X-ray of the bladder with contrast injection. Sequence of examination in children

Cystography or radiography Bladder is a diagnosis using an endoscope aimed at identifying organ diseases. It is performed on patients of any age if necessary.

In order to evaluate the bubble in all respects, it is necessary to pour a special solution into it - contrast. With its help you can see the structure and integrity of the organ. The information obtained helps to begin timely treatment. X-ray of the bladder with contrast agent prescribed only by a urologist, and sometimes by a surgeon.

The procedure is carried out using two methods - ascending and descending. In the first case, the contrast enters through the urethra in an amount of 150-200 ml. The second option involves intravenous administration. For the solution to reach the urea, you should wait about 45 minutes.

Today there are several options for contrast agents. These include triombrast, urografin, iodamide.

Bladder pathologies can be detected fairly quickly by x-rays. It's about about reflux, constrictions, cystitis, fistulas, neoplasms, diverticula, calculi.

X-rays with contrast allow you to find out the cause of urinary incontinence, as well as evaluate the excretory function of the kidneys. Half an hour after the administration of the contrast agent, if there are no failures in the functioning of the kidneys, then only its remnants will remain in the cups and pelvis. Otherwise, the substance will be found in large quantities. It means that excretory system works at a slow pace.

X-ray of the bladder. Source: Bladder X-ray

Bladder x-ray is indicated in the following cases:

violation of the integrity of the organ in case of injury;
suspicion of reflux;
congenital pathologies;
complications after infections;
urinary incontinence during the day and night;
presence of stones;
if tumor processes are suspected;
during illnesses related to genitourinary system.

Contraindications

Despite the fact that radiography of the bladder is considered a reliable way to confirm the diagnosis, it also has some contraindications. Cystography is prohibited in the following cases:

pregnancy;
inflammatory processes;
excretion of urine with blood.

As you know, x-rays of any organs are contraindicated. if a woman is carrying a child due to radiation that negatively affects the fetus. If the patient suspects inflammation of the bladder or ureters, then the insertion of a catheter may intensify the disease.

When appearing in urine blood clots the image will be distorted, so the results cannot be considered reliable.

Alternative Methods

Due to the fact that X-ray of the bladder has the above contraindications, the doctor chooses alternative studies. These include pneumocystography or MRI. In the first case, gas is introduced as a contrast. Sometimes used combined method, in which a traditional contrast agent and gas are injected (15-20 ml and 180-200 cm3, respectively).

Victory cystography is also used, in which diagnosis is made during urine output. This procedure is necessary to assess the condition of the urinary canals.

Compared to ultrasound and MRI, cystography is quite painful method, so it is never assigned as preventive examination, but only in really serious cases.

Methodology for examining children

An infant's bladder can be x-rayed no earlier than five months of age. Many parents are not ready to expose their child to radiation, and are also wary of injecting contrast into the bladder. If there is no other way out, then you should carefully prepare for the procedure.

The child should receive about a week diet food which does not cause bloating. On the day of the procedure, an enema is indicated to cleanse the intestines. A drug test should be carried out.

If there are compelling reasons to examine the bladder, an x-ray is performed on the child as follows:

a contrast agent is injected into the bladder through the urethra;
contrast is administered both before and after urine output;
so that young children can endure the procedure, they are given anesthesia;
the child should not eat or drink 6 hours before the procedure;

The duration of the examination is no more than 15 minutes.

X-ray of a child's bladder. Source: dcenergo.ru

After the x-ray, the little patient remains under the supervision of medical staff for 2 hours. It is important to empty your bladder during this time so that all the contrast material comes out. It will take about a day for complete removal. At this time, an increased drinking regime is indicated.

Methodology for examining adults

Patients must prepare for the study. All foods that cause signs of flatulence are excluded from the diet. Prohibited the following drinks: strong brewed tea and coffee, sparkling water.

The patient needs to lie down. Then he is injected with 200 ml of a solution obtained by diluting the contrast agent.

When all the fluid has been introduced, the catheter is clamped. Otherwise, the solution will flow back. The specialist will manage the process, so all his commands must be followed. As a result, the images will reflect the health status of the organ as accurately as possible.

X-ray of the bladder is performed in several positions. The patient will have to turn from back to side. Pictures are also taken after the bladder is empty. By comparing the images that were taken when the bladder was full and when it was empty, a reliable diagnosis can be made.

