectal access is also often used in men when it is necessary to evaluate the condition of not only the bladder, but also the prostate gland, seminal vesicles and other genital organs. Transvaginal access for ultrasound of the bladder is used only for women, and transrectal is used mainly for men and young girls (virgins). Transrectal ultrasound of the bladder in adult women is rarely performed, preferring transvaginal access when necessary to obtain detailed data on the condition of the organ. Transurethral access for ultrasound examination of the bladder is rarely used, since it requires special expensive equipment and the need for pain relief. Let's look at how an ultrasound of the bladder is performed using transabdominal, transvaginal and transrectal methods.
To perform an ultrasound using transabdominal access, the patient needs to lie on his back on the couch and expose bottom part abdomen (the area from the pubis to the navel). The doctor will apply a special gel to the abdomen, which is necessary to improve the quality of the image obtained on the monitor. The gel is usually cold, so in the first few seconds after its application you may experience discomfort, however, they will pass quickly. After this, the doctor will press the ultrasound machine probe firmly against the abdomen and move it over the surface of the skin with light pressure, obtaining images of the bladder on the screen from different angles. The procedure is completely painless and usually lasts from 5 to 15 minutes. After the ultrasound is completed, the doctor will remove the transducer from the abdomen, and the patient will need to clean the skin and get dressed.
In some cases, when an ultrasound of the bladder is prescribed through transabdominal access with determination of the volume of residual urine, after the main study, the doctor asks the patient to urinate, after which he again places the sensor on the abdomen and measures required parameters and determines how many milliliters of urine remain in the organ after urination.
To perform an ultrasound of the bladder through transvaginal access, the woman is positioned on a couch lying on her back with her knees bent and her legs spread apart. It will be necessary to remove clothing from the lower half of the body, including underwear. Next, the doctor lubricates the sensor with a special gel, puts a condom or sterilized rubber cap on it and inserts the device into the vagina. By turning the sensor into the vagina at different angles, the doctor sees on the monitor an image of the bladder from different angles, which makes it possible to diagnose various pathologies. After the test is completed, the doctor removes the sensor from the vagina, and the woman can get dressed and leave.
To perform an ultrasound of the bladder via transrectal access, the patient should lie on the couch on his side, pull his legs bent at the knees towards his stomach, after removing clothes from the lower abdomen. The doctor lubricates the sensor with gel, puts a special sterile cap or condom on it and inserts the instrument into the rectum 5–6 cm. Then, by changing the position of the sensor, the doctor receives images of the bladder on the monitor from different angles. After completing the examination, the doctor removes the instrument from the rectum, after which the patient can get dressed and leave.
Ultrasound of the bladder in women and men
There are no fundamental differences in performing ultrasound of the bladder in men and women, but there are a number of features that should be mentioned. Thus, men are usually prescribed an ultrasound of the bladder to determine the volume of residual urine, which is due, firstly, to the need to diagnose the pathology of not only the bladder, but also the genital organs located next to it (prostate, seminal vesicles). And secondly, in men a simple ultrasound of the bladder is less informative than in women, therefore, for high-quality diagnosis it is necessary to determine a larger number of parameters, one of the most important of which is the volume of residual urine. If a man is suspected of having pathology only of the urinary system, then a transabdominal ultrasound is usually prescribed. But if a man is suspected of having a pathology not only of the urinary system, but also of the reproductive system, or if it is necessary to distinguish between diseases of the bladder and prostate/seminal vesicles, then a transrectal ultrasound is prescribed. Since men often have situations when the doctor needs to accurately determine whether the existing symptoms are due to pathology of the urinary or reproductive system, in practice, representatives of the stronger sex are usually prescribed transrectal ultrasound of the bladder. Women are usually prescribed a transabdominal ultrasound of the bladder without determining the volume of residual urine, since this study is quite sufficient for diagnosis. If the doctor needs the most accurate data, then women are usually prescribed a transvaginal ultrasound of the bladder, which allows not only to increase the information content of diagnosing bladder diseases, but also to distinguish them from possible pathology genital organs (adnexitis, salpingitis, etc.).
There are no other fundamental differences in ultrasound of the bladder in women and men.
What parameters are assessed by ultrasound of the bladder?
When performing an ultrasound, the following parameters must be assessed:- The location of the bladder relative to neighboring organs and tissues;
- Condition of Lieto's triangle and bladder neck;
- Bladder size (three dimensions are measured - width, length and depth);
- Bladder shape (normally round, oval or slightly triangular, always symmetrical);
- Contours of the bladder (smooth, uneven, scalloped, etc.);
- Condition and thickness of the bladder wall;
- Bladder capacity;
- Release from the ureters and the rate of bladder filling with urine;
- The presence of neoplasms in the bladder (if they are detected, their shape, size, and growth pattern are determined);
- The presence of suspension (pus, blood, sand, etc.) and stones in the contents of the bladder;
- Condition of the ureters.
