How is ultrasound diagnosis of the bladder performed? Diagnostic methods for inflammation of the bladder Types of ultrasound examination

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With the help of ultrasound examination on modern devices it is possible to visualize the size, shape, position of the organ, inclusions and intensity of blood flow in it. To exclude artifacts and obtain reliable data, proper preparation for ultrasound is necessary, which depends on which organ is planned to be examined.

Indications for ultrasound of the bladder

An ultrasound examination of the bladder is performed if a number of diseases are suspected and the corresponding symptoms are present, such as:

• Frequent painful urination and pain in the lower abdomen. They may be a manifestation of inflammation of the bladder (cystitis), urolithiasis with stone passage, or tumor diseases.
• The appearance of blood in the urine (hematuria). When urinating, the urine turns red and may be accompanied by a burning sensation in the area of ​​the bladder and urethra. These symptoms accompany urolithiasis, tumor process or organ injury genitourinary system. In this case, in addition to ultrasound of the kidneys and bladder, a clinical urine test is mandatory.
• Feeling incomplete emptying Bladder. Happens with adenoma ( benign tumor) prostate in men, foreign bodies or tumors of the bladder or other pelvic organs.
• Any abnormalities in the clinical analysis of urine, such as the appearance of protein and bacteria in the urine, an increase in the content of leukocytes and casts (protein casts of the renal tubules).

The examination can be carried out without indications, simply at the request of the patient. Diseases that can be detected using ultrasound of the bladder:

• acute and chronic cystitis;
• diverticulum - a condition in which a protrusion forms in the wall of the bladder; over time it can become inflamed;
• stones in the bladder due to urolithiasis;
• anomalies in the structure of the bladder - a change in the shape and location of the organ, is a congenital condition as a result of a violation of its development;
• foreign body;
• Tumors are new growths that can be benign (polyps) or malignant (cancer).

What does an ultrasound of the bladder show?

Using an ultrasound examination, the doctor can see the following abnormalities:

• thickening of the walls of the bladder (hypertrophy) – observed with cystitis and impaired urine outflow;
• diverticula and the presence of inflammation in them;
• stones and foreign bodies;
• space-occupying formations that protrude into the cavity of the bladder (tumor);
• changes in the shape and location of an organ due to its anomalies;
• increase in residual urine volume.

How is an ultrasound of the bladder performed?

Ultrasound is performed on a full bladder, as this makes it easier to visualize with ultrasound. The completeness of the examination is determined by such characteristics as:

• bladder size and shape;
• localization (location);
• condition of the bladder walls (normally 0.3-0.5 cm);
• the presence of stones or other foreign bodies;
• tumor visualization.

The results obtained are analyzed and documented. The ultrasound doctor makes a conclusion. The diagnosis is made by the attending physician based on all examination results and clinical picture, therefore, the ultrasound conclusion and the final diagnosis may not coincide.

There are three ways to carry out the procedure:

1. non-invasive method - the nozzle is applied to the anterior wall of the abdomen in its lower parts;
2. transrectal method - a special nozzle is inserted into the rectum, allowing a good examination of the neck of the bladder and its lower parts;
3. transvesical method - the nozzle is inserted into the cavity of the bladder and is used for direct examination of formations and tumors.

If the patient has impaired urine outflow, an ultrasound is performed to determine residual urine. The essence of this technique is that an ultrasound examination is performed twice - before and after emptying the bladder. During the first ultrasound, all indicators are examined. After urination, ultrasound is used to determine the amount of remaining urine, the normal volume of which is no more than 50 ml.

Preparing for an ultrasound of the bladder

The patient is not required to do any special training for examination. The only thing you need to do is drink 1-1.5 liters of liquid (water, tea, compote) an hour before the examination. Then you will have to be patient and not urinate until the end of the ultrasound. If an unbearable urge to urinate occurs, the bladder can be partially emptied, but not completely.

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Without any restrictions, ultrasound of the bladder can be performed in children and pregnant women, since ultrasound does not damage body tissue and does not cause long-term consequences. This research method is harmless, painless and has no contraindications.

How to prepare for an ultrasound examination of the bladder?

Ultrasound of the bladder is prescribed to diagnose urinary diseases excretory system. It is always examined as part of a comprehensive ultrasound examination of the pelvic organs in women and men.

The peculiarity of the bladder is that it is a hollow organ. If it is not filled with liquid, it “creases” and does not allow sound waves to pass through it. It is not visible on the monitor and cannot be measured, so the interpretation of the results will be inaccurate. Examination with an empty bladder does not show stones or sediment in its cavity; does not allow us to take into account such an important diagnostic factor as residual urine. At comprehensive ultrasound not only empty, but also insufficiently filled urine reduces the accuracy of visualization of the uterus, ovaries, and prostate. Therefore, you need to prepare for an ultrasound of the bladder in advance.

How is an ultrasound examination performed?

The procedure is carried out in two ways: externally, through the anterior wall of the peritoneum, and internally, through the vagina in women and through the rectum in men. The interpretation of the research results is the same in both cases.

1. External, transabdominal ultrasound of the bladder can be done already at initial appointment urologist or gynecologist. If the attending physician, after deciphering the ultrasound report, discovers a pathology in the bladder or other pelvic organs, he recommends an in-depth study.
2. Ultrasound with the introduction of a sensor through the rectum is called transrectal, and through the vagina - intravaginal. It is carried out during diagnosis gynecological diseases in women and prostate diseases in men, at the same time examining the bladder and ureters. It shows not only problems with bladder, but also their relationship with other pathologies of the pelvic organs.

For children, ultrasound of the bladder (for cystitis and other urination disorders) is done only transabdominally. To a small child who cannot be explained how to prepare for the procedure, the doctor will prescribe another examination method. However, in some cases, ultrasound is performed on children without preparation in order to determine residual urine: if there is a lot of it, this indicates serious problems with the baby’s health.

Getting ready for the examination

Preparation for an ultrasound of the bladder partly coincides with preparation for an ultrasound examination of organs abdominal cavity and small pelvis. It is not done after gastro- and colonoscopy - ultrasound examination after these procedures will not harm you, but its results will be inaccurate. If you are constantly taking any medications, warn your ultrasound doctor about this.

If the purpose of the study is only to diagnose diseases of the urinary system, it is not necessary to follow the rules. But if the doctor warns that during an ultrasound of the bladder an examination of all pelvic organs is expected, you will have to prepare for it several days in advance. The purpose of preparation is to reduce flatulence, as gases make inspection difficult. Therefore, 1-2 days before the ultrasound, stop eating foods that cause fermentation in the intestines:

• raw vegetables and fruits and juices from them;
• cakes, baked goods;
• milk and dairy products;
• legumes;
• black bread;
• carbonated drinks.

Ultrasound of the bladder is best performed in the morning on an empty stomach. If it is scheduled for the afternoon, a light breakfast is allowed in the morning (except for the products listed above, you should not eat fatty foods and eggs). For ultrasound to show accurate results, you can have breakfast no later than six hours before your doctor’s visit.

Special rules

Whether you need any specific preparation for the procedure depends on how bladder ultrasounds are performed at your facility. For example, a transvaginal ultrasound is performed with an empty bladder, but it is usually done during a comprehensive examination of the abdominal or pelvic organs, so it is necessary to reduce flatulence.

You only need to prepare specifically for transabdominal and transrectal ultrasound examinations. It is carried out once or twice: with full bubble and after urination (with determination of the amount of residual urine).