Diagnostics using the descending type are carried out 30 minutes after the administration of contrast. Or even in an hour. This pause is necessary to provide more detailed visualization of the contours of the bubble. And after that the pictures will show whether there is pathological changes.

Doctors always warn patients that some aspects of the procedure may cause discomfort and pain. If such inconveniences are unpleasant due to increased pain threshold, give pain relief.

Cystography requires preliminary consultation with a urologist, nephrologist and radiologist. It is important to discuss all the nuances of the study with these specialists in order to carry out the procedure with maximum benefit and as comfortable as possible.

Examination of the bladder - x-ray with contrast injection - requires bed rest after the procedure. The patient needs to drink a lot clean water to cleanse the body of the solution.

results

A healthy organ has an oblong shape. It has oval or rounded contours. For female patients, an oval-shaped bubble is typical. The outer contour will be slightly concave. Pear-shaped urethra most often occurs in children. In men it looks like a triangular figure.

If, when receiving images, the organ is asymmetrical or has an unusual structure, then this will certainly be reflected in the conclusion. If the bladder is displaced, a diagnosis of cystocele is made.

The pictures are decrypted quite quickly - within half an hour. After this, the patient must, along with the conclusion, go to his attending physician, who will prescribe timely treatment taking into account the data obtained.

Preparing the patient for x-ray examination kidneys and upper urinary tract: the night before and on the day of the examination - a cleansing enema, in the morning on the day of the examination - a light breakfast. Before an x-ray of the bladder, one morning enema is sufficient. In young people with good independent bowel movement, special preparation is not required.

Survey radiography. X-ray examination of the patient begins with a survey X-ray of the entire urinary system. An image is taken of the area of the kidneys, ureters and bladder. In addition to the bone skeleton, in most cases one can see the shape and position of the kidneys, the edge psoas muscle(Fig. 37, a). Radiography makes it possible to identify stones in the kidneys, ureters, bladder, prostate, and urethra. Oxalates, phosphates and especially carbonates block X-rays to a much greater extent than surrounding tissues, and therefore are clearly contoured (Fig. 37, b), urates, xanthine, cystine stones give a faint shadow or are not visible at all in survey photographs.

Rice. 37. Survey X-ray areas of the kidneys and ureters (a), shadow of a kidney stone on a radiograph (b).

Stone-like opacities can be caused by calcified areas of veins - phleboliths (mainly in the pelvis), costal cartilages and lymph nodes. Salt-encrusted foci of cheesy decay in kidney tuberculosis or calcified areas of neoplasms can be mistakenly mistaken for stones. To distinguish such “false” shadows from the image of a ureteral stone, a survey photograph is taken in direct and oblique projection with a catheter inserted into the ureter. The shadow of the stone coincides with the shadow of the catheter in both projections; the shadow of the phlebolith, lymph node, etc. is located away from it.

Contrast radiography. An image of the renal pelvis and calyces (pyelography) is obtained by filling them with contrast media that retain X-rays to a greater extent than the surrounding tissues (solutions of iodine compounds) or to a lesser extent (oxygen, carbon dioxide).

Retrograde pyelography. After insertion of the ureteral catheter into renal pelvis Using a 10-20 gram syringe with a needle of the appropriate caliber, a sterile 20% solution of contrast liquid (Sergosine, Urocon, etc.) warmed to body temperature in an amount of 8-10 ml is slowly injected through the catheter into the pelvis until a feeling of heaviness appears in the kidney area and an X-ray is taken snapshot.

To avoid an excessive increase in intrapelvic pressure and the occurrence of pelvic-renal reflux, you should not use ureteral catheters thicker than No. 5 on the Charrière scale, so that the contrast fluid can flow back from the pelvis past the catheter into the bladder.

To prevent an attack of pyelonephritis after retrograde pyelography, it is recommended intramuscular injection 200,000 units of penicillin.

A normal pyelogram appears in the following form: the pelvis is located at the level of XII thoracic-II lumbar vertebra, the cups are located lateral to the pelvis, the XII rib crosses the left pelvis in its middle part, and the right one - on the border of the upper and middle third. The ureter runs parallel to the spine, forming an arch in the pelvic region with its convexity facing the lateral side.

There are two main types of renal pelvis. The first type is the ampulla-shaped pelvis, which is relatively large sizes with three short and wide cups - upper, middle and lower; the pelvis is located outside the renal parenchyma, medial to it; its capacity is approximately 8-10 ml. With the second, branched type of pelvis, its dimensions are small, the calyxes are long and narrow; the pelvis is located inside the renal parenchyma (Fig. 38); its capacity does not exceed 3-4 ml.