Interpretation of ultrasound of the bladder
Normally, the bladder should have a round, oval or slightly triangular shape, with clear, even contours. The thickness of the bladder wall is normally 2–5 mm, and the inside of the organ should be hollow (echo-negative) without suspension, pinpoint inclusions (stones, blood clots), etc. The doctor also evaluates the release from the ureters into the bladder, which is normally visible on the monitor, and its speed is up to 14.5 cm/s. The rate of filling of the bladder with urine is normally 50 ml per hour, and the volume of the organ in women ranges from 250 to 550 ml, and in men from 350 to 750 ml. A sign of pathology is a thickening of the bladder wall of more than 5 mm, which may indicate an inflammatory process, closure of the organ lumen with a stone or tumor.
If the contour of the bladder is scalloped, cysts or a bifurcated wall are visualized around it, then this indicates diverticula, ureterocele, etc.
If the volume of the bladder is larger than normal, then this may be a sign of narrowing, stone or injury to the urethra, enlarged prostate in men, cystocele, or neurogenic bladder. If the volume of the bladder is less than normal, this may indicate cystitis, schistosomiasis or a tumor.
Small multiple hyperechoic/hypoechoic formations in the bladder cavity may indicate cystitis or sand. If the hyperechoic/hypoechoic formations are larger, then this may be a sign of stones, cysts, polyps or bladder tumors. Polyps, cysts and tumors usually look like stationary hyperechoic inclusions in the cavity of the bladder, and stones and sand look like mobile ones.
If the doctor detects the backflow of urine from the bladder into the ureters, this may indicate neoplasms, stones, sand, or abnormalities in the structure of the urinary organs.
The volume of residual urine is normally less than 50 ml, and if it is more, then this may be a sign of an inflammatory process, stones, tumors (and in men, also pathology of the prostate gland and seminal vesicles).
We have indicated the main ultrasound signs of normal and pathological bladder, on the basis of which we can only roughly orient ourselves regarding general condition organ. But a full interpretation of ultrasound data can only be carried out by a doctor, taking into account the person’s clinical symptoms and data from other examinations (tests, palpation, etc.).
Bladder ultrasound price
Currently, the cost of ultrasound of the bladder via transabdominal access ranges from approximately 500 to 3500 rubles. The cost of the study is slightly cheaper in government institutions healthcare and more expensive - in private centers. In addition, the cost of the study depends on whether it includes determination of residual urine volume. If such a parameter is included in the study, then it is approximately twice as expensive as a simple ultrasound of the bladder without determining the volume of residual urine.Ultrasound of the bladder - video
Before use, you should consult a specialist.Many techniques are used to diagnose diseases of the urinary system. One of the first places among them was given to ultrasound diagnostics, which is prescribed for the study of the urinary organs and male genital area. Before performing an ultrasound of the bladder in men, preparation is necessary to help obtain the most accurate result.
Types of diagnostics
Bladder examination in men is done in the following ways:
- Transabdominal. The study with this method is carried out through the abdominal wall. Allows you to diagnose diseases of the bladder and prostate.
- Transrectal. Diagnosis is carried out through the anus using a special ultrasound sensor. This type allows you to determine the presence of a connection between pathologies of the prostate gland and the bladder. With its help it is possible to control the amount of residual urine. Allows for biopsy.
- Transurethral. Carried out in exceptional cases. Reveals the relationship between the urethra and the bladder. This is done using a urethral sensor. It's pretty painful procedure, which is produced by local anesthesia. By doing this, there is a risk of damage to the urethra.
Indications for research
A urologist performs a study if the following indicators are present:
- frequent, painful urination;
- the presence of various impurities and sediments in the urine;
- urinary retention;
- if you suspect ICD;
- sharp pain pulling character in lower area belly.
In addition, an ultrasound examination is prescribed after the following surgical interventions: after removal of tumor tumors of the bladder, crushing or removal of stones, removal of adenoma through the bladder, surgery on the urethra, ureter. Ultrasound of the bladder is prescribed for men in the presence of tumors of the organ. Moreover, diagnosis should be carried out both before and after therapy. It allows you to detect the presence of metastases.
Widely used this method to differentiate other diseases that have similar clinical picture. Among them:
- inflammation of the prostate gland;
- inflammatory processes of the ureter;
- kidney pathologies.
