When the doctor directs the patient for an ultrasound of the bladder, which the procedure shows , the person is not excited out of idle curiosity. Now in the arsenal of doctors there is cystoscopy, x-ray and tomography. Is the good old ultrasound so informative against the background of modern diagnostic techniques?
We will explain why doctors often use ultrasound to assess the condition of the bladder, describe the methods of the procedure and the pathology that can be identified by the results of the diagnosis.
Why is ultrasound prescribed?
The bladder (urine) is an organ of the human urinary system. Its middle part is associated with the ureters, through which it receives and accumulates urine from the kidneys, and removes it through the urethra.
In a healthy person, the process of receiving, retaining and draining urine occurs reflexively and does not cause discomfort. However, any disturbances in the coordinated work of the urinary system often make themselves felt already at the initial stages of the development of pathologies, which can indicate an ultrasound of the bladder.
It is important to consider that the excretory system is closely connected with the reproductive organs, therefore, ultrasound diagnostics can detect many acute and chronic diseases of the genitourinary apparatus in the framework of one study.
The main indications for the procedure
A doctor-urologist is involved in the diagnosis and treatment of pathologies of the urinary system, but the primary care doctor gives the primary direction for an ultrasound of the bladder with the following patient complaints:
- Painful outflow of urine.
- Rapid urination or urinary retention.
- Feeling of incomplete emptying.
- The appearance of pathological impurities in the urine (blood, flakes, sediment).
- Painful sensations in the lower abdomen of a different nature before or after urination.
It is important to note that such symptoms are characteristic of pathologies of the prostate gland in men and diseases of the fallopian tubes and ovaries in women. Therefore, an ultrasound of the bladder will become one of the important tools for a comprehensive differential diagnosis.
Often, patients are interested in what shows an ultrasound of the kidneys and bladder, which is performed simultaneously. The results of the study can confirm the development of various pathologies, for example, ureterohydronephrosis - an abnormal expansion of the renal pelvis, calyx and ureter.
However, it is impossible not to mention in what other cases this type of diagnosis is indispensable.
When a bladder ultrasound is used
Ultrasound can be used during operations for crushing stones, when removing neoplasms of the bladder and prostate adenoma by endoscopy.
Patients after abdominal operations on the organs of the excretory system must and repeatedly do an ultrasound of the bladder, which shows how the body responds to treatment.
Directions for diagnosis are often issued to middle-aged and older patients during medical examination as a prophylaxis of diseases of the genitourinary system.
In case of abdominal injuries, when it is necessary to confirm or exclude the risk of rupture of the urea, ultrasound is used urgently.
The whole procedure lasts about 15-20 minutes. It is completely safe for men and women (including pregnant women), as well as for young children.
Many people wonder if ultrasound will show bladder cancer. In the initial stage of the disease, most likely not. With the mass death of cells that are visible when projected onto the screen, a disappointing diagnosis can be confirmed.
Not everyone knows that today several methods of the procedure are practiced. All of them have some limitations, so the doctor chooses the most suitable and most promising for the patient.
Transabdominal method
This is the classic and most widely used diagnostic method, which is carried out externally through the front wall of the peritoneum. It is used for any age group, it is safe at all stages of pregnancy.
The patient exposes the abdomen from the navel to the pubic bone and lays on the couch. The sonologist applies a special gel to the patient’s stomach, which serves as a conductor between the ultrasound probe and human skin, providing continuous acoustic communication.
Modern ultrasound gels eliminate the risk of irritation and do not cause allergic reactions, therefore they are easily tolerated by the skin of patients and do not leave stains on clothes.
While the procedure is in progress, you can talk with your doctor, for example, ask if an ultrasound scan will show inflammation of the bladder.
To undergo transabdominal ultrasound, the patient urea must be full. This is an important condition under which the maximum stretched organ will not have folds that prevent the doctor from conducting an objective examination.
However, in some cases it is impossible to make diagnostics in the traditional way.
Contraindications for transabdominal ultrasound
An experienced specialist will not send the patient to an ultrasound of the bladder, which is performed externally, in the following cases:
- Enuresis (urinary incontinence).
- The presence of skin diseases affecting the lower abdomen, for example, pyoderma in children or purulent rashes of a viral nature in people of any age.
- Obesity that does not allow for accurate diagnosis due to the thick fat layer.
- Cicatricial formations on the walls of the bladder that remain after injuries and operations.
In this case, there are alternative research methods that are not so comfortable, but no less informative.
Transvaginal method
This diagnostic method involves the introduction of an ultrasound probe into the vagina of the patient, therefore it is used only for women who have had sexual intercourse.
The procedure is prescribed not only for the above reasons. It helps to confirm or exclude concomitant pathologies of the reproductive system. Some patients are interested in whether an ultrasound scan will show bladder leukoplakia. If this infectious disease is suspected, cystoscopy gives the best results.
The patient lies on a couch with legs bent at the knees and legs apart. Before testing, a condom is put on the sensor and lubricated with gel. The procedure does not bring women pain, but in some patients it can cause psychological discomfort.