Rice. 38. Extrarenal on the right and intrarenal on the left type of the renal pelvis, Retrograde pyelogram.

Excretory urography. Along with retrograde pyelography wide use received excretory (descending, excretory, intravenous) urography. A solution is injected into a vein organic compound iodine - monoatomic (sergosine), diatomic (cardiotrast, diodon), triatomic (triyotrast), the molecule of which is excreted by the kidneys without cleavage free iodine, causing defeat urinary tract and the phenomenon of iodism. The contrast agent fills the renal pelvis and is released through the ureter into the bladder. In serial photographs at certain intervals, images of all these parts of the urinary tract are obtained (Fig. 39). For intravenous urography most often used is sergosine (sodium monoiodomethane sulfonic acid), containing 52% organic iodine (15-20 g of dry preparation for an adult). A heated 40% sergosine solution in an amount of 30-40 ml is injected slowly into the cubital vein. The first picture is taken after 7-10 minutes, repeated - after 15-20 and 30-45 minutes after administration of the contrast agent. The dose of sergosine for children is determined by age: 0.1 g of dry preparation per 1 year of the child’s life.

Rice. 39. Excretory urogram.

Excretory urography has a number of positive aspects: it is painless, does not require cystoscopy and catheterization of the ureters. It gives an idea not only morphological picture urinary tract, but allows one to judge the function of each kidney separately, but in terms of image clarity it is often inferior to retrograde pyelography, especially when reduced function kidneys

Excretory urography is contraindicated in acute diseases liver, blood diseases, Graves' disease, during menstruation, with high azotemia.

Pneumourene and pneumoretroperitoneum. If you surround the kidney with a layer of gas, you can get clear outlines of it in the picture. Gas in an amount of 500-600 cm 3 is injected through a long needle, which is injected into the angle between the XII rib and long muscles back with the patient positioned on the opposite side. The technique of needle insertion is the same as for perinephric blockade. Having passed through the muscle wall, the needle seems to fall through and enter the perinephric tissue. To avoid air embolism wait for 1-2 minutes to see if blood appears from the needle. This method is called "pneumorain". It is not completely safe, as the needle can injure large vessels, kidney, liver, spleen. In view of this, it is preferable to administer the gas presacrally, i.e., between the coccyx and the rectum (“presacral pneumo-retroperitoneum”). Under the control of a finger inserted into the rectum, the needle is injected to a depth of 4-5 cm and 1000-1500 cm 3 of gas is injected through it, which spreads through the retroperitoneal tissue within 30-40 minutes, surrounding the kidneys and ureter. The advantages of pneumoretroperitoneum are its safety, simplicity, and the fact that it makes it possible to simultaneously obtain an image of both kidneys on an x-ray (Fig. 40). It is recommended to introduce oxygen rather than air, which is easily absorbed by hemoglobin, forming oxyhemoglobin. When recognizing tumors and cysts of the kidneys, tumors of the adrenal gland and retroperitoneum, as well as renal anomalies, pneumo-retroperitoneum provides valuable data, especially in combination with pyelography.

Rice. 40. Pneumoretroperitoneum.

Renal angiography. The diagnosis of kidney disease in some cases can be clarified by serial renal angiography. Contrast liquid - 70% solution of triyotrast or cardiotrast in an amount of 30 ml - is introduced into the aorta by translumbar puncture or through a polyethylene catheter retrogradely inserted into the aorta through an exposed branch femoral artery(a. profunda femoris) or by percutaneous puncture of the femoral artery (according to Seldinger). The administration of contrast fluid and photographs should be taken with great speed (at least 3 photographs per second).

The first picture is taken at the end of the administration of the contrast solution, the next 2-3 pictures are taken within the next second. The first image - an arteriogram - produces an image vascular network kidneys (Fig. 41), on the second and third - nephrograms - in addition, shadows of the kidney, diffusely saturated with a contrast agent, are visible, on later ones - image collecting system and ureter - urogram.

Rice. 41. Translumbar angiography of the kidneys. Normal angiogram. Vascular phase.