Conducting a transrectal examination
Contraindications
There are some contraindications for ultrasound examination of the bladder, which are related to the diagnostic method. It is not indicated to conduct a transabdominal examination of the organ in the presence of urinary incontinence, since this study carried out only when the bladder is well filled, overweight(because scanning is difficult subcutaneous fat), damage to the skin on the research area, scars and sutures on the bladder.
Transrectal diagnosis is not performed when inflammatory processes rectum, absence of rectum, intestinal obstruction, allergic reaction to latex. Transurethral examination is not done if intolerant medications, which have an analgesic effect, inflammatory processes of the urethra.
Preparatory activities
Preparation for the study also varies depending on the type of diagnosis. If the procedure is performed transabdominally, you should arrive with a full bladder and empty bowels. To do this, you need to drink at least 1 liter of clean water within 2 hours. Before the procedure, take a diuretic, which is necessary for accelerated outflow of urine by the kidneys. In addition, for 2 days you must adhere to a diet that reduces increased gas formation.
Dietary food limits the consumption of:
- raw vegetables;
- juices;
- dairy products;
- alcohol;
- carbonated drinks;
- fresh baked goods;
- legumes;
- coffee.
The last meal should be no later than 7 pm. You must come for diagnostics on an empty stomach. You should also administer a cleansing microenema the day before. You can reduce the number of gases using activated carbon, Espumisana. To prepare for a transrectal examination, you should cleanse the intestines by using a mild herbal laxative or an enema.
If a patient needs to undergo a transurethral examination, then, due to the fact that it is performed under anesthesia, it is necessary:
- exclude the use of any alcoholic drinks, since they can interact in unpredictable ways with medicines;
- Take a light breakfast in the morning. For two hours before the procedure, it is necessary to avoid exposure to nicotine. Since nicotine, as a result of pain relief, can lead to nausea;
- notify the doctor about the presence allergic reactions, diseases of the respiratory system, cardiovascular system.
How the research is carried out
If the diagnosis is carried out transabdominally, then the patient lies on the couch with the abdomen freed from clothing. The doctor moves the ultrasound sensor around skin, scanning the bladder and nearby organs. To evaluate the functioning of the prostate gland during the procedure, the doctor asks you to visit the toilet. Next, visualization is performed after emptying the bladder. Usually the procedure does not take more than 20 minutes. In transrectal ultrasound, an ultrasound probe is inserted into the rectum. During the diagnosis, the doctor may ask you to change the position of the body.
A condom with applied gel is placed on the sensor. During the internal examination, the distance between the bladder and the sensor is reduced. This allows you to examine the organ in detail.
Decoding
The bladder belongs to the category of hollow muscular organs that can be easily diagnosed using ultrasound. Doctors, assessing its work, pay attention to the shape, volume, thickness, structure, filling of the organ, emptying, contents, volume of residual urine. These parameters will allow the specialist to assess the condition and make an accurate diagnosis.
Normal indicators bladder in men are:
- rounded shape with clear and even contours;
- echogenic structure, which changes due to the patient’s age. In older people and people suffering chronic diseases bladder, increased echogenicity is observed;
- volume from 350 to 750 ml;
- wall thickness varies from 2 to 4 mm. This has a connection with the fullness of the organ. If thickening or thinning is observed in any area, then this is classified as a pathology;
- the volume of residual urine should not be more than 50 ml.
Diagnosed pathologies
As a result of the study, the following diagnoses can be made:
- cystitis;
- cancerous tumors;
- presence foreign body;
- vascular changes;
- reflux in the form of urine backflowing into the ureter from the bladder;
- inflammation;
- congenital pathologies;
- increased functionality;
- enuresis;
- diverticula.
Increased echogenicity of the organ occurs:
- with stones;
- cysts;
- polyps;
- narrowed size of the ureter;
- neoplasms.
Formations that cause an increase in echogenicity can be mobile, such as stones, or immobile, such as polyps. New formations with a denser structure are visible on the device as light spots, for example, stones. Polyps and cysts will appear as lighter spots. Urine reflux into the ureter from the bladder, which can reach the renal pelvis, is caused by an abnormality of the urinary tract, sediment and stones, and neoplasms.
In this case, Doppler ultrasound is performed to determine the volume of thrown and residual urine. It detects the direction of the current and assesses the degree of the disease. Ultrasound diagnosis of the bladder makes it possible to identify multiple pathologies at the very beginning of their development. This safe technique, which can be carried out more than once to monitor the result of the prescribed treatment.