It is for this reason that a sonologist conducting a transvaginal ultrasound of the bladder should be not only a specialist in his field, but also a good psychologist, able to calm and cheer the patient.
Contraindications to ultrasound transvaginal method
This research method is not prescribed for patients with infectious diseases of the genital tract, pregnant women with a period of 12 weeks and women with a fairly rare allergy to rubber.
Let's find out what is offered to patients as an alternative.
Transrectal method
Diagnosis through the rectum is recommended for patients who have not had sexual intercourse, who can not conduct a standard ultrasound examination, as well as for men with suspected prostate diseases.
What does an ultrasound of the bladder in men, performed by a transrectal method? This is an important diagnostic measure that allows you to detect prostate pathologies in the initial stages of development, establish their relationship with the urea and objectively assess the degree of its damage.
The patient lies sideways on the couch and pulls the legs bent at the knees to the chest. The doctor puts on a condom on the rectal sensor, processes it with gel and injects it into the patient's anus to a depth of about 10 cm. Manipulations cause short-term discomfort.
Before a study, patients with a low pain threshold are treated with an anesthetic.
Contraindications to ultrasound transrectal method
This diagnostic technique is not suitable for patients with strictures (narrowing) of the rectum, hemorrhoidal sphincter fissures and inflammatory processes in the intestine, as well as latex intolerance. The procedure cannot be performed if the rectum is removed.
And now we will consider the method of ultrasound diagnostics of the bladder, which is used extremely rarely.
Transurethral method
This is a rather painful procedure, which is based on the introduction of a sensor into the urethra. It allows you to accurately assess the condition of the urinary system.
The technique requires the use of local anesthesia and the high professionalism of the doctor, since during the procedure there is a high risk of injury to the urethra. Therefore, in cases where it is necessary to examine the ureter and urethra, cystoscopy is often prescribed.
Writing out the direction for ultrasound of the bladder, which shows the procedure and whether it is necessary to prepare for it, the doctor must tell his patient.
Preparatory Activities
Crowded intestines and excessive gas formation do not give an objective picture of the state of the abdominal organs, therefore, on the eve of the procedure, it is not recommended to eat products that cause fermentation. Black bread, raw fruits and vegetables, especially legumes, are excluded from the diet. You can not drink soda. Strong coffee and alcohol should also not be consumed the day before the procedure. 12 hours before the ultrasound, it will not hurt to take activated charcoal (1 tablet per 10 kg of weight) and no longer eat.
The day before the transrectal examination, it is important to empty the intestines as much as possible, if necessary, use a laxative or enema.
It is necessary to come to the procedure with a full bladder with all types of ultrasound, except transvaginal. Therefore, for 1.5-2 hours, you will have to drink at least 1 liter of plain water or not to commit an act of urination 5-6 hours before the study.
We have already examined how an ultrasound of the bladder is performed, and what the procedure shows, will tell you the abnormalities found during the study.
Normal performance
The ultrasound diagnostic method is based on the ability of human tissues and organs to absorb and reflect high-frequency waves. The pulse sensor gives signals, receives them back, processes the information and transfers it to the monitor screen.
The data obtained allow us to objectively assess the state of the organ, starting from the following parameters:
- The bladder without pathological changes is round or oval (depending on the projection) and necessarily symmetrical.
- The normal volume of fluid contained is about 500 ml.
- The outlines of the body are smooth and pronounced, without dips and blurry areas.
- The space inside the urea should be free of foreign substances.
- Over the entire area of a healthy organ, the wall thickness is uniform, without seals.
Many patients are interested in whether an ultrasound of the bladder will show cystitis. This highly informative diagnostic method allows you to establish a wide range of diseases of the genitourinary system. Below we will consider those that are most common.
Pathological abnormalities
The diagnostic doctor (sonologist) describes the identified pathologies, but does not diagnose the patient. This is done by urologists and gynecologists. This is done not only on the basis of ultrasound, but also laboratory diagnostics.
What can show an ultrasound of the bladder:
- A pathological increase in organ volume is a consequence of a violation of innervation (neurogenic bladder) or a benign neoplasm (prostate adenoma).
- Uneven walls and a lack of symmetry often mean the development of a ureterocele (cystic pathology of the ureter), polyps or ingrown stones, as well as prostatic hypertrophy.
- An ultrasound of the bladder shows cystitis, when the picture shows clearly visible spots on the back of the organ, and thickening of the walls in combination with a flocculent sediment indicates a chronic form of the disease.
- Sediment, local wall thickening, and multiple moving particles are characteristic of sand and stones.
- Deformations, irregularities, accumulations of small formations of an inhomogeneous structure (especially in the lower part of an organ) can mean oncology.
Among what the bladder ultrasound shows, it is also worth noting metastases from neighboring organs, malformations, obstruction of the urinary ducts (reflux), pathology of the fallopian tubes and ovaries, diverticula (protrusion of the wall) and other diseases of the genitourinary system. Therefore, you should not ignore the direction to the procedure.
If the clinic does not have an ultrasound diagnostic room, you can do an ultrasound of the bladder in a private medical facility. The cost of the procedure is from 500 to 3500 rubles.