Renal angiography can be used to diagnose kidney abnormalities, tumors, and cysts. Accumulations of contrast fluid in the form of spots and excessive branching small vessels are considered a sign of a tumor (see Fig. 104); a rounded avascular area indicates the presence of a kidney cyst (see Fig. 60), the absence great vessels kidneys - about their atresia and congenital aplasia kidneys

Lymphography. To identify metastases of malignant neoplasms of the genitourinary system - testicles, prostate, bladder, kidneys - in the inguinal and retroperitoneal lymph nodes, lymphangiography is used. 0.5 ml of paint solution (Evans blue) is injected into the skin of the interdigital fold between the first and second toes of each foot. After a few minutes, staining of the lymphatic vessels of the feet occurs. In the middle third of the back of each foot, under local anesthesia over painted lymphatic vessel cut the skin. Using thin tweezers, the vessel is isolated, a thin thread is placed under it and, by pulling it, lymph stasis and dilation of the vessel are created. 10 ml of iodolipol is slowly injected into the dilated area of the vessel through a thin needle over 3 hours. The uniformity and duration of administration is achieved by applying pressure to the syringe piston using a finely threaded screw. Filling of the inguinal and retroperitoneal lymph nodes with iodolipol occurs within 20-24 hours. The lymph nodes, affected by tumor metastasis, are increased in size, filling defects or uneven accumulations of contrast agent are detected in them (Fig. 42).

Rice. 42. Lymphogram for a bladder tumor.

Tomography. X-ray diagnosis of diseases of the kidneys, urinary tract and adrenal glands is supplemented by layer-by-layer X-ray images - tomography. The kidneys are located in a layer located on average 5-10 cm from the plane of the X-ray table when the patient is positioned on his back. Selective radiography of only this layer eliminates overlapping shadows abdominal wall, intestines and other neighboring organs. Thanks to this, the contours of the kidneys and adrenal glands become clearer. Tomograms sometimes reveal kidney stones or tumors that are not detected on regular photographs. Tomography makes it easy to differentiate kidney stones from gall bladder stones because they are located in different planes.

Cystography. When the bladder is filled with sergosine solution or gas (oxygen), an X-ray image of its cavity can be obtained. This method is called cystography.

Normally, a bubble filled with a contrast agent has rounded shape; the density of the contrast medium is the same. The contours of the bubble are smooth (Fig. 43).

Rice. 43. Normal cystogram.

Urethrography. The patient is placed at an angle of 30° to the plane of the table. On the side deviated from the table, the leg is extended, on the side adjacent to the table, it is bent at the hip and knee joints and somewhat retracted outward. The penis is stretched parallel soft tissues thighs of a bent leg, and a 10% sergosine solution from a syringe with a cone-shaped rubber tip is injected into the lumen of the urethra (Fig. 44). This type of urethrography is called ascending urethrography.

Normally, the anterior part of the urethra on a retrograde urethrogram appears as a uniform strip with a diameter of 0.8-1 cm. The bulbous part of the urethra forms an extension in the form of an arch convex downwards. The membranous and prostatic parts of the urethra look like a narrow strip extending from the bulbous urethra at a right angle.

For a clearer image of the posterior part of the urethra, descending urethrography is used: the bladder is filled with a contrast agent through a thin catheter; after removing the catheter at the moment of “urination”, i.e. releasing the contrast liquid with the patient in the position described above, an image is taken. The lumen of the prostatic urethra is clearly contoured on the descending urethrogram (Fig. 45, a and b).

Rice. 45. Urethrograms. a - ascending urethrogram; b - descending urethrogram

Most often, urethrography is used to recognize narrowings and obliterations of the urethra (gonorrheal and traumatic origin) (see Fig. 131). It also allows you to obtain images of diverticula and urethral fistulas, paraurethral passages.

Rice. 44. Position of the patient during urethrography.

Prostatography. Normal prostate on the x-ray image it is not contoured against the background of surrounding tissues. Only its stones, usually multiple, stand out in the form of small shadows against the background pubic bones or above the edge of the symphysis (see Fig. 99).

Having filled the bladder with oxygen, you can see the shadow of the prostate adenoma protruding into the cavity of the bladder above the symphysis (see Fig. 119).

Vesiculography(Fig. 46). Changes in the configuration of the seminal vesicles - expansion of the passages and cavities, emptying or shrinking of them - are important for recognizing tuberculosis or cancer of the seminal vesicles or prostate. For the study, a puncture of the exposed vas deferens is made and 3-4 ml of 30% iodolipol is injected into the seminal vesicles.

