The urinary bladder ultrasound is done as part of the investigation of possible bladder tumor and provides a simple method of estimating postvoid residual urine volume. This test reduces the need for urinary catheterization and the risk of subsequent urinary tract infection. Portable bladder scans can be used at the bedside or in the practitioner’s office. This point-of-care testing allows for rapid, noninvasive measurement of bladder volume and postvoid residual urine volume. See Figure 13.1. Endourethral urologic ultrasound utilizing a transducer can be executed to place a stent.

1. Instruct the patient to lie supine, with bladder fully distended, on an examination table.

2. Apply a coupling agent to the anterior pelvic region to allow maximum penetration of the ultrasound beam.

3. Place the active face of the transducer in contact with the patient’s skin and sweep across the area being studied.

4. Instruct the patient to void. This is typically done when the full-bladder scans are completed. Then take additional images then to check for residual volume.

5. Tell the patient that total examination time is about 10–20 minutes.

6. See Chapter 1 guidelines for intratest care.

Abnormal results may reveal the following:

1. Tumors of the bladder

2. Cancerous extension to urinary bladder

3. Thickening of bladder wall

4. Masses posterior to bladder

5. Ureterocele

Pretest Patient Care

1. Explain the purpose, benefits, and procedure of the test.

2. Ask the patient to have a full bladder at the beginning, and tell them that they will need to empty the bladder to complete the examination.

3. Assure the patient that there is no pain involved, but that some discomfort may be experienced from maintaining a full urinary bladder.

4. Explain that a liberal coating of coupling agent must be applied to the skin so that there is no air between the skin and the transducer and to allow for easy movement of the transducer over the skin. Explain that a sensation of warmth or wetness may be felt. Tell the patient that the couplant (ultrasound gel) does not stain or discolor clothing, but they may prefer to don a gown.

5. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

1. Residual barium from previous radiology studies affects test results.

2. Overlying gas or fat tissue affects test results.

Normal

• Normal pattern image of the exact dimensions and contour of the bladder and little residual volume