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Urinary Tract Ultrasound

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Also Known As

Renal ultrasound, kidney ultrasound, renal sonography, urinary system sonography, bladder ultrasound, renal tract ultrasonography, urinary tract sonogram, kidney and bladder ultrasound, urinary system imaging, renal imaging

Definition

A urinary tract ultrasound is a non-invasive diagnostic imaging procedure that uses high-frequency sound waves to create detailed pictures of the kidneys, ureters, bladder, and urethra.1 The procedure works by emitting sound waves from a transducer placed against the skin, which bounce off internal organs and tissues, creating echoes that are converted into real-time images.2 These images allow healthcare professionals to evaluate the size, shape, and position of urinary tract structures, as well as detect abnormalities such as stones, tumors, or obstructions.3

The procedure is performed by placing a handheld device called a transducer against the skin over the area to be examined. A water-based gel is applied to the skin to help transmit the sound waves.4 The transducer sends sound waves into the body and receives the returning echoes, which are processed by a computer to generate images displayed on a monitor.5 Doppler ultrasound, a special ultrasound technique, may also be used to measure the direction and speed of blood flow in the urinary tract.6

Urinary tract ultrasound is highly specific for detecting moderate and severe hydronephrosis, which appears as an enlarged anechoic area within the normally hyperechoic collecting system.7 It is considered safe, painless, and does not expose patients to ionizing radiation, making it suitable for repeated examinations and for use in children, pregnant women, and patients with kidney dysfunction.8

Clinical Context

Urinary tract ultrasound is primarily used in clinical settings to evaluate and diagnose various urinary system conditions and abnormalities.1 It serves as a first-line imaging modality for patients presenting with symptoms such as flank pain, hematuria (blood in urine), recurrent urinary tract infections, difficulty urinating, and suspected kidney stones.2

The most common indication for point-of-care ultrasound of the urinary system in emergency departments is concern for ureteral obstruction caused by nephrolithiasis.3 Patients typically present with sudden-onset, unilateral, colicky flank pain that may radiate anteriorly or to the groin, often accompanied by microscopic or gross hematuria, nausea, and vomiting.3 The most specific finding indicating ureteral obstruction on ultrasound is hydronephrosis, which appears as an enlarged anechoic area within the normally hyperechoic collecting system.3

Urinary tract ultrasound is also valuable for evaluating kidney size, shape, and position; detecting kidney stones, tumors, or cysts; assessing bladder wall thickness and post-void residual volume; and monitoring conditions such as hydronephrosis.4 In pediatric patients, it is particularly useful for evaluating recurrent urinary tract infections and vesicoureteral reflux, as it avoids radiation exposure.5

The procedure is indicated for patients of all ages, including infants, children, adults, and pregnant women, due to its safety profile and lack of ionizing radiation.6 It is especially beneficial for patients who require repeated imaging, those with kidney dysfunction who cannot receive contrast agents, and situations where immediate bedside evaluation is necessary.7

In urological practice, ultrasound measurements such as bladder volume, wall thickness, and urinary flow rates can provide valuable diagnostic information for conditions like benign prostatic hyperplasia and lower urinary tract symptoms.8 These measurements help clinicians assess disease progression and treatment efficacy over time.8

Scientific Citation

[1] Southgate SJ, Herbst MK. Ultrasound of the Urinary Tract. StatPearls [Internet]. 2023 Jan 16. PMID: 31475976. DOI: https://www.ncbi.nlm.nih.gov/books/NBK535381/

[2] National Institute of Diabetes and Digestive and Kidney Diseases. Urinary Tract Imaging. 2023. Available from: https://www.niddk.nih.gov/health-information/diagnostic-tests/urinary-tract-imaging

[3] Radiological Society of North America. Renal (Kidney) Ultrasound. RadiologyInfo.org. 2022. Available from: https://www.radiologyinfo.org/en/info/ultrasound-renal

[4] Liu TT, Rodgers AC, Nicholson TM, et al. Ultrasonography of the Adult Male Urinary Tract for Urinary Functional Testing. J Vis Exp. 2019 Aug 14;(150):10.3791/59802. DOI: 10.3791/59802. PMID: 31475976; PMCID: PMC7328372.

[5] Yeung CK, Sreedhar B, Leung YF, Sit KY. Correlation between ultrasonographic bladder measurements and urodynamic findings in children with recurrent urinary tract infection. BJU Int. 2007 Mar;99(3):651-5. DOI: 10.1111/j.1464-410X.2006.06580.x. PMID: 17092286.

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