Contents
X-ray (cystography) of the bladder X-ray, non-invasive diagnostics, which is carried out to detect pathological changes in the genitourinary system. The procedure is prescribed for both adults and children. X-ray examination is done with application a contrast agent that allows you to study the integrity, condition and structure the investigated organ. As a result of the study, serious diseases can be identified, an accurate diagnosis can be made and immediate treatment can be started.
Features of bladder cystography
An X-ray of the bladder has a high degree of information content, it is prescribed by a urologist or surgeon. Cystography is carried out with the addition of a solution that is administered in 2 ways: the first is ascending (using a catheter, 150-200 milliliters of the substance is injected through the urethra), the second is descending (intravenously). After intravenous administration, you should wait 30-45 minutes for the bladder to fill.
As a contrast, preparations can be used: urographin, iodamide, triombrast. Radiography with contrast helps to detect serious diseases: vesicoureteral reflux, fistulas, pathological narrowing, chronic cystitis (inflammation of the bladder), malignant and benign tumors, bladder diverticula, neoplasms, stones.
Contrast x-ray is prescribed to assess the condition of the bladder and urinetochnikov. With the help of the procedure, it is possible to identify the cause of urinary incontinence, to analyze the excretory function of the kidneys. 25-30 minutes after the administration of the contrast agent, during normal kidney function, only the remains of the contrast will be traced in the pelvis and calyces. If a large amount of the substance remains in the pelvis and calyces, this will indicate a slow excretion of urine.
Indications and contraindications
Indications include: ruptures and reflux, congenital pathologies, complications after infectious and inflammatory diseases, enuresis, sand and stones, tuberculosis of the internal organs of the genitourinary system, suspicion of a tumor, injuries of internal organs, diseases of the bladder and kidneys.