1. One to two hours before your visit to the doctor, drink several glasses of any liquid: tea, compote, still water. If after an hour you do not feel that the bladder is full, you need to drink a few more glasses of liquid. It’s hard to endure, but it’s not time to go for an ultrasound yet? Urinate and drink tea or still water again.
2. When an ultrasound of the bladder is scheduled for early morning (for example, in a hospital), you can prepare for it the “natural way”, that is, not urinate at night. This method is ideal for people who rarely wake up at night to go to the toilet.
3. Sometimes in a hospital or at a doctor’s appointment there is a need for urgent diagnosis of the bladder and kidneys (if renal colic or suspected stone blockage). The patient does not have time to prepare for the procedure, and the doctor prescribes a single dose of a diuretic. Diuretics are not used by people with cardiovascular disease.
4. If an ultrasound of the bladder needs to be performed on a person suffering from urinary incontinence, before the procedure the bladder is catheterized and filled with saline. But inserting a catheter is quite traumatic, so it is used only as a last resort.

Before transrectal ultrasound, so that feces do not interfere with the procedure, make a microenema of 200 ml as usual boiled water. The large intestine needs to be cleaned an hour and a half before the procedure and then the rectum should be emptied.

Ultrasound of the bladder

Ultrasound examination plays an important role in determining bladder diseases. This diagnostic method is prescribed in the presence of symptoms indicating pathology of the genitourinary system. To obtain reliable results, an ultrasound of the bladder should be taken seriously and prepared. All instructions regarding preparation for the examination are given by the doctor and it is very important to follow them. This method has no contraindications and is allowed even for children.

Indications for ultrasound examination

This examination method is distinguished by its simplicity, absence of contraindications, complications, and speed of obtaining results. A study is prescribed for the following symptoms:

• frequent or difficulty urinating;
• incontinence;
• suspicion of kidney stones;
• with cystitis;
• urine laced with blood;
• suspicion of vesicoureteral reflux.

Additionally, a study is prescribed to assess kidney function, diagnose cystitis (both chronic and acute), and pyelonephritis. If adenoma or inflammation is suspected in men, prostate examinations are simultaneously performed. For a complete assessment of the condition of the genitourinary system, women may be prescribed additional examinations uterus and appendages.

How to properly prepare for an ultrasound of the bladder

Preparation for a bladder ultrasound plays a very important role. By the time of the procedure, the organ should be filled - this will help determine the thickness of the walls, the shape of the organ and its contour. To do this, approximately 1.5 - 2 hours before the ultrasound, you need to drink about 2 liters of liquid in the form of teas, compotes, still water. There is another way - do not empty the bladder for 5 - 6 hours before the procedure.

If the ultrasound will be performed transrectally, it is necessary to do a cleansing enema on the eve of the procedure and several hours before it. After such preparation, patients have no questions about whether they can eat before ultrasound of the bladder. After all, it is already clear that it is better to conduct an examination after an enema on an empty stomach or on a diet (for other types of examination: external and transvaginal or transurethral).

Many patients find it difficult to refrain from urinating before the procedure and the question arises of how to prepare then. In this case, it is recommended to partially evacuate, but you will need to drink 1.5 - 2 liters of liquid so that the organ is filled again by the time of the ultrasound. From proper preparation The accuracy of the results after the examination depends on the patient, because only a full bladder can determine the condition of the organ.

How is the procedure performed?

Ultrasound of the bladder is performed in 3 ways:

1. Abdominal - with this examination, the examination is carried out from the anterior abdominal cavity. This is an external type of research.
2. Transurethral - diagnosis occurs through the urination channel.
3. Transrectally - the organ is examined through the rectum.

The most used is the first method of examination. The other two are necessary to confirm or refute problems that were identified during an external examination. Ultimately, the method of performing an ultrasound is determined by the attending physician, who prescribes this procedure. The patient’s position is determined during the diagnosis; you will be asked to lie on your back or side, in some cases you will be asked to stand up so that the organ can be examined for the presence of formations inside it .

How to do an ultrasound of the bladder in women

Diagnosis sometimes differs depending on the gender of the patient. Women also have their uterus and ovaries examined. The procedure makes it possible to measure these organs, determine their structure, location, and shape. In some cases, women undergo transvaginal ultrasound. This helps to clearly see the picture of the state of the organs inside and accurately diagnose the existence of certain diseases. Pregnancy and menstruation are not an obstacle to diagnosis; it is only important to warn the doctor so that he can choose the right examination method.

Ultrasound of the genitourinary system in men

The examination of male patients has some of its own characteristics, for example, during an ultrasound of the bladder, sometimes there is a need to diagnose the prostate gland. If you suspect diseases associated with the prostate, ultrasound of the bladder with determination of residual urine. To do this, the man is asked to go to the toilet, and then the amount of fluid that is retained in the organ is measured. Otherwise, the diagnosis of a bladder in men and women is no different.

What an ultrasound can show

Organ diagnostics helps to see:

• Patency of the ureteral canals.
• The presence of foreign formations, tumors, stones.
• Sediment in the bladder on ultrasound is visible in the form of salts, crystalline formations, epithelium, erythrocytes and leukocytes.
• Inflammation (acute or chronic).
• Increased tone.
• Atony.
• Wall diverticulosis.
• Organ prolapse.
• Existence of prostate problems (in men).
• Diseases of the ovaries, appendages, uterus (in women).

Primary diagnosis of cystitis is carried out using urine and blood tests. After the doctor receives the results, he can refer the patient for an ultrasound examination of the urinary system. Ultrasound of the bladder for cystitis is a necessary measure.

If the doctor has difficulty making a diagnosis, this method diagnostics helps to obtain an accurate picture of the development of the disease, since ultrasound visually shows the structure of the bladder, in which characteristic signs of inflammation are visible when cystitis occurs.

Cystitis is an inflammation of the bladder walls that most often occurs as a result of penetration into the urinary organ bacterial infection . Today this disease is quite common, especially among women. The fact is that representatives of the fairer sex have a concomitant anatomical structure of the urinary organs - a wide and short urethra, through which pathogenic microflora can quickly penetrate the body, thereby causing inflammation.

Is it possible to determine whether there is a problem by early stage? Cystitis often appears in a person as a result of the development of an ascending infection in the body, which complicates diagnosis and treatment of the disease.

When is it prescribed?

The main indications for ultrasound if cystitis is suspected are:

• rare or, conversely, too frequent urination;
• the presence of pus or blood clots in the urine;
• the appearance of large white flakes in urine;
• false urge to go to the toilet, when only a couple of drops of urine containing impurities of pus or blood are released from the bladder (often this phenomenon is observed with cystitis, which was caused by a specific flora);
• change in urine color;
• demotion total number urine produced per day;
• pain or discomfort when going to the toilet “in a small way”;
• discomfort in the pubic area;
• an increase in low-grade fever to 38 degrees or more.

It is important to note that these symptoms can characterize not only cystitis, but also other pathologies of the bladder or the entire excretory system (pelvic organs). Therefore, the patient is prescribed an ultrasound, with the help of which the diagnosis will be established accurately. The question “is it necessary to do an ultrasound” in such a situation does not arise.

What does it show?

Is the disease visible on the study? When performing an ultrasound, doctors can detect diverticula - these are peculiar sac-like neoplasms located on the walls of the bladder or growing into its cavity. Also in the organ it is possible to detect sand or oxalate (salt) stones, which significantly disrupt the integrity of the mucous membrane, and are also considered the main factor in the development of cystitis.

Video 1. Cystitis on ultrasound.