Rice. 46. Normal left-sided vesiculogram.

Cystography is difficult diagnostic procedure. An examination of the bladder is carried out strictly according to indications, if other methods do not provide an accurate answer to the question about the causes of pathological processes in the bladder. urinary tract.

It is important to know the indications and contraindications for cystography in children. How is a bladder examination performed using a contrast agent? Is there any discomfort during the procedure? What does the study show? The answers are in the article.

general information

The procedure involves the introduction of an X-ray contrast agent into the cavity of the bladder. Doctors fill the cavity with a solution (from 50 to 200 ml depending on the age of the child) containing 10-30% Urografin, Iodamine, Triombrast.

At the beginning of the procedure and after filling all areas with a contrast agent, the doctor takes x-rays to assess the condition of the genitourinary system. Special drug stains tissue, all affected areas stand out well in the photographs. According to the results of the study, a clear radiographic picture of the bladder cavity is visible. The procedure, depending on the variety, takes from 30 to 60 minutes, with preparation - up to two hours.

Features and types of research

Cystography is carried out using two main methods:

bottom-up method. An X-ray contrast agent is injected into the bladder through the urethra using a catheter. To reduce discomfort, use Katedzhel gel with an analgesic effect;
top-down method. The composition is injected into a vein, then the blood carries the substance throughout the body, after certain time the drug enters the bladder and stains the tissue. From this point on, x-rays can be taken. The method is less painful, but the penetration of contrast into the blood increases the risk allergic reactions.

On a note:

with the development of non-contrast and small tumors, another type of study is required - pneumocystography. The main difference is the introduction into the cavity of the bladder not of a liquid form of the drug, but of gas. Oxygen is used for the procedure carbon dioxide or nitrous oxide;
sometimes doctors combine gas and liquid to diagnose complex cases of diseases, abnormalities of the urinary tract and tumor process. Lacunar cystography is a highly informative method;
If a child has problems with urination, the urologist may prescribe voiding cystography. The study is carried out directly during urine excretion. The technique provides accurate data on areas of X-ray contrast agent leakage. Unpleasant moment - psychological discomfort which is difficult for a child to cope with.

Advantages and disadvantages

Diagnostic studies using contrast have both strong and weak sides. Despite the high information content of cystography, the method has some negative points, which are important for parents to pay attention to.

The doctor should explain how to prepare the child for the procedure to reduce the risk of complications and inaccurate results. Doctors must warn Negative consequences, strictly follow the diagnostic rules, take into account the patient’s age, the condition of the patient’s problematic organs.

Advantages:

on x-rays all deviations that are difficult to recognize with and are noticeable;
for the most full picture at difficult cases doctors can choose optimal method: lacunar or pneumocystography;
the result of the study is ready a short period of time after the procedure. The doctor evaluates tissue damage, gives a preliminary conclusion, and refers to a pediatric urologist;
new X-ray machines with digital resolution make it possible to study the entire process: from filling the bladder to removing urine. With dynamic cystography, radiation exposure is significantly reduced, which is especially important when examining children.

Flaws:

psychological discomfort;
the child does not always understand the doctor’s instructions;
Painful sensations appear during catheter insertion;
complications are possible in the form of allergic reactions to the drug, nephrotoxic effect. With retrograde cystoscopy, the listed complications are absent, but other problems are possible: acute delay urine due to sphincter spasm and injury to the urethral mucosa (more often in elderly patients);
When the walls of the bladder rupture, the penetration of the contrast agent into the bloodstream can provoke sepsis.

Indications for diagnostics

Complex diagnostic test prescribed after a preliminary examination of a small patient. It is important to collect blood tests, urine tests, do an ultrasound, and conduct.

Injection of a radiopaque substance into the bladder cavity in childhood undesirable, the child and parents are often afraid of the procedure, creating conditions for the development of stress. If the results of other types of examination do not provide accurate data on the causes negative symptoms, localization, severity pathological process in the urinary tract, then cystography has to be performed.

Main indications:

pathologies of the bean-shaped organs and bladder;
bladder rupture or reflux;
detection of a tumor of unknown etiology;
accumulation of salt stones;
developmental abnormalities of the genitourinary system.

Contraindications

Ascending cystography is not performed in the following cases:

inflammation in the scrotum, urethra, bladder;
excretion of blood clots in the urine or massive hematuria.

