Ultrasound of the urinary bladder

Synonyms

Medical: Vesica urinaria

Ultrasound, bladder, urinary bladder infection, cystitis, cystitis

English: bladder

introduction

To Ultrasound examination of the urinary bladder an ultrasound head with 3.5-5 MHz is used. The thickness of the urinary bladder wall should not exceed 6-8 mm in the ultrasound examination. Ultrasound is used to determine the length, width and thickness of the urinary bladder.
Below is a list of urinary bladder diseases.

Course of the ultrasound of the urinary bladder

In order to allow a good assessment of the urinary bladder, it is important that the urinary bladder when filled is sounded. This serves as a bony orientation Pubisover which the filled urinary bladder extends. Sometimes it is necessary to use the transducer backwards (towards the back) or downward (towards the feet) so that the pubic bone does not cover the urinary bladder with its acoustic shadow.

Like any organ, the urinary bladder is in two levels screened and assessed. It can happen that Loops of intestine overlay the urinary bladder and thus a Make investigation difficult. In such cases, the examiner must slowly but firmly push the transducer into the lower abdomen in order to move the intestinal loops.

What can you see in an ultrasound of the urinary bladder?

The urinary bladder can only when filled be sounded well.

At empty bladder the roof of the bladder sinks in and that Organ is covered by intestinal loopsso that no insight is possible. In the filled state, however, it presents itself as round, anechoic structure which can also serve as a sound window for structures behind and under the bladder. Occasionally can in the urinary bladder Repetition and layer thickness artifacts occur. In no case should they be confused with pathological changes.

The sexual organs can also be recorded with the same transducer settings: woman can you vagina as well as the uterus consider where man the prostate as well as the Seminal vesicles.

Ultrasound can do that maximum volume of the urinary bladder or the prostate be calculated. It is also possible one Residual urine determination to be carried out by measuring the maximum volume of the filled bladder, then asking the person to urinate and then continuing the examination.

The Bladder volume measured. An ultrasound scan can also reveal bladder stones or a bladder tumor. It is also possible through the bladder echo, a benign prostate enlargement to see where here is more of a transrectal ultrasound examination suitable. A Urinary catheter can also be visualized using ultrasound.

You might also be interested in: Prostate enlargement

Urinary bladder disorders

Bladder infection / urinary tract infection

The urinary bladder can also be involved in a urinary tract infection (UTI). A urinary tract infection is usually caused by bacteria that enter the normally sterile bladder from outside, for example. Since in women the exit of the urethra (urethra) is closer to the anus and generally the urethra is shorter and thus the infection routes are shorter, the urinary tract infection (UTI) occurs (Cystitis) in women 10 times more often than in men. Typical symptoms can be a burning sensation when urinating. In some cases, bacteria can be detected in the urine as a sign of a urinary tract infection (= urine culture or uricult for short) without symptoms of an infection. In this case one speaks of an asymptomatic urinary tract infection. If there is an infection in the bladder (urinary bladder inflammation), the germs can also enter the supplying ureters (Ureter) rise and encompass the renal pelvis (pelvis renalis) and the kidney. This is called an inflammation of the renal pelvis (Pyelonephritis). Inflammation of the kidneys is usually a dangerous disease that can be accompanied by symptoms such as pain in the kidney bed, i.e. on the flanks and in the back, and fever.
If left untreated, inflammation of the kidney pelvis can develop into blood poisoning (sepsis), which can have potentially life-threatening consequences. A urinary tract infection is detected by microscopic examination of the urine, which reveals bacteria and white blood cells (Leukocytes) provide a hint. A urine test strip can be used to get initial clues about the presence of bacteria in the urine.

A urinary tract infection is treated with an antibiotic, for example with trimethoprim and sulfamethoxazole (e.g. Cotrim ®), amoxillin or a so-called gyrase inhibitor such as ciprofloxacin (Ciprobay ®).

The bacteria can be grown as part of a microbiological examination and their effectiveness against the various antibiotics tested. This process is called an antibiogram.

Bladder tumor / bladder cancer

The lining of the bladder can also degenerate, so that Bladder cancer can arise. Bladder cancer is the fourth most common tumor disease in men and is 3 times more common than in women. Most of the time the tumor removed by means of the so-called electroresection and then examined (histological examination). Sometimes surgical removal is sufficient, but in some cases the whole must be bladder removed. This makes a bladder replacement necessary. For this purpose, the urinary tract can be connected to the small intestine or, similar to the artificial anus, can be guided to the surface via the skin. chemotherapy is usually only necessary if there are daughter tumors (Metastases) have discontinued.

Injury to the urinary bladder

From the neighborhood to the Pubic bone (Pubis) the urinary bladder is easily vulnerable Pelvic fracture. The bladder wall can tear and urine can leak into the surrounding connective tissue; serious inflammation is the result, which affects the entire abdomen (Peritonitis) can overlap.An injury can be diagnosed using ultrasound.

Bar bubble

Does the bladder have to be constantly emptied against resistance, such as B. with enlargement of the prostate / Prostate gland (Prostate hypertrophy), the muscles gain mass. A so-called "bar bubble" forms, which can be clearly seen on X-rays with a contrast agent.

Artificial bladder

If the bladder had to be removed because of one of the diseases mentioned above or for any other reason, there are several ways to restore the urinary drainage. On the one hand, a connection to the abdominal wall can be created at various points in the system, which continuously drains urine into a bag attached there. (stoma). On the other hand, a replacement bladder (Pouch) and these are connected to either the urinary or digestive system, which causes a renewed continence.
Another common problem related to the urinary bladder is Bladder weakness (Incontinence) which manifests itself in uncontrolled leakage of urine. Older women are particularly affected. A distinction is made depending on the situation in which the bladder weakness occurs Stress incontinence, whereby the burden can be, for example, coughing, of Urge incontinence if the urge to urinate is frequent. For bladder weakness there are both physiotherapeutic approaches such as pelvic floor exercises, as well as medicinal or, as a last alternative, surgical treatment methods.