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[1] [2] Urine normally travels in one direction (forward, or anterograde) from the kidneys to the bladder via the ureters, with a one-way valve at the vesicoureteral (ureteral-bladder) junction preventing backflow. The valve is formed by oblique tunneling of the distal ureter through the wall of the bladder, creating a short length of ureter (1 ...
Hydronephrosis describes hydrostatic dilation of the renal pelvis and calyces as a result of obstruction to urine flow downstream. Alternatively, hydroureter describes the dilation of the ureter, and hydronephroureter describes the dilation of the entire upper urinary tract (both the renal pelvicalyceal system and the ureter).
Ultrasound of the urinary tract involves the use of an ultrasound probe to image parts of the urinary tract. The urinary tract is the path that urine follows after it is formed within the kidneys , and involves a left and right ureter , the bladder , and the urethra .
Bladder outlet obstruction can be identified during routine prenatal ultrasonography as dilation of the fetal urinary tract [3] and decreased amniotic fluid levels. If dilation of the fetal urinary tract is suspected during pregnancy, an ultrasound of the infant's kidneys and bladder should be obtained after birth.
Cystoscopy has similar indications in animals, including visualisation and biopsy of mucosa, retrieval or destruction of urinary bladder stones and diagnosis of ectopic ureters. [ 9 ] [ 10 ] [ 11 ] In turtle and tortoises, cystoscopy has additional value as it permits the visualisation of internal organs due to the thin urinary bladder wall. [ 12 ]
Ultrasound imaging can give information on the shape of the bladder, post-void residual volume, and evidence of kidney damage such as kidney size, thickness or ureteral dilation. [9] Trabeculated bladder on ultrasound indicates high risk of developing urinary tract abnormalities such as hydronephrosis and stones. [10]
All males with recurrent UTIs (urinary tract infections) or abnormality on ultrasound if first UTI. Females < 3 years of age with their first UTI. Females < 5 years of age with febrile UTIs; Older females with pyelonephritis or recurrent UTIs; Suspected obstruction (e.g. bilateral hydronephrosis) Suspected bladder trauma or rupture
Abdominal ultrasound is of some benefit, but not diagnostic. Features that suggest posterior urethral valves are bilateral hydronephrosis, a thickened bladder wall with thickened smooth muscle trabeculations, and bladder diverticula. [citation needed] Voiding cystourethrogram (VCUG) is more specific for the diagnosis.