On a note! Descending cystography has the same limitations as excretory urography: severe pathologies liver and kidneys, allergies to iodine preparations, renal failure, thyroid diseases, poor clotting blood.

In most cases, doctors avoid cystography and use other diagnostic methods. If descending or ascending cystography is unavoidable, parents will have to explain to the child how the study will be carried out and why they will have to be patient a little during the procedure.

Important psychological preparation, an accessible explanation of the essence of the method and the importance of the examination. The less parents panic, the lower the risk of developing fear in their son or daughter.

For getting reliable results the young patient’s diet will have to be changed:

within a week, exclude from the menu all items that provoke increased gas formation in the intestines. Do not give legumes, carbonated drinks, baked goods, fresh milk;
if the child suffers from constipation, then for two weeks before the procedure the little patient takes a mild laxative;
children receive tea that prevents the accumulation of gases or dill water;
two days before the bladder examination, the doctor categorically prohibits foods that cause flatulence;
On the day of the study, an enema must be given to maximize the removal of food debris and gases from the intestines.

How to treat ? Check out the selection effective options therapy.

About how it is carried out excretory urography kidneys using a contrast agent is written on the page.

How is the procedure performed?

All types of cystography cause psychological discomfort to the patient; with the ascending method of examination, pain is felt when inserting a urethral catheter. It is important to follow all medical commands in order to get the maximum exact result. After the procedure, the urine often changes color: a radiopaque substance comes out.

Study information:

After preparation, the patient lies down on the X-ray machine (“supine” position). During the first phase you need to lie still. The doctor does general shot organs of the genitourinary system;
Then the doctor proceeds to the most unpleasant part - he inserts a catheter through which the cavity of the bladder is filled with liquid with a radiopaque substance or gas. Up to 12 years of age, 50-100 ml of the drug is sufficient; adolescents are prescribed adult norm- 200-300 ml;
During the administration of contrast and during examination, the doctor presses the catheter, which provokes pain and the urge to urinate. This step cannot be avoided - it is important to retain the contrast inside the cavity so that the substance does not leak out of the bubble during the procedure;
After filling the bladder with a special substance, the radiologist takes several pictures in different projections: on the side, from the stomach and from the back. A small patient should raise his legs to 90 degrees and additionally raise his shoulders. In this position, the pictures are the clearest and most informative;
at the end of the procedure, the doctor removes the catheter and takes a photo of the empty bladder;
After the examination, the doctor examines the finished images and analyzes the image. If fistulas or ruptures of the walls of the urethra or bladder are detected, hospitalization of the child is required to prevent sepsis: through the zones of ruptures, contrast enters the blood;
After the procedure, if there are no complications, a hospital stay is not required; most often, cystography is performed on an outpatient basis. Observation by doctors of the urology department is necessary if a small patient was previously admitted to a medical institution with severe pathologies of the urinary tract, and cystography is one of the planned methods examinations.

Diagnostic results

What does cystography show? The procedure allows you to accurately determine the localization zone of the pathological focus, the severity of the changes and the spread of inflammation, the type of tumor process or the size of the stones. In the first image, the radiologist sees the exact location of the kidneys and other organs of the urinary system. After filling the cavities with an X-ray contrast agent, it is possible to identify pathologies that are difficult to recognize on ultrasound and cystoscopy.

Deviations are clearly visible in the colored organs:

congenital defects of the bladder and bean-shaped organs;
and renal-ureteral reflux;
stones in the urinary tract;
change in the structure and thickness of the walls of the bubble;
fistulas, traumatic injuries bladder walls and other parts of the urinary system;
tumors and stones of any size;
inflammatory processes in natural filters, bladder, ureters, other pathologies.

At proper preparation Following the instructions of a radiologist, cystography in children provides accurate data on the nature, stage, and localization of pathological foci in the urinary tract. Parents must properly prepare the child psychologically and change the diet to eliminate interference during the study.

There are several ways to conduct a bladder examination. One of them is ultrasound (ultrasound examination). This procedure is quite safe.

Ultrasound of the bladder

How is an ultrasound of the bladder performed?

Ultrasound examination of the bladder helps to assess the volume of the bladder, urinary retention in a patient for one reason or another, the volume of residual urine in patients who have decreased urine production for any reason. Bladder ultrasound can also be used to identify and evaluate the structure of the bladder.

Ultrasound examination of the bladder is also used to evaluate bladder function for incontinence and urinary tract retention.

