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Bladder ultrasound

Is a safe and painless test that uses sound waves to make images of the bladder before and after urination (peeing). During the examination, an ultrasound machine sends sound waves into the bladder area and images are recorded on a computer.

Bladder ultrasound can also give information about:

  • The bladder wall
  • Diverticula (pouches) of the bladder
  • Prostate size
  • Stones
  • Large tumors in the bladder
  • Urinary retention
  • Urinary catheter confirmation
  • Free fluid in the pelvis
  • Determine post void residual
  • Nephrolithiasis in the UVJ
  • Typically included in renal ultrasound and FAST exams

Preparation

Usually, you don't have to do anything special to prepare for a bladder ultrasound, although the doctor may ask that your child drink lots of fluids before the exam so that he or she arrives with a full bladder. You should tell the technician about any medications your child is taking before the test begins.

Procedure

The bladder ultrasound will be done in the radiology department of a hospital or in a radiology center. Parents are usually able to accompany their child to provide reassurance.

Your child will be asked to change into a cloth gown and lie on a table. The room is usually dark so the images can be seen clearly on the computer screen. A technician (sonographer) trained in ultrasound imaging will spread a clear, warm gel on the lower abdomen over the pelvic area, which will help with the transmission of the sound waves.

The technician will then move a small wand (transducer) over the gel. The transducer emits high-frequency sound waves and a computer measures how they bounce back from the body. The computer changes those sound waves into images to be analyzed.

After the first image with a full bladder is taken, your child will be asked to empty the bladder and more images will be recorded. Sometimes a doctor will come in at the end of the test to meet your child and take a few more ultrasound pictures. The procedure usually takes less than 30 minutes.

Bladder volume/post-void residual

  • Use calc mode and measure in 3 dimensions (anterior posterior, right left, and superior inferior)

Stones

  • Ureteral jets can indicate patent ureter
  • Bladder bulge may indicated a UVJ stone
  • Twinkle Sign: Rapid alternation of color immediately behind a stationary echogenic object, acquiring a false appearance of movement in color Doppler mode

Free fluid

  • Anechoic (black) fluid outside the bladder is suggestive of free fluid
  • Look for 'pointy edges' which increases suspicion for fluid not in another structure (cyst, ovary, bowel, etc)

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