X-ray of the bladder with the introduction of contrast. The sequence of examination in children

Cystography or X-ray Bladder is a diagnostic using an endoscope, aimed at identifying diseases of the organ. Carry out it to patients of any age if necessary.

In order to assess the bubble in all respects, it is necessary to fill it with a special solution - contrast. With it, you can see the structure and integrity of the body. The information obtained helps to start timely treatment. X-ray of the bladder contrast agent is prescribed only by a doctor - a urologist, and sometimes a surgeon.

The procedure is carried out in two ways - ascending and descending. In the first case, the contrast gets inside through the urethra in the amount of 150-200 ml. In the second variant, it is supposed to be administered intravenously. For the solution to reach the urea, you should wait about 45 minutes.

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

Pathology of the bladder X-ray reveals quite quickly. It's about about reflux, constrictions, cystitis, fistulas, neoplasms, diverticula, calculi.

X-ray with contrast allows you to find out the cause of urinary incontinence, as well as evaluate the excretory function of the kidneys. Half an hour after the introduction of a contrast agent, if there are no malfunctions in the work of the kidneys, then only its remains will remain in the cups and pelvis. Otherwise, the substance will be detected in large quantities. It means that excretory system works in slow motion.

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

An x-ray of the bladder is indicated in the following cases:

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

Contraindications

Although 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-ray of any organs is contraindicated. if a woman is carrying a child due to radiation that adversely affects the fetus. If a patient has suspicions of inflammation of the bladder or ureters, then the introduction of a catheter may aggravate the disease.

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

Alternative Methods

Due to the fact that the bladder x-ray 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).

Voiding cystography is also used, in which the diagnosis is similar during urine output. Such a 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 x-ray of the bladder of an infant can be carried out no earlier than five months of age. Many parents are not ready to expose their child to radiation, and are also wary of introducing 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. Be sure to conduct a drug test.

If there are good reasons for examining the bladder, an x-ray of the child is performed as follows:

through the urethra, a contrast agent is injected into the bladder;
contrast is administered both before and after urine output;
so that small 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 the child's bladder. Source: dcenergo.ru

After the x-ray, the small patient remains under the supervision of the medical staff for 2 hours. It is important to empty the bladder during this time so that all the contrast material comes out. It will take about a day for complete elimination. At this time, an enhanced drinking regimen is shown.

Method of examination of adults

Patients must be prepared for the study. All foods that cause signs of flatulence are excluded from the diet. Forbidden following drinks: tea and coffee strongly brewed, sparkling water.

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

When all the fluid has been introduced, the catheter is clamped. Otherwise, the solution will flow back. The specialist will lead the process, so all his commands must be followed. As a result, the images will reflect the state of health 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 has been emptied. By comparing the images that were taken when the urea was full and when it was empty, a reliable diagnosis can be made.

Downward diagnostics is carried out 30 minutes after contrast injection. Or even an hour later. Such a pause is necessary to provide a more detailed visualization of the contours of the bubble. And after that, the pictures will already show whether there is pathological changes.

Doctors always warn patients that some moments of the procedure can bring discomfort and pain. If such inconveniences are unpleasant due to the increased pain threshold do anesthesia.

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

Examination of the bladder - x-ray with the introduction of contrast - 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, a bubble in the form of an oval is characteristic. The outer contour will be slightly concave. Urine in the form of a pear most often occurs in children. In men, it looks like a triangular figure.

If, when taking pictures, the organ is asymmetric, it has an unusual structure, then this will certainly be reflected in the conclusion. When the bladder is displaced, a cystocele is diagnosed.

Pictures are decrypted quite quickly - for half an hour. After that, the patient must, together with the conclusion, go to his doctor, who will prescribe timely treatment taking into account the received data.

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

Plain radiography. X-ray examination of the patient begins with a survey radiography of the entire urinary system. Produce a picture of the kidneys, ureters and bladder. In addition to the bone skeleton, in most cases, the shape and position of the kidneys can be seen in the overview image, the edge psoas(Fig. 37, a). Radiography makes it possible to identify stones in the kidneys, ureters, bladder, prostate, urethra. Oxalates, phosphates, and especially carbonates trap X-rays to a much greater extent than the surrounding tissues, and therefore are clearly contoured (Fig. 37, b), urates, xanthine, cystine stones give a weak shadow or are not visible at all in survey images.