During certain forms of the disease, such a study will be endowed with specific manifestations.

Ulcerative and herpetic forms

For these forms of cystitis characteristic symptom As the disease progresses, erosions and small ulcers will appear in the inner part of the bladder. At first they will develop on the mucous membrane, and then begin to spread into the deeper layers of the organ. This form is accompanied by severe pain , therefore, the patient should be treated immediately after identifying signs of cystitis.

Candidiasis form

With the development of candidal cystitis, ultrasound will show formations that have appeared in the urinary cavity. They can have different shapes and sizes. The rate of growth of neoplasms depends on the state of the patient’s immunity and the duration of cystitis.

Acute form

Significant thickening of the walls of the bladder becomes noticeable only with the onset of an acute form of pathology. At the beginning of its development, an ultrasound will show an even contour of the organ, which will be completely free of deformation. However as inflammation progresses, the walls of the bladder will gradually thicken, the contour will become more crooked and the shape uneven - with the help of ultrasound, such negative changes in the organ can be noticed without problems.

Chronic form

With the development of this form, thickening of the walls of the organ also occurs. Ultrasound shows the presence of flakes in the bladder, which indicates advanced disease.

If the inflammation is too advanced, hypo and hyperechoic areas can be found in the inflamed organ. by them there may be blood clots. They also cause circuit disruption urinary organ, being in a liquefaction phase, causing it to appear asymmetrical.

Healthy Bladder

In a normal and healthy state, the organ is smooth, symmetrical, without protruding walls or an uneven contour. The mucous membrane should be free of deformations, ulcers, spots and thickenings. A healthy organ has a wall thickness of 5 mm.

Preparation

Preparation for the study depends on the method of conducting it.

Known 4 options Ultrasound of the bladder. This:

• transvaginal;
• transurethral;
• transabdominal;
• transrectal.

Ultrasound is accompanied, if necessary, by other types of studies.

Also, to make a diagnosis of cystitis, a method is often used that helps to identify all the obstacles that urine overcomes when entering or leaving the bladder.

The effectiveness of this method lies in the study of the patient's residual urine.

Interpretation of results and norm

Diagnosis of cystitis, performed in the acute phase, reveals the following picture: inside the bladder, tiny particles endowed with high echogenicity are clearly visible. They are usually united into foci. Usually, these particles are an accumulation of a large number of cells– leukocyte, epithelial or erythrocyte. Crystals of salts (oxalates) can also be found in them.

The outflow of urine when it reaches its maximum peak should be less than 15 cm/s– otherwise, we can talk about the development of cystitis or other diseases of the urinary organs.

Complications

Cystitis most often develops as a result of an active infection in the body. Therefore, the causative agent of the disease can easily penetrate the kidneys through the ureters, which will worsen the patient’s condition, causing pyelonephritis and other diseases of the paired organ.

Pros and cons of organ ultrasound

This study is absolutely safe for the patient’s health and is also painless. The safety of this diagnostic method is used in the case of studies of pregnant women, children and the elderly.

Conclusion

Ultrasound performed on the bladder is considered one of the most informative examination methods, which is prescribed for the development of cystitis in acute form. Using this diagnostic method, it is possible to see changes in the urinary organ, the negative effect of pathology on the bladder, and also understand exactly how many layers are involved in the inflammation process.

The advantage of ultrasound is that today there are several options for carrying out the procedure., so it can be selected individually for each patient.

A doctor can diagnose cystitis based on the results of urine and blood tests. But often the specialist has difficulties in precise definition pathology, so he refers the patient to an ultrasound examination of the urinary organs.

Indications for the procedure

A number of symptoms from the urinary system are indications for an ultrasound scan for cystitis. Among them:

• the appearance of bloody impurities or pus in the urine;
• frequent urge to urinate or acute urinary retention;
• small volume of urine;
• pain in the suprapubic area that appears periodically.

Preparation

A person who has received a referral for a procedure must prepare for it. An ultrasound examination will be performed with a full bladder, so 1.5-2 hours before the ultrasound you need to drink about 2 liters of still water or other liquid. If this cannot be done, then it is recommended not to have a bowel movement for 5-6 hours.

The procedure may be hampered by a gas-filled intestine. Those who suffer from flatulence should follow a diet for 2-3 days before the ultrasound. It is necessary to exclude from the diet foods that contribute to gas formation - vegetables, fruits, legumes, carbonated and alcohol-containing drinks.

If the study is carried out using the transrectal method, then a cleansing enema must be done a few hours before the procedure.

Types of ultrasound examination

Ultrasound examination of the bladder is carried out in several ways:

1. Transabdominal. Most common method instrumental diagnostics and less invasive for the patient. Passed through the front abdominal wall with a full urinary organ. For urinary incontinence and obesity, transabdominal ultrasound is not prescribed.
2. Transrectal. It is performed through the rectum for patients of both sexes.
3. Transurethral is a rare diagnostic method that requires mandatory anesthesia. Carried out through urethra using a special tip. The procedure causes discomfort to the person, and the urinary tract may be injured.
4. Transvaginal. Women are examined using this method. The urinary organ must be completely emptied. Transvaginal examination allows detailed analysis, but causes some inconvenience to the patient.

Pathogenic microorganisms that cause cystitis are able to ascend through the genitourinary canals into the kidneys, causing pyelonephritis. If the patient complains of back pain, then an ultrasound scan for cystitis is performed to examine the kidneys.

Differences between men and women

Depending on the gender of the patient, the examination is carried out differently. If a woman comes to the appointment, the ultrasound doctor additionally analyzes the condition of the uterus and ovaries: the organs are measured, their location, shape and structure are determined. Ultrasound can be performed during menstruation and pregnancy, but you should notify your doctor so that he can select the right technique carrying out the procedure.

During the examination of a man, the doctor can analyze the condition of the prostate gland. If prostate pathology is suspected, the remaining 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.

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results

The results of an ultrasound examination of the bladder indicate several parameters that help make a final diagnosis:

• bubble shape;
• its volume;
• amount of residual urine;
• bubble structure;
• Wall thickness;
• rate of bladder emptying.

Ultrasound allows you to determine whether it is developing in the urinary organ inflammatory process.

The echo picture of a patient with acute cystitis shows accumulations of cells - epithelium, erythrocytes and leukocytes, which are described in the study results by the term “sediment”. If the patient lies down during the ultrasound, the sediment is localized near the posterior wall of the bladder. When the patient stands up, the sediment will move to the front wall.

At chronic form pathology or with the progression of acute cystitis, the results of the study will show that the organ has an uneven contour and the walls are thickened. The presence of blood clots in the bladder cavity is shown on the echo picture.

The results of an ultrasound examination must be deciphered by the urologist who referred the patient for the procedure. If necessary, the doctor selects a treatment course.

The results of the bladder examination are normal:

1. Form. In the transverse projection the bubble should be round, in the longitudinal projection it should be ovoid. The shape of the female organ is influenced by the number of pregnancies and births.
2. Structure. Normally, it is echo-negative, but the parameter depends on the age of the person: the older you are, the higher the echogenicity should be.
3. Volume. Average values ​​for women are 250-550 ml, for men - 350-750 ml.
4. Walls. The same thickness over the entire surface - 2-4 mm. If any area shows thickening or thinning, this indicates the presence of pathology in the organ.
5. Residual urine. Its quantity should not be more than 50 ml. When conducting a study, it is mandatory to measure.