How does the process of examining the bladder occur? Uses special ultrasound scanner, which is powered by a battery. It consists of a portable unit and an attached ultrasound. During examination of the patient's abdomen, a special sensor, which is ultrasonic, transmits sound waves. These, in turn, are displayed on the transducer. Data on the condition of the bladder during the study are transferred to a computer. Bladder volume is calculated automatically. The procedure lasts about two minutes. It eliminates the complications associated with catheterization. It should also be said that this procedure is non-invasive.

It is very important that ultrasound examination of the bladder does not have any complications.

After the process is completed, you need to unhook the sensors and wipe the gel off the skin.

Bladder examination

The diagnosis of a disease such as cystitis is made based on a doctor’s examination and laboratory data.

What about laboratory data? Firstly, this general analysis urine, in which the doctor can detect the presence of pus. Next point laboratory research genitourinary system - urine culture. This analysis helps to find out the nature of the pathogen that caused the inflammation. It is also necessary to take a general blood test in order to find out the severity of inflammation in the body.

Sometimes it is necessary to do an immunogram in order to identify immune disorders. However, most often the examination of the bladder is carried out by cystoscopy. This inspection allows you to examine the bladder from the inside, as well as determine the to a large extent probability of the nature of the disease and its prevalence.

Ultrasound of the bladder - preparation for the study

One of the most informative methods research and diagnosis of diseases is ultrasound of the bladder. His preparation is minimal. In addition, this method is absolutely painless and safe. Ultrasound can be performed even on the youngest patients. This is why ultrasound has become so widespread and is used in the most different areas medicine. For ultrasound of some organs, no special preparation is required, for others there are special rules. So, if the doctor has prescribed an ultrasound for you, preparation is simply necessary. If you ignore it, the study will be uninformative and the results will be unreliable. Since ultrasound is used to diagnose whole line diseases, it is better to spend time preparing for the procedure.

So, ultrasound of the bladder is prescribed for bladder injuries, tumors and cystic formations, suspected bladder disease, stones, blood in the urine, bladder outlet obstruction, to study the urodynamics of the upper urinary tract. In addition, ultrasound of the bladder is performed to monitor the treatment process, for research and during a preventive medical examination.

What do you need to know if you are going to do this research? Remember that before an ultrasound of the bladder, preparation is as follows:

What time of day should I go for an ultrasound of the bladder? If you have the opportunity to choose the time of the procedure, it is better to choose the morning hours. In this case, the study is carried out on an empty stomach. If an ultrasound of the bladder is to be performed in the second half, then a light breakfast is acceptable, but no later than 6 hours before the procedure.

What foods should not be consumed before undergoing a bladder ultrasound? A couple of days before upcoming research Eliminate foods from your diet that can cause increased gas formation in the intestines. This whole milk, legumes, raw vegetables and fruits, carbonated drinks, black bread, grapes, mayonnaise, high-calorie confectionery.

What to do if you have increased gas formation? In case of increased gas formation, a few days before the examination it is necessary to start taking enterosorbents (espumisan, Activated carbon).

What should you tell your doctor before performing an ultrasound of the bladder? If two days before the ultrasound of the bladder you had a colonoscopy or fibrogastroscopy, tell your doctor about this, in which case the ultrasound examination must be rescheduled. After an X-ray of the stomach or intestines using contrast, it is necessary to pause for 3-4 days.

How much fluid do you need to drink for a bladder ultrasound? An ultrasound is performed with a full bladder; you need to drink about a liter of liquid an hour before the examination.

X-ray of the bladder

How is a bladder x-ray performed?

X-rays are performed in hospitals or clinics to diagnose diseases related to urinary system.

There are two types of bladder x-ray:

urethrography;
cystography.

With urethrography, it is possible to diagnose diseases associated with the urethra. On this variety x-ray examination With an x-ray of the bladder, a specialist can see injuries to the urethra, sand in the canals, foreign bodies and education.

Cystography is used to diagnose diseases associated with prostate gland and directly with the bladder. This study gives a complete picture of the described organs; with an x-ray examination, you can see tumors, stones and sand, foreign bodies and chronic cystitis. Cystography is used to treat urinary incontinence problems.

These studies can be carried out in calm state or when urinating. An x-ray examination of the bladder is carried out in a special x-ray room, with the patient lying on a couch. The entire study is carried out under the supervision of a urologist, who comments on the condition of the organs being examined. For a complete picture when researching in urethra A contrast agent is injected, and an X-ray is taken at the doctor’s command.