Rice. 37. Plain radiograph areas of the kidneys and ureters (a), the shadow of a kidney stone on the radiograph (b).

Stone-like blackouts can be caused by calcified areas of the veins - phleboliths (mainly in the pelvis), costal cartilages and lymph nodes. Foci of cheesy decay encrusted with salts in tuberculosis of the kidneys or calcified areas of neoplasms can be mistaken for stones. In order to distinguish such "false" shadows from the image of a ureteral stone, a survey picture is taken in a 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. The image of the renal pelvis and calyces (pyelography) is obtained by filling them with contrast media, which 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 A 10-20-gram syringe with a needle of the appropriate caliber is slowly injected through the catheter into the pelvis, a sterile 20% solution of contrast fluid (sergozin, urocon, etc.) heated to body temperature in an amount of 8-10 ml until a feeling of heaviness appears in the kidney area and X-ray is performed snapshot.

To avoid an excessive increase in intrapelvic pressure and the occurrence of pelvic-renal reflux, ureteral catheters thicker than No. 5 on the Charrière scale should not be used 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 following form: the pelvis is located at the level of the XII chest - II lumbar vertebra, the cups are located laterally from 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 arc in the pelvic region, facing the bulge in the lateral direction.

There are two main types of renal pelvis. The first type is an ampulla-shaped pelvis relatively large sizes with three short and wide cups - upper, middle and lower; the pelvis is located outside the renal parenchyma, medially from it; its capacity is approximately 8-10 ml. With the second, branched, type of pelvis, its dimensions are small, the cups are long, 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. solution is injected into a vein organic compound iodine - monoatomic (sergosin), diatomic (cardiotrast, diodeon), triatomic (triiotrast), 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 excreted through the ureter into the bladder. On serial pictures at certain intervals, images of all these sections of the urinary tract are obtained (Fig. 39). For intravenous urography most often used sergosin (sodium monoioidomethanesulfonic acid), containing 52% organic iodine (15-20 g of dry preparation for an adult). A heated 40% solution of sergosin in an amount of 30-40 ml is slowly injected into the cubital vein. The first picture is taken after 7-10 minutes, repeated - after 15-20 and 30-45 minutes after the injection of the contrast agent. The dose of sergosin for children is determined by age: 0.1 g of a dry preparation for 1 year of a child's life.

Rice. 39. Excretory urogram.

Excretory urography has a number of positive sides: it is painless, does not require cystoscopy and ureteral catheterization. It provides insight not only into morphological picture urinary tract, but allows you to judge the function of each kidney separately, but the clarity of the image is often inferior to retrograde pyelography, especially when reduced function kidneys.

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

Pneumoren and pneumorethroperitoneum. If you surround the kidney with a layer of gas, you can get its clear contours in the picture. Gas in the 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 on the opposite side. The needle insertion technique is the same as for perirenal blockade. After passing through the muscle wall, the needle seems to fall through and enter the perirenal tissue. To avoid air embolism wait for 1-2 minutes for blood to come out of the needle. This method is called "pneumoren". It is not completely safe, as the needle can hurt large vessels, kidney, liver, spleen. In view of this, it is preferable to inject gas presacral, that is, between the coccyx and the rectum (“presacral pneumorethroperitoneum”). 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 pneumorethroperitoneum are in its safety, simplicity and in the fact that it makes it possible to obtain an image of both kidneys on the radiograph at the same time (Fig. 40). It is recommended to inject not air, but oxygen, which is easily absorbed by hemoglobin, forming oxyhemoglobin. When recognizing tumors and cysts of the kidneys, tumors of the adrenal gland and retroperitoneal space, as well as renal anomalies, pneumorethroperitoneum provides valuable data, especially in combination with pyelography.

Rice. 40. Pneumoretroperitoneum.

Renal angiography. Diagnosis of kidney disease in some cases can be clarified by serial renal angiography. A contrast fluid - a 70% solution of triiotrast or cardiotrast in an amount of 30 ml - is injected 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 introduction of a contrast fluid and pictures should be made with great speed (at least 3 pictures per second).

The first shot is taken at the end of the injection of the contrast solution, the next 2-3 shots - within the next second. On the first picture - an arteriogram - an image is obtained vasculature kidneys (Fig. 41), on the second and third - nephrograms, - in addition, shadows of a kidney diffusely saturated with a contrast agent are visible, on later images pelvicalyceal system and ureter - urogram.