What is the price

Ultrasound prices depend on various factors: city of the study, clinic (in a commercial medical center the cost of the service can be 2-3 times higher than in a specialized hospital in a municipal hospital), level of qualifications of the specialist performing the procedure.

In Moscow and St. Petersburg, the average cost of an ultrasound scan of the urinary organ is from 600 to 2,500 rubles.

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 occurs due to upward path E.coli. E. coli ( coli) is an opportunistic flora that lives in the rectum and vagina (in small quantities). Cystitis can also be caused by staphylococcus (occurs with febrile fever), such specific pathogens as chlamydia, mycoplasma, ureaplasma. Very rarely, cystitis can occur hematogenously or lymphogenously (risk of interstitial cystitis).

Symptoms

The main manifestations of cystitis are:

Pain in the suprapubic region;

Cystitis can occur for the following reasons:

Irregular or improper hygiene (in girls);

Diagnostics

What tests will the doctor need to make a diagnosis:

Collection of medical history and complaints;

Ultrasound of the bladder for cystitis carried out after special preparation of the patient. The patient should drink 1-1.5 liters of still water or another drink (not milk) 1-1.5 hours before the scheduled procedure. With chronic cystitis, ultrasound shows thickened walls, as well as sediment at the bottom of the bladder.

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2016-09-27 19:08:37

Valeria asks:

Hello! I have this problem. I’ll start from the very beginning. In July of this year I lost my virginity. A couple of weeks later I began to feel pain when urinating in the clitoral area. I thought it was cystitis, I bought a powder to treat it, drank it and the next day the symptoms disappeared After some time, I began to feel like there was a needle in my bladder, I especially felt it when I lay on my stomach. I went to the therapist, he sent me for an ultrasound of the bladder and a urine test. The test was clear, so was the ultrasound. Kidney stones too. no For the last couple of days I have been feeling pain when urinating. Help, what could this be?

2012-10-16 10:56:24

Olga asks:

Hello! My name is Olga, I am 26 years old, I have been suffering from cystitis for 3 years, at first it was cystitis in the usual form, the urologist prescribed antimicrobial drugs, then it became chronic. I did an ultrasound bladder, everything normal, then I had a urine culture, they found a microorganism and determined sensitivity to antibiotics. I completed the course of treatment, the cystitis stopped bothering me for a while. Now I’m on sick leave (animia), the other day cystitis worsened again for no reason. I went to the gynecologist, the diagnosis was Kalpitis, the doctor advised take tests (scraping) for Ureoplasma, mycoplasma, chlamydia, candida, gardinella and virus herpes simplex., because believes that Kalpitis may be the cause of Cystitis. Why did antibiotics not help, since the microorganism was detected and the correct treatment was prescribed? And can cystitis appear due to Kalpitis? How effective will these tests be? It seems to me that there is a connection here. If something is found during a scraping, will this be considered the cause of Cystitis? Please help(((Thank you.

Answers Brezitsky Yuri Iosifovich:

Only after examining you, conducting a full laboratory examination, conducting detailed analysis previous prescriptions and failures from previous therapies, the right solution can be found.

2010-05-22 20:37:36

Ramzia asks:

Hello dear consultants.
I am 48 years old. 10 months ago, due to CIN stage 3, I had an extirpation of the uterus and ovaries. I have dyshormonal cystic mastopathy, so the end-gynecologist did not recommend HRT (I take Cyclim, calcium D3 Nikomed, Aevit and the regimen) I am worried about minor hot flashes, lumbago and distension in the rectum, constant pain in the lower abdomen, a feeling of incomplete emptying of the bladder and with slight body tension, running, coughing, the desire to urinate. There are no stings or blood pain when urinating.
A general blood test is normal, a general urinalysis, urine according to Nechiporenko and flora - without pathology.
Sigmoidoscopy - the intestines were examined at 25 cm. There was no tumor pathology.
Irrigography - Sigma with additional bending, sagging of the transverse colon to the entrance to the pelvis. Without organic changes - dyskinia of the right parts 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, parenchyma 19.
The relationship between the parenchyma and the renal sinus is preserved.
The kidney cavities 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 small pelvis there is an adhesive process.
Ultrasound of the bladder - the walls are thickened by 7 mm. There is echogenic sediment along the posterior-inferior wall.
I saw a urologist, he said it was chronic cystitis, it needs to be treated, but because of it there cannot be such constant severe pain.
I visited the surgeon and he said that the stomach is calm, so what if adhesions cause constant severe pain and problems with urination.
Pain in the lower abdomen in the midline and heaviness (feeling as if I was dragging 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.
We kindly ask you to duplicate the answer to my email address.

Answers Zheleznaya Anna Alexandrovna:

I would advise you to take FSH estradiol TSH T4 free and, depending on the results, discuss HRT taking into account mastopathy.
Try a course of rectal suppositories Distreptaza or Biostrepta, serate 2 tablets 3 times a day for 10 days, absorbable drugs.
And most importantly, is there any indication of endometriosis in your histological response after surgery? If so, then be sure to treat it.

2009-12-08 13:04:39

Maria asks:

Hello. I have been suffering from cystitis for 4 years now, but maybe it’s not cystitis, because treatment does not bring results. During the first attack of cystitis, I treated myself on the advice of friends, which I now very much regret. She was treated with furadonin, furagin, herbs, and a heating pad. At that time it helped, and there were exacerbations 1-2 times a year. Later I tried other medications: cephalexin, urolesan, cyston, cystenal, amoxicycline, monural, I don’t remember everything. For the last year and a half, symptoms have been haunting me almost constantly, there are sudden attacks, and the rest of the time there is a constant feeling of discomfort when urinating, a burning sensation, the urge to go to the toilet is not so frequent, as well as pain during sexual intercourse. In the fall of 2008, I went to a urologist at a local hospital, took urine, cultured the tank and found Sf epidermidis, E. coli 1000 in 1 l.. Urobilin 0.173 g/l, epithelium-spl, leukocytes - 5-7, salts - val. Detrid - sick, mucus - sick, prescribed Nolitsin + Phytolysin (10 days). It helped for a while, then the symptoms appeared again. In the winter of 2009, I went to a gynecologist with the same problem, took tests for an ultrasound scan, and nothing was found. I was prescribed Viferon suppositories and diuretics for prevention. The symptoms never went away. In September, I went to a “quality” clinic on the advice of friends, to a gynecologist. PCR diagnostics were made for Micoplasma Genitalius, Chlamydia trachomatis, Ureaplasma urealyticum, Ureaplasma parvum, Gardnerella vaginalis, Neisseria gonorrhoeae, Trichomonas vaginalis, Candida albicans, HPV n.r. (6,11), HPVv.r. (16), HPVv .r.(18). Only Candida was detected (I could tell that myself). Smear: leukocytes – uretra 1-3, Vagina 5-10, Canalis Cervicalls – 5-10. Epithelium – Uretra, Vagina, Canalis Cervicalls – flat in large quantities. Flora – Uretra, Vagina, Canalis Cervicalls – moderately rod-like. Fungal elements – Vagina – found, Uretra, Canalis Cervicalls – absent.
Cytological examination (scraping from the cervix): Among single neutrophilic leukocytes, squamous epithelial cells and fungal elements were found. The cytogram was without features.
Tank. Analysis of vaginal discharge: Staphylococcus epidermidis, Candida albicans with determination of sensitivity to antibiotics. Tank urine test for Escherichia coli with sensitivity testing.
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 cystitis did not go away. Biseptol, a diuretic 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 when urinating, pain during sexual intercourse. I was prescribed Furamag 1 tab per day for 4 months and chamomile baths for 10 days, Clotrimazole ointment for 10 days.
I’m already disappointed, I don’t know where to turn for help, the treatment is not bringing results. Thank you in advance

Answers Chernikov Alexey Vitalievich:

Hello Maria. You should have turned not to a gynecologist, but to a urologist a long time ago. You have not yet had a cystoscopy or a full examination. It's a pity that you were not redirected to to the right specialist. Treatment by a gynecologist, therapist or doctor general practice justified only in uncomplicated and unadvanced cases. You need to contact a urologist or nephrologist and be examined. Because really, it may not be cystitis. Be healthy.

