Bladder Imaging Studies

Diagnosis of urinary incontinence will sometimes require imaging studies that give a physician a much better look at the structure and function of the different physiological parts of the urinary tract system. These parts include the kidneys, ureters, bladder and urethra. Each of these different parts plays a key role in helping the body to eliminate waste products from the blood. The kidneys filter the vascular system and eliminate waste products, concentrating them and sending them down the ureters for storage in the bladder before they are eventually expelled through the urethra.

Individuals who suffer from urinary incontinence can experience problems in several different arenas all of which cause urinary incontinence. These problems can be related to stress incontinence, overactive bladder, neurogenic bladders or overflow incontinence. In each of these cases imaging studies can assist the physician to confirm a diagnosis and outline a specific treatment protocol which should be more successful because the diagnosis was conclusive.

One of the more basic imaging studies are abdominal x-rays that are done without contrast material. Abdominal x-ray can also be done with contrast and can highlight the kidneys and urinary collecting system which is of particular importance in specific types of structural abnormalities.

In instances when the physician is particularly interested in viewing the vascular structures that support the bladder and kidneys, they may recommend a CAT scan or MRI which includes contrast material. These particular x-rays also will illuminate large kidney stones that may require surgery, a benign growth or carcinoma. For the most part noninvasive vascular imaging, including ultrasound, CT, MRI and radionuclide scanning, has replaced angiography. During this particular test contrast material is injected into the renal vein.

Doppler ultrasound is also widely used to look at the kidneys, bladder, prostate and testicles. This particular test is believed to be very safe but provides no information about the function of the kidneys and bladder. Also the quality of the test is dependent specifically upon the individual who is operating machinery. No preparation is needed but having a full bladder will facilitate imaging.

A CT scan will provide a broad view of both the urinary tract system and the surrounding structures. It can be done both with and without contrast material. It is used without contrast for evaluation of trauma or other disorders in which an acute hemorrhage may be expected. An MRI is used to enhance the blood vessels and is a specific test that has virtually replaced angiography in evaluating renal artery stenosis and renal artery thrombosis. It is the best test used for determining the extent of any tumor invasion was in the bladder wall and can identify lymph node metastasis.

Radionuclide scanning is the last particular type of imaging study used by physicians who are evaluating urinary incontinence. In this test contrast is used to image the renal area and provides more information about the interior workings of the kidneys than it does about the function of the kidneys and bladder.

Post-void residual volume is a test which is done to evaluate how much fluid may be left in the bladder after an individual has voided. This particular procedure requires ultrasound and uses catheterization is well. Cystoscopy is a test that performed when urodynamic testing fails to duplicate the symptoms the individual is experiencing or when urinalysis reveals that a specific disease process is underway in the body. It is not an imaging study but helps to identify the presence of other lesions and foreign bodies that can the specifically impact urinary incontinence.

Individuals who suffer from urinary incontinence, overactive bladder or stress incontinence often suffer socially and feel isolated because of their condition. By using specific imaging studies and other diagnostic tests physicians are able to pinpoint reasons why individuals are having these problems and then helped to develop successful treatment protocols that allow individuals greater freedom of movement.

RESOURCES

British Journal of Urology International: Imaging for staging bladder cancer

US Department of Health and Human Services National Guideline Clearinghouse: Guideline Summary

Department of Pediatrics University of Texas: Imaging of Kidneys, Ureters and Bladder

Incontinent Pelvic Floor Dysfunction: Genitourinary Tract Images

MayoClinic: Urinary Incontinence

University of Maryland Medical Center: Urinary Incontinence