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

Renal angiography can be used to diagnose abnormalities, tumors, and cysts in the kidneys. Accumulations of contrast fluid 6 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 main vessels kidneys - about their atresia and congenital aplasia kidneys.

Lymphography. To detect metastases of malignant neoplasms of the organs of the genitourinary system - testicles, prostate, bladder, kidneys - in the inguinal and retroperitoneal lymph nodes, lymphangiography is used. 0.5 ml of a paint solution (Evans blue) is injected into the skin of the interdigital fold between the 1st and 2nd toes of each foot. After a few minutes, the lymphatic vessels of the feet are stained. In the middle third of the rear of each foot under local anesthesia over painted lymphatic vessel cut through the skin. The vessel is isolated with thin tweezers, a thin thread is brought under it and, pulling it, creates lymph stagnation and expansion of the vessel. 10 ml of iodolipol are slowly injected into the expanded part of the vessel through a thin needle over 3 hours. The uniformity and duration of the introduction is achieved by the fact that the pressure on the syringe piston is carried out using a screw with a thin thread. Filling of the inguinal and retroperitoneal lymph nodes with iodolipol occurs in 20-24 hours. The lymph nodes tumors affected by metastasis are enlarged in size, filling defects or uneven accumulations of a contrast agent are determined in them (Fig. 42).

Rice. 42. Lymphogram with a tumor of the bladder.

Tomography. X-ray diagnostics of diseases of the kidneys, urinary tract and adrenal glands is supplemented by layered x-rays - tomography. The kidneys are located in a layer spaced on average 5-10 cm from the plane of the X-ray table when the patient is in the supine position. Selective exposure of only this layer eliminates superimposed shadows abdominal wall, intestines and other neighboring organs. Thanks to this, the contours of the kidneys and adrenal glands become clearer. On tomograms, sometimes stones or tumors of the kidneys are found that are not detected on ordinary pictures. Tomography makes it easy to differentiate kidney stones from gallbladder stones, since they are located in different planes.

Cystography. When filling the bladder with a solution of sergosin or gas (oxygen), an image of its cavity can be obtained on an x-ray. This method is called cystography.

Normally, a bladder filled with a contrast agent has round shape; the density of the contrast medium is the same. The contours of the bladder are even (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 outwards. The penis is stretched parallel soft tissues the hips of the bent leg, and a 10% solution of sergosin from a syringe with a cone-shaped rubber tip is injected into the lumen of the urethra (Fig. 44). Such urethrography is called ascending.

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 arc 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 back of the urethra, descending urethrography is used: the bladder is filled with a contrast agent through a thin catheter; after the removal of the catheter at the time of "urination", i.e., the release of a contrast fluid with the patient in the position described above, a picture 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 narrowing and obliteration of the urethra (gonorrheal and traumatic origin) (see Fig. 131). It also allows you to get an image of diverticula and fistulas of the urethra, paraurethral passages.

Rice. 44. The position of the patient during urethrography.

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

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

Vesiculography(Fig. 46). Changes in the configuration of the seminal vesicles - expansion of passages and cavities, their desolation or wrinkling - are important for recognizing tuberculosis or cancer of the seminal vesicles or prostate. For research, 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 - difficult diagnostic procedure. The study of the bladder is carried out strictly according to indications, if other methods do not give an accurate answer to the question about the causes of pathological processes in urinary tract.

It is important to know the indications and contraindications for cystography in children. How is a bladder exam done with a contrast agent? Is there any discomfort during the procedure? What does the study show? Answers in the article.

general information

The procedure involves the introduction of a radiopaque substance 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 organs of the genitourinary system. Special preparation stains tissues, all affected areas stand out well in the pictures. 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:

ascending method. The X-ray contrast agent is injected into the bladder through the urethra using a catheter. To reduce discomfort, apply the Cathejel gel with analgesic effect;
descending 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, stains the tissues. 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 bubble not of the liquid form of the drug, but of the gas. The procedure uses oxygen carbon dioxide or nitrous oxide;
sometimes physicians combine gas and liquid to diagnose complex cases of disease, urinary tract abnormalities, and tumor process. Lacunar cystography is a highly informative method;
if the child has problems with urination, then the urologist may prescribe a voiding cystography. The study is carried out directly during the excretion of urine. The technique provides accurate data on the areas of leakage of the radiopaque substance. bad moment - psychological discomfort difficult for a child to deal 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 to which it is important to draw the attention of parents.