2009-06-29 23:52:09

Kate asks:

Hello! I am bothered by 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, mainly before menstruation. cutting during and stabbing pains or burning after urination. Sometimes it hurts left side backs. A large amount of water will help reduce the symptoms. No abnormalities or diseases were found in gynecology. Tests for all kinds of sexually transmitted infections are negative. The only thing that worries me with particular regularity is thrush. But some gynecologists claim that this is vaginal dysbiosis, since thrush was sometimes not confirmed by tests. I treated both, but it still happens every month ((. According to urine tests, there is an increased content of leukocytes, but in Lately the same symptoms are observed with normal analysis! They did a cystoscopy and there were no noticeable changes. Ultrasound of the bladder shows signs of cervical cystitis. Kidney ultrasound: RD-15? RS-19 mm. Its echogenicity is increased.
Tell me what to do?? What else could this look like? I can’t suffer anymore... Thank you in advance!

Answers Velichko Marina Borisovna:

Good afternoon. Do a urine culture tank. Most likely, you are constantly not receiving additional treatment. In such cases, long-term prophylaxis is recommended 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.

2008-01-23 10:31:19

Victoria asks:

Hello. I was diagnosed with Chronic Cystitis. I underwent a course of treatment with collargol, in my opinion, bladder indistillation. But after a month of feeling well, the attack recurred after hypothermia. The whole story: I have been suffering for 2 years. Pain when urinating, cutting. When passing urine, there is a significant amount of bacteria. Ultrasound - The bladder is enlarged to 6mm. According to gynecology, everything is normal. But 2 months ago they discovered uroplasma, and an ultrasound showed colitis. Tell me if cystitis can be treated in my situation. Thank you in advance.

Answers Manzhura Alexander Ivanovich:

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 do not overcool.

2015-02-01 16:32:05

Irina asks:

Hello
A week ago, some discomfort began in the vagina - burning and itching, frequent urination. I myself bought fluomizin suppositories and started using them, but after 3 days I began to have severe pain in the groin in the area of ​​the left ovary for about four days. On the 5th day in the morning, my ovary was already aching a little, but I still went to the gynecologist, during the examination, when she pressed hard on the ovaries, I felt pain. After taking a smear, 40-50 leukocytes and nitimicelium were detected. How the doctor explained that this is a beginning thrush or, on the contrary, a finishing one, since I put fluomizin suppositories before the smear and she cannot say what exactly could have caused inflammation of the ovaries, since putting fluomizin suppositories could kill the first true infection.
Urethral smear is all clear
General urine test - 1-3 leukocytes and mucus, no protein, no bacteria, she said that the problem is not in the bladder
She poisoned me with an ultrasound. By ultrasound
Day 24 of the cycle (my usual cycle is 31-34 days)
uterus anteflexsio, smooth, 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 menstrual cycle
Homogeneous
Right ovary 31/26
The 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 still not legibly written, like 23
I prescribed Azitrox 500 to drink for 3 days, once a day.
And revitax suppositories for 10 days
Fluzak 200 1st, 3, 5, 7 days once
And since I have relapses of cystitis, urolesan in drops and furamag

I started taking antibiotics that same day and by the next morning the ovary was almost gone, but for some reason, after a couple of hours when I woke up, it started to hurt much more than it had before. I can’t understand why during treatment, on the contrary, the pain worsened and antibiotics did not help.
Tell me, is this treatment effective? It seems to me that Revitaxa does not treat 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 given birth yet and my husband and I are very worried
Please help

Answers Bosyak Yulia Vasilievna:

Hello Irina! Your left ovary is enlarged, due to which it is difficult to say. As I understand it, 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 disease. Do you have a regular monthly cycle? Have you donated blood for sex hormones? To make a diagnosis, it is necessary to donate blood for AMH. If you have polycystic disease, you do not need to take an antibiotic.

2014-09-23 16:00:33

Katerina asks:

Hello! Since 2003 I have been seeing a psychiatrist. Neurotic depression with insomnia (I have difficulty falling asleep, the quantity and quality of sleep is poor). For a long time I took azaleptol and amitriptyline. In January of this year on day hospital They suggested sonapax and quetiron. But in the summer, side effects from the drugs began to appear, and urinary retention began. At first I couldn’t cure cystitis for a long time, only after the 4th course of antibiotics did I cure it. Then there was a strong urge to urinate. I contacted the Institute of Urology: they did an ultrasound to determine residual urine - much higher than normal, they did uroflowmetry - it showed a delay in urination in the bladder. The urologist explained to me that this is happening to me from taking psychotropic drugs.
Please advise what to do and where to go for qualified help where they could help me choose suitable drugs that will not cause urinary retention and promote sleep?
The urologists did everything they could. I'm still taking tamsulide to make urine flow easier (sometimes no-shpu during spasms).
One psychiatrist said that it is rare for anyone to experience such side effects from psychosis. drugs, in particular azaleptol, etc. Although drugs with anticholinergic side effects lead to neurovegetative disorders such as urinary retention, disrupting the normal contractions of the sphincters. (This is especially true for tricyclic antidepressants). So far they have prescribed Miaser and, in addition to it, Sonovan and Gidazepam.
But how much this will help me and for how long, I don’t know! Please advise what to do so that I can sleep and avoid side effects from the medications?

This is one of the most common pathologies of the genitourinary area. It refers to inflammatory diseases Bladder. It is characterized by damage to the mucous membrane by pathogenic bacteria. The disease affects people of any gender. But women especially often suffer from this disease due to their special anatomical structure, which facilitates easy penetration of pathogenic microflora (saprophytic bacillus, intestinal staphylococcus and other microorganisms) into the urinary cavity. The disease can have an acute or chronic course.

For a comprehensive diagnosis of urinary tract, not only routine methods such as general analysis urine and blood, but also methods functional diagnostics. The main one is ultrasound of the bladder. Ultrasound examination (ultrasound, sonography) - examination internal organs, performed using ultra sound waves, for cystitis, allows you to obtain information about the condition of the organ itself and the tissues surrounding it.

Diagnosing cystitis is not particularly difficult. A patient comes to the doctor with typical complaints.

The presence of a characteristic medical history helps the doctor to suspect cystitis in a patient. To confirm the diagnosis, use additional methods research.

These include

• general urine analysis;
• general blood analysis;
• urine culture to detect growth pathogenic flora;
• vaginal smear for the presence of pathogenic flora in women;
• cystoscopy;
• testing for sexually transmitted diseases;
• Ultrasound of the urinary system (kidneys, ureters, bladder);
• mucosal biopsy.

All these studies will help the doctor differentiate cystitis from other diseases of the genitourinary system with similar symptoms.

Indications for ultrasound

In the process of complex diagnostics, it is important to prescribe an ultrasound scan to a patient with suspected cystitis. Carrying out this diagnostic procedure will allow the specialist to determine the size of the affected organ, its shape and wall thickness.