Features of a bladder x-ray

The examination is not very painful and most often takes place without much suffering for the patient. But if the patient is too sensitive to pain, a bladder examination is performed under local anesthesia. Special training is required from the patient before the study. Before starting an x-ray examination, the patient must observe for several days special diet. The diet should contain a minimum of carbohydrates. Before the x-ray of the bladder itself, the patient must have a complete bowel movement. The day before an x-ray examination of the bladder, an enema is done, and this procedure is repeated in the morning before the x-ray. Depending on the state of the intestines, the urologist may prescribe charcoal or a laxative, which must be taken several days before the examination.

For a more accurate diagnosis of the disease X-ray examination bladder is carried out together with ultrasound examination or computed tomography. All these studies are carried out, both comprehensively and independently, to obtain reliable information about the patient’s disease.

X-ray of the bladder (cystography) - a type x-ray examination organ using a contrast agent. You can undergo the study in specialized diagnostic centers or multidisciplinary clinics. The task of cystography is to identify pathological changes in the organ cavity, including malignant neoplasms. The study is highly informative and helps to detect pathology in its infancy and resort to therapy as soon as possible.

In what cases is cystography prescribed?

Cystography in urological practice is often prescribed due to its high reliability. X-ray of the bladder with contrast agent is important for diagnosis early stages cancer. These stages take the form of polyps growing from the wall of the organ into the cavity. They are often asymptomatic, but sometimes cause blood in the urine. Suspicion may arise due to ultrasound, which visualizes thickening of the bladder wall or the polypous structure itself.

Like any other type of diagnostic procedure, it has its own indications and contraindications. Recommendations for the manipulation are as follows:

suspicion of the development of an atypical process (malignant, cystic formations);
the presence of sand and other stones in the bladder;
definition congenital pathologies and anomalies in children;
previously identified enterovesical fistulas;
urinary incontinence of unknown etiology;
complications during an infectious or inflammatory disease;
chronic urethritis, cystitis, urolithiasis.

The following should be noted as contraindications:

recent surgical intervention on the bladder;
violation of the patency of the urethra;
Availability infectious process in acute form;
pregnancy, in particular in the early stages;
allergic reaction to contrast agents;
acute renal failure.

How to prepare for diagnostic testing

X-ray of the bladder with contrast does not require any special preparatory procedures. There are recommendations, following which you can obtain the most informative research results.

A few days before cystography, it is necessary to exclude the consumption of foods that provoke increased gas formation: strong coffee, soda, cabbage, legumes, dairy products. Immediately before the procedure, a cleansing enema or cleansing with laxatives is performed.

How is diagnosis carried out?

If cystography is performed using the ascending method, the patient takes horizontal position. Next, the specialist introduces 200-250 ml of liquid into the bladder cavity using a special catheter. After filling the substance, the examination begins.

The photographs are taken in several positions, which allows you to obtain a detailed image: in the supine position, on the side, at the time of urine discharge and after it. After complete urination, the catheter is removed and a control image of the empty bladder is taken for subsequent comparison.

Using descending path, a contrast agent is injected into a vein and only after 40-60 minutes the diagnostic procedure begins. Since the manipulation is more inconvenient and painful, an anesthetic drug is used at the patient’s request.

Possible consequences of a bladder x-ray

Cystography cannot be attributed to safe methods research.

During the manipulation, there is a risk of damage to the mucous membrane and infection in the bladder. For this reason, research should be conducted in extreme cases, and, if possible, replace with gentle methods.

Diagnosis does not require a subsequent stay in an inpatient department. But, after the procedure, within 24 hours you will need bed rest And increased consumption purified water, which will allow you to quickly remove the contrast from the body.

After the manipulation, within 2-3 days (in some patients up to a week), pain appears during urination. In this case, the urine takes on a slightly pink tint. Painkillers may be prescribed.

If there is an increase pain syndrome, deterioration in health, increase in temperature, you should consult a doctor as soon as possible.

Cystography is carried out exclusively as prescribed by a doctor, since there is a certain dose of radiation exposure. Patients also complain of painful and burning sensations during urination, which occur after the examination. These problems are caused by irritation of the lining of the urethra, but disappear within one day. Diagnosis is quite inconvenient, in particular for men, since the urethra has some bends. Experts advise patients to follow the recommendations regarding preparation, which will allow them to get an accurate result.