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

Advantages:

on x-rays all deviations are noticeable, which are difficult to recognize at and;
for the most complete picture at difficult cases doctors can choose best method: lacunar or pneumocystography;
the result of the study is ready after a short period of time after the procedure. The doctor assesses tissue damage, gives a preliminary conclusion, and refers to a pediatric urologist;
New digital-resolution X-ray machines allow you to study the entire process, from bladder filling to urine excretion. 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 instructions of the doctor;
during the introduction of the catheter, painful sensations appear;
possible complications in the form of allergic reactions to the drug, nephrotoxic effect. With retrograde cystoscopy, these complications are absent, but other problems are possible: acute delay urine against the background of spasm of the sphincter and trauma to the urethral mucosa (more often in elderly patients);
when the walls of the bladder rupture, the penetration of a contrast agent into the bloodstream can provoke sepsis.

Indications for diagnostics

complex diagnostic study prescribed after a preliminary examination of a small patient. It is important to collect blood tests, urine, do an ultrasound scan, conduct.

Injection of a radiopaque substance into the bladder cavity childhood undesirable, the child and parents are often afraid of the procedure, conditions are created for the development of stress. If, according to the results of other types of examination, there is no exact data on the causes negative symptoms, localization, severity pathological process in the urinary tract, it is necessary to carry out cystography.

Main indications:

pathology of bean-shaped organs and bladder;
bladder rupture or reflux;
detection of a tumor of unknown etiology;
accumulation and salt stones;
anomalies in the development of the organs of the genitourinary system.

Contraindications

Ascending cystography is not performed in the following cases:

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

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

In most cases, doctors avoid cystography, use other diagnostic methods. If descending or ascending cystography is indispensable, parents will have to explain to the child how the study will take place, and why you will have to suffer a little during the procedure.

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

For getting reliable results You will have to change the diet of a young patient:

for a week, exclude from the menu all items that provoke increased gas formation in the intestine. You should not give legumes, carbonated drinks, muffins, fresh milk;
if the child suffers from constipation, then for two weeks before the procedure, the small patient takes a mild laxative;
babies receive tea that prevents the accumulation of gases or dill water;
two days before the examination of the bladder, the doctor categorically prohibits products that cause flatulence;
on the day of the study, an enema is required 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 done excretory urography kidney with the use of a contrast agent is written on the page.

How is the procedure carried out

All types of cystography cause psychological discomfort to the patient; with an ascending method of research, pain is felt when placing a urethral catheter. It is important to follow all the commands of the doctors in order to get the most 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 (position "on the back"). 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 bladder cavity is filled with liquid with a radiopaque substance or gas. Up to 12 years, 50-100 ml of the drug is enough, adolescents are supposed to adult norm- 200-300 ml;
during the introduction of contrast and during the examination, the doctor presses the catheter, which provokes soreness and the urge to urinate. You can’t do without this stage - it is important to hold the contrast inside the cavity so that the substance does not leak out of the bladder during the procedure;
after filling the bladder with a special substance, the radiologist takes several pictures in different projections: on the side, from the abdomen and from the back. A small patient should raise his legs to the level of 90 degrees, additionally raise his shoulders. In this position, the pictures are the most clear and informative;
at the end of the procedure, the doctor removes the catheter, takes a picture of an empty bladder;
after the examination, the doctor examines the finished images, 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, the contrast enters the blood;
after the procedure, in the absence of complications, a hospital stay is not required; most often, cystography is performed on an outpatient basis. Observation by doctors of the urological department is necessary if a small patient was previously admitted to a medical facility with severe pathologies of the urinary tract, and cystography is one of planned methods examinations.

Diagnostic results

What does a cystogram show? The procedure allows you to accurately determine the area of localization 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 picture, the radiologist sees the exact location of the kidneys and other organs of the urinary system. After filling the cavities with a radiopaque substance, pathologies that are difficult to recognize on ultrasound and cystoscopy can be detected.