Indications for an ultrasound of the urinary system are the presence of the following signs:

• feeling of pain, tingling in the lower abdomen;
• frequent or infrequent episodes of urination;
• changes in urine color;
• the presence of inclusions of various types in the urine (pus, blood clots, white flakes and other types of sediment);
• decrease in the total daily amount of urine;
• pain and;
• pulling and other unpleasant sensations in the pubic area;
• pain in the lower abdomen radiating to the lower back or perineum;
• increased body temperature (up to 38 degrees and above);
• feeling of not completely emptying the urine.

The organs of the urinary system are closely interconnected, and the infection can quickly spread upward. It may be unclear to what extent the inflammation is localized specifically in the urinary tract or whether it has already gone further. Often after cystitis, pyelonephritis quickly occurs.

How and where the procedure takes place

Ultrasound of the urinary tract is performed in many private and public multidisciplinary medical centers, clinics and hospitals. Usually in all major medical institutions There is a functional diagnostics department with an equipped ultrasound diagnostics room where ultrasounds are performed. The study is performed by a functional diagnostics doctor. He specializes in performing this type of diagnostic procedures.

Objectives of ultrasound examination of the bladder for cystitis:

• find an inflammatory focus in the wall of the organ;
• determine the amount of residual urine;
• assess the wall thickness, contours and dimensions of the organ;
• identify the causes that contribute to the development of inflammation (foreign bodies, calculi (stones), neoplasms, pathologies of organ development).

Preparation

Before this diagnostic procedure some preparation is required. Without it, it is impossible to achieve clear and reliable results.

Preparation for this type of diagnosis includes following the following recommendations:

• three days before the study is necessary. Avoid foods that cause increased gas formation in the intestines (legumes, cabbage, confectionery, fried and fatty foods);
• the last meal should be eight hours before the test;
• It is recommended to drink one hour after the last meal Activated carbon in tablets (one tablet per 10 kg of patient weight) to reduce gas formation in the intestines;
• during transrectal ultrasound, an enema is performed an hour before the examination;
• with vaginal and transurethral access, careful treatment of the genital organs is carried out;
• an hour before the test you need to drink at least one and a half liters of still water;
• you can take a diuretic before the examination, if recommended by your doctor, in cases where it is necessary to carry out an urgent diagnosis;
• try not to urinate before the examination.

Progress of the procedure

It may vary depending on access.

There are several ways to examine the condition of the bladder:

• transabdominal (classical) method - the examination is carried out with a sensor through the anterior wall of the abdomen, it is carried out only with a full bladder;
• transvaginal examination is carried out for women - the results are more reliable, a vaginal sensor is used, the bladder must be empty;
• transrectal access - a sensor is inserted into the rectum, most often done for men in order, in addition to the bladder, to assess the condition of the prostate gland (it is also used if the patient is overweight);
• transurethral access is carried out through the urethra, is performed under local anesthesia, and allows examination of the urethra.

Most often, ultrasound is performed transabdominally. This is a completely painless procedure.

The procedure goes as follows;

• the patient lies on the couch on his back;
• it is necessary to unbutton your clothes and provide the doctor with access to the lower abdomen;
• doctor applies to skin special gel, ensuring movement and tight fit of the sensor to the skin;
• the doctor scans the organ using a sensor;
• an image (2D or 3D) of the bladder tissue is sent to the screen;
• the doctor evaluates the resulting image.

The duration of the study is approximately twenty minutes. If the doctor needs to examine the walls of the organ in detail, he will ask the patient to visit the toilet and empty the urine. After this, the study will continue, and the doctor will determine the amount of residual urine.

Decoding the results

Only a specialist should decipher the results of a study of the pelvic organs. He compares the results obtained with established standards and clinical manifestations the patient and then makes a final diagnosis.

Parameters that the doctor evaluates based on the research data:

• bladder size;
• the presence of various formations;
• content composition;
• possibility of filling and emptying;
• volume of residual urine;
• organ shape;
• its structure (walls and cavity).

When assessing the parameters, there is a search for signs of inflammation and the factors that provoke it. The assessment of these parameters influences the diagnosis.

Echogenicity

In a normal state, the bubble is echo-negative, its echogenic structure is smooth. Echogenicity increases with the development of inflammation and as the human body ages.

With inflammation in the bladder, multiple particles appear with increased echogenicity. These are specific foci consisting of a complex of many cells (leukocytes, epithelial cells, erythrocytes) with salt crystals (oxalates and phosphates). When examined, they are visible as light spots on a dark background. They are characterized by movement when the patient's body position changes. With advanced inflammation, hyper- and hypoechoic areas may appear on the wall of the bladder.

Dimensions

Normally, the volume of the bladder is from 350 to 750 milliliters in men, and from 250 to 550 milliliters in women. The volume of residual urine in representatives of both sexes is normally no more than 50 milliliters. An increase in the size of the bladder is almost always accompanied by an increase in the volume of residual urine.

The flow of urine may be difficult for the following reasons:

• formation of valves in urinary tract(more often in children);
• stones in the bladder cavity that disrupt the outflow;
• disturbance of innervation;
• formation of a diverticulum (pathological protrusion of the organ wall);
• prostate hyperplasia (in men).

An increase in organ size and amount of residual urine usually results in urolithiasis disease, or the formation of a tumor that interferes with the flow of urine.

A decrease in organ size is also pathological. It may be a consequence of tissue wrinkling during nonspecific inflammatory processes and some congenital anomalies.

The size of the organ decreases due to the following diseases:

• schistostomal invasion in the terminal (final) stage;
• consequences of surgery;
• consequences of chemotherapy;
• urinary tuberculosis.

Most often, a decrease in the size of the organ can be observed at the final stage of the inflammatory process.

Walls and cavity

Normally, a filled bladder in transverse sections has a round shape, in a longitudinal section it has an elongated ovoid shape, and a saucer shape after urination. The wall of a healthy bladder is even and smooth. The normal thickness of the walls of the bladder does not exceed five millimeters. There should be no defects or any shoots.

If the thickness is greater, then this is interpreted as a thickening of the wall, which is typical for. Thickening can be local or diffuse. Significant thickening of the walls is typical for the acute form of the pathology. The contour of the walls is usually curved, and the shape of the bubble is uneven. The organ cavity can take on an asymmetrical shape.

Thinning of the walls of the organ (less than 2 mm) is also considered a serious pathology with cystitis. This can be due to a long-term chronic inflammatory process. Thinning threatens the occurrence of wall perforation, which is a serious complication.

Education

Ultrasound of the bladder with cystitis reveals pathological formations. They can be mobile or immobile. The degree of their echogenicity and density are important. The denser the formation, the lighter it looks on ultrasound. The lightest of the pathological formations are stones, the darkest are cysts.

Volumetric pathological formations include:

• stones;
• tumors (malignant and benign);
• polyps;
• blood parietal clots;
• foreign bodies;
• cysts;
• large flakes.

As long as the pathology has not reached advanced stages, sudden changes will not be visible on ultrasound. Therefore, all the results obtained during this examination require further differential diagnosis.

Video

From this video you can learn what an ultrasound of the bladder is, how this examination is carried out, and what are the ECHO signs of cystitis.

Watch this video to learn how to prepare for an ultrasound.

Ultrasound of the bladder for cystitis is a non-invasive, safest, atraumatic and harmless method that allows you to make an objective assessment of the condition of the bladder organ. As an informative diagnostic search when examining many urological pathologies, ultrasound today is becoming the preferred or even the main method diagnostic examination.

