Normal ultrasound images of the lower renal tract

When the bladder is distended with urine, the walls are thin, regular and hyperechoic. The walls may appear thickened or trabeculated if the bladder is insufficiently distended, making it impossible to exclude a bladder lesion.
The ureteric orifices can be demonstrated in a transverse section at the bladder base. Ureteric jets can easily be demonstrated with colour Doppler at this point and normally occur between 1.5 and 12.4 times per  minute (a mean of 5.4 jets per minute) from each side1 (Fig. A).
It is useful to examine the pelvis for other masses, e.g. related to the uterus or ovaries, which could exert pressure on the ureters causing proximal dilatation. The prostate is demonstrated transabdominally by angling caudally through the full bladder (Fig. B). The investigation of choice for the prostate is transrectal ultrasound; however an approximate idea of its size can be gained from transabdominal scanning.
When prostatic hypertrophy is suspected, it is useful to perform a postmicturition bladder volume measurement to determine the residual volume of urine (see Measurements below).
Fig. A
Ultrasound images TS through the base of the bladder,
demonstrating a left ureteric jet
ultrasound images post mict and pree mict Longitudinal section (LS) and TS scans through the bladder after
micturition demonstrating an enlarged prostate (P) and a small residual urine volume of 40 ml.
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