In the stained organs, deviations are clearly distinguishable:

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 bladder walls;
fistula, traumatic injuries the walls of the bladder and other parts of the urinary system;
tumors and calculi of any size;
inflammatory processes in natural filters, bladder, ureters, other pathologies.

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

There are several methods that allow you to conduct a study of the bladder. One of them is ultrasound (ultrasound). This procedure is quite safe.

bladder ultrasound

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 due to any reason. Bladder ultrasound can also be used to find out and evaluate the structure of the bladder.

Bladder ultrasound is also used to assess bladder function in incontinence and urinary tract retention.

How does the process of examining the bladder take place? Uses special ultrasound scanner which is battery powered. It consists of a portable unit and applied ultrasound. During the examination of the patient's abdomen, a special sensor, which is ultrasonic, transmits sound waves. They, in turn, are displayed on the converter. Data on the state of the bladder during the study are transferred to a computer. The bladder volume is calculated automatically. The procedure takes 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 the ultrasound examination of the bladder does not have any complications.

After the process is completed, it is necessary to unhook the sensors and wipe the gel from the skin.

Bladder examination

The diagnosis of a disease such as cystitis is made on the basis of a doctor's examination and laboratory data.

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

Sometimes it is required to make an immunogram in order to identify violations of the immune system. However, most often the study of the bladder is carried out by the method of cystoscopy. This inspection allows you to examine the bladder from the inside, as well as determine with 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 study and diagnosis of diseases is the ultrasound of the bladder. His training is minimal. In addition, this method is absolutely painless and safe. Ultrasound can be performed even for the smallest patients. That is why ultrasound has become so widespread and is used in the most different areas medicine. For ultrasound of some organs, special preparation is not 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, then the study will be uninformative, and the results will be unreliable. Since ultrasound is used to diagnose whole line diseases, it is better to take the time to prepare 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, infravesical 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, the 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 stop at the morning hours. In this case, the study is carried out on an empty stomach. If an ultrasound of the bladder is due in the second half, then let's say a light breakfast, but no later than 6 hours before the procedure.

What foods should not be eaten before undergoing an ultrasound of the bladder? A couple of days before upcoming study Eliminate from the diet foods 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 with increased gas formation? In case of increased gas formation - a few days before the examination, it is necessary to start taking enterosorbents (espumizan, Activated carbon).

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

How much liquid do you need to drink for an ultrasound of the bladder? Ultrasound is performed with a full bladder, an hour before the study, you need to drink about a liter of liquid.

Bladder x-ray

How is a bladder x-ray performed?

X-rays are taken in hospitals or clinics to diagnose diseases associated with urinary system.

There are two types of bladder x-rays:

urethrography;
cystography.

With urethrography, it is possible to diagnose diseases associated with the urethra. On this variety x-ray examination of the bladder with an x-ray, 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 and directly to 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 while urinating. An x-ray examination of the bladder is carried out in a special x-ray room, when the patient lies on the couch. The entire study is carried out under the supervision of a urologist, who comments on the state of the organs under study. For a complete picture, when examining urethra a contrast agent is injected, and an x-ray is taken at the doctor's command.

Features of the bladder x-ray

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

For a more accurate diagnosis of the disease X-ray examination bladder is carried out together with ultrasound 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 a 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 often assigned, which is associated with its high reliability. X-ray of the bladder with contrast medium 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 the thickening of the bladder wall or directly the polyposis structure.

Like any other type of diagnostic procedure, it has its own indications and contraindications. The recommendations for 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 in the course of an infectious or inflammatory disease;
chronic urethritis, cystitis, urolithiasis.

As contraindications, it should be noted:

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

How to prepare for a diagnostic test

X-ray of the bladder with contrast does not require special preparatory procedures. There are recommendations, adhering to which you can get the most informative result of the study.

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

How is the diagnosis carried out

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

Pictures are taken in several positions, which allows you to get a detailed image: in the supine position, on the side, at the time of urine output and after it. After complete urination, the catheter is removed and a control image of the empty bladder is taken for later 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 has increased inconvenience and pain, at the request of the patient, an anesthetic is used.

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 mucosa and infection in the bladder. For this reason, research should be carried out in extreme cases, and if possible, replace with gentle methods.

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

After manipulation, within 2-3 days (in some patients up to a week) there is pain during urination. In this case, the urine acquires a slightly pink tint. It is possible to prescribe painkillers.

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

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