According to international statistics, more than 10% of those examined with ultrasound healthy people, pathologies were identified that had not previously been diagnosed at all.

Oddly enough, the forefathers of modern ultrasound machines are the English military-industrial sonar and radar systems (RADAR and SONAR), which work on the principle of reflecting a pulse of sound waves from certain objects. And the pioneers of scanning human body became American researchers (Hour and Holmes). They placed a “volunteer” in a tank filled with water and passed ultrasound around him.

But the era of real ultrasound diagnostics began in 1949, when the American D. Hauri first created a functioning ultrasound machine.

An important contribution to the modification of this new diagnostic method, allowing to expand its capabilities, was made by the Austrian mathematician and physicist K. Doppler. His developments in comparing and recording impulses and speed of the object of study made it possible to study blood circulation in large vascular beds.

Since 1960, ultrasound examination has been firmly established in medicine. Soon (1964), a group of Japanese researchers proposed using sensors of various modifications when examining the bladder and prostate - rectal, which allows one to obtain an image of the organ in a cross-sectional view, and intracavitary (urethral), which allows one to diagnose various pathological changes in the tissue structure of the cavity of the urinary reservoir.

Today, there are several modes of ultrasound machines - one-dimensional and echography (“M” and “A” modes).

With their help, all anatomical components of the human body are examined, visualized and measured. Mode “B” is called scanning or sonography. It allows you to obtain more effective information - a two-dimensional picture on a monitor with the ability to observe the process in motion (Doppler effect).

Methods of instrumental diagnosis of MP in cystitis

One of effective methods examination of the reservoir cavity of the bladder during the development of inflammatory processes in it - the CUDI method (urodynamic diagnostics). The urodynamics method itself is a means of assessing the difference in pressure in the urethra and bladder in order to identify the functional viability of the lower parts of the urethra.

Diagnosis of CUD includes several methods:

• uroflowmetry, which allows you to determine the volume of urine and measure its speed;
• , which is used to determine the presence of detruser hyperactivity (involuntary muscle contractions of the bladder walls), pressure during the period of hyperactivity and during urination, and the volume of the bladder cavity;
• flow-pressure ratio test - shows the relationship between the pressure required for urination in relation to the rate of urine flow;
• electromyography, used for suspected damage to nerve or muscle tissue and their effect on urination processes;
• multichannel urodynamics – synchronous recording of pressure in the cavity and outside the bladder, urine flow and pressure in the urethra, ensuring its retention (profilometry);
• videourodynamics, which allows for video observation and recording of functional parameters of the urinary tract.

Types of ultrasound examination

Diagnosing cystitis these days is not difficult, since urologists have in their “arsenal” different kinds diagnostic search. First of all, this is ultrasound diagnostics. Ultrasound of the bladder in women and men is performed various methods, which are determined by the doctor by analyzing the clinical picture of the disease and the individual characteristics of a particular patient.

The transabdominal ultrasound method is the most common type of instrumental diagnosis.

The organ is examined by moving an abdominal sensor along the anterior wall of the peritoneum. This method makes it possible to clarify the size, structure and shape of the organ, but is not effective if the patient is clearly obese or is unable to hold urine. Because required condition during the procedure - a filled bladder.

Transabdominal ultrasound method.

"TVUS" method (transvaginal). An ultrasound probe is placed in the vagina (vagina). It is considered the most informative diagnostic method, allowing to accurately and correctly detect various pathological processes. It is carried out with an empty urinary reservoir.

Transvaginal method - TVUS.

"TUUS" (transurethral method). Diagnosis is carried out by inserting a sensor into the urethral cavity, thus providing excellent visualization. It is carried out using anesthesia. This method allows you to assess the condition of the urethral wall, the severity of its damage and possible pathological processes in nearby organs. It is used in exceptional cases, since there is a high probability of damage to the walls of the urethra by the sensor and the development of complications.

TRUS technique (transrectal method). The sensor is inserted rectally (into the rectum). It is mainly used when it is necessary to perform an ultrasound of the bladder in men. This method reveals the pathological connection between the bladder and prostate organs. It is sometimes used when examining girls for whom the transabdominal method is contraindicated, but the presence of a hymen is an obstacle to another method.

Transrectal method - TRUS.

Doppler diagnostics. Allows you to identify changes in structural tissues bladder walls and study the residual volume of urine in the bladder reservoir. Diagnostics consists of two stages - scanning the organ when it is completely full and when it is empty.

Examination of pregnant women and children

In case of inflammatory processes in the bladder, any methods of instrumental diagnostics that can harm the development of the fetus or injure female organs, do not apply. This applies to cystoscopy, CT, x-ray examination, or the use of contrast agents during angiography. The safest option for examining pregnant women is ultrasound scanning, which cannot harm either the fetus or the expectant mother.

Ultrasound diagnostics does not carry any radiation exposure and is completely safe. Therefore I received wide application and for examination of various ages children. The study is carried out only in a transabdominal way (through the peritoneal wall). Prescribed for signs of painful urination and the presence of pathogenic flora in urine sterility tests.

But if a child has problems with filling the bladder (the study is possible only if the bladder is full), the doctor can prescribe appropriate treatment based on the severity of the clinical picture. An important indicator of the disease is sediment in the bladder and the possible volume of its filling with urine. To prevent false analysis conclusions, it is necessary to comply with certain conditions for preparing for the examination.

Preparation stages

Each method of diagnostic examination has its own algorithm of preparatory measures.

How to properly prepare for a transabdominal examination

Preparation for ultrasound of the bladder in women, men and children is similar.

If patients suffer from constipation or flatulence (accumulation of intestinal gases), they must follow a diet for 2 days before the examination. The diet should not include:

• dishes made from legumes that cause bloating;
• baked goods and dairy products;
• coffee and drinks based on it;
• sparkling water and alcohol.

Shortly before diagnosis, you should cleanse the intestines - give a cleansing enema.

To properly prepare the bladder organ for examination, you must:

• 3 hours before the procedure, consume from 0.5 to 1.5 liters. Water;
• refrain from urinating;
• if the process of filling the bladder is delayed, take diuretics to speed up urine formation.

The amount of fluid required to fill the bladder in children should correspond to the age of the child. Children can be offered various herbal teas, fruit drinks, non-carbonated mineral water or compotes. Parents should receive all necessary recommendations for preparing their child for examination from a doctor.

Preparation for examination using the transrectal method

Preparation for this procedure consists, first of all, of observing hygienic measures. It is necessary to carefully prepare the rectum. It needs to be cleaned. The procedure is due to the use of cleansing microenemas, the introduction of glycerin rectal suppositories. You can use laxatives (if urgently needed).

Transvaginal diagnosis: preparation

When performing a transvaginal examination, filling the bladder organ with urine is not required. The effectiveness and reliability of the result is affected by insufficient cleanliness of the intestines, flatulence, or the presence of leukoplakia (hardening of mucous tissues) in a woman.

On the eve of diagnosis, you should take all measures to cleanse the intestines, prevent gas formation and warn the doctor about the existing pathology.

The presence of menstruation at the time of ultrasound does not affect the diagnostic results, but the very fact of their presence is unpleasant even for the woman herself, not to mention the doctor. Therefore, if the manipulation is not vital at the moment, it is better to postpone it to another time.

How to properly prepare for TUUS

This diagnosis is carried out in men, so preparing the bladder for ultrasound concerns them specifically. Since the examination involves the use local anesthesia, it is necessary to ensure its good tolerability. For this:

• Limit yourself to a light diet on the day of the examination;
• the day before the procedure, avoid alcohol;
• refrain from smoking 2 hours before the procedure.

Failure to comply with these measures may result in unwanted reactions with an anesthetic and cause nausea or vomiting during examination.

What can an ultrasound show for cystitis?

By comparing the results of sonography with established standards, taking into account the patient’s symptoms and complaints, the doctor can determine accurate diagnosis– or inflammatory process (cystitis).

1. In an acute process, sonography shows signs of increased echogenicity, which indicates the presence inflammatory reactions. Sediment in the urine of the bladder cavity appears in the form of various cells and salt crystals. At the initial stage of cystitis development, the structure of the walls of the organ remains smooth. The progression of the process causes the development of their asymmetrical shape.

1. A chronic process on ultrasound is indicated by thickening of the walls of the bladder and the presence of sedimentary flakes. With prolonged chronic course process, the presence of blood clots attached to the internal walls of the organ is diagnosed. At the stage of the process of liquefying hemorrhagic clots, their coagulation creates the appearance of uneven borders of the bladder.
the opportunity to use the service of conducting an examination at home.

Prices for ultrasound examinations in private clinics vary from 800 rubles.



Cost of ultrasound in one of the Moscow clinics.

Despite constant updating diagnostic techniques, ultrasound continues to be the most informative method for assessing the condition of the bladder. Each patient has his own examination method, which the attending physician can easily recommend. Compliance with all the basic rules for preparing for an ultrasound and the doctor’s recommendations is a guarantee of a reliable diagnosis for adult patients and children.

Primary diagnosis of cystitis is carried out using urine and blood tests. After the doctor receives the results, he can refer the patient for an ultrasound examination of the urinary system. Ultrasound of the bladder for cystitis is a necessary measure.

If the doctor has difficulty making a diagnosis, this diagnostic method helps to obtain an accurate picture of the development of the disease, since ultrasound visually shows the structure of the bladder, in which characteristic signs of inflammation are visible when cystitis occurs.

Cystitis is an inflammation of the bladder walls that most often occurs as a result of bacterial infection entering the urinary organ. Today this disease is quite common, especially among women. The fact is that representatives of the fairer sex have a concomitant anatomical structure of the urinary organs - a wide and short urethra, through which pathogenic microflora can quickly enter the body, thereby causing inflammation.

Is it possible to detect a problem at an early stage? Cystitis often appears in a person as a result of the development of an ascending infection in the body, which complicates diagnosis and treatment of the disease.

When is it prescribed?

The main indications for ultrasound if cystitis is suspected are:

• rare or, conversely, too frequent urination;
• the presence of pus or blood clots in the urine;
• the appearance of large white flakes in urine;
• false urge to go to the toilet, when only a couple of drops of urine containing impurities of pus or blood are released from the bladder (often this phenomenon is observed with cystitis, which was caused by a specific flora);
• change in urine color;
• decrease in the total amount of urine produced per day;
• pain or discomfort when going to the toilet “in a small way”;
• discomfort in the pubic area;
• an increase in low-grade fever to 38 degrees or more.

It is important to note that these symptoms can characterize not only cystitis, but also other pathologies of the bladder or the entire excretory system (organs). Therefore, the patient is prescribed an ultrasound, with the help of which the diagnosis will be established accurately. The question “is it necessary to do an ultrasound” in such a situation does not arise.

Reference! In advanced forms of cystitis, the procedure is performed not only to examine the condition of the urinary organ, but also to identify the dynamics of the disease. This allows doctors to monitor the patient’s condition, as well as avoid the transition of chronic cystitis to acute.

What does it show?

Is the disease visible on the study? When performing an ultrasound, doctors can detect diverticula - these are peculiar sac-like neoplasms located on the walls of the bladder or growing into its cavity. Also in the organ it is possible to detect sand or oxalate (salt) stones, which significantly disrupt the integrity of the mucous membrane, and are also considered the main factor in the development of cystitis.

Video 1. Cystitis on ultrasound.

During certain forms of the disease, such a study will be endowed with specific manifestations.

Ulcerative and herpetic forms

For these forms of cystitis, a characteristic symptom of the development of the disease will be the appearance of erosions and small ulcers in the inner part of the bladder. At first they will develop on the mucous membrane, and then begin to spread into the deeper layers of the organ. This form is accompanied by severe pain, therefore, the patient should be treated immediately after identifying signs of cystitis.

Candidiasis form

With the development of candidal cystitis, ultrasound will show formations that have appeared in the urinary cavity. They can have different shapes and sizes. The rate of growth of neoplasms depends on the state of the patient’s immunity and the duration of cystitis.

Acute form

Significant thickening of the walls of the bladder becomes noticeable only with the onset of an acute form of pathology. At the beginning of its development, an ultrasound will show an even contour of the organ, which will be completely free of deformation. However as inflammation progresses, the walls of the bladder will gradually thicken, the contour will become more crooked and the shape uneven - with the help of ultrasound, such negative changes in the organ can be noticed without problems.

Chronic form

With the development of this form, thickening of the walls of the organ also occurs. Ultrasound shows the presence of flakes in the bladder, which indicates advanced disease.

If the inflammation is too advanced, hypo and hyperechoic areas can be found in the inflamed organ. by them there may be blood clots. They also cause disruption of the contour of the urinary organ while in a liquefying phase, causing it to appear asymmetrical.

Healthy Bladder

In a normal and healthy state, the organ is smooth, symmetrical, without protruding walls or an uneven contour. The mucous membrane should be free of deformations, ulcers, spots and thickenings. A healthy organ has a wall thickness of 5 mm.

Preparation

Preparation for the study depends on.

Known 4 options Ultrasound of the bladder. This:

• transvaginal;
• transurethral;
• transabdominal;
• transrectal.

Ultrasound is accompanied, if necessary, by other types of studies.

Also, to make a diagnosis of cystitis, a method is often used that helps to identify all the obstacles that urine overcomes when entering or leaving the bladder.

The effectiveness of this method lies in the patient.

Interpretation of results and norm

Diagnosis of cystitis, performed in the acute phase, reveals the following picture: inside the bladder, tiny particles endowed with high echogenicity are clearly visible. They are usually united into foci. Usually, these particles are an accumulation of a large number of cells– leukocyte, epithelial or erythrocyte. Crystals of salts (oxalates) can also be found in them.

Reference! If a person lies down during an ultrasound, the lesion with sediment will be located on back wall urea; if the patient stands, particles will be found on the front wall of the organ.

The outflow of urine when it reaches its maximum peak should be less than 15 cm/s– otherwise, we can talk about the development of cystitis or other diseases of the urinary organs.

Complications

Cystitis most often develops as a result of an active infection in the body. Therefore, the causative agent of the disease can easily penetrate the kidneys through the ureters, which will worsen the patient’s condition, causing pyelonephritis and other diseases of the paired organ.

Pros and cons of organ ultrasound

This study is absolutely safe for the patient’s health and is also painless. The safety of this diagnostic method is used in the case of studies of pregnant women, children and the elderly.

Conclusion

Ultrasound performed on the bladder is considered one of the most informative examination methods, which is prescribed for the development of acute cystitis. Using this diagnostic method, it is possible to see changes in the urinary organ, the negative effect of pathology on the bladder, and also understand exactly how many layers are involved in the inflammation process.

The advantage of ultrasound is that today there are several options for carrying out the procedure., so it can be selected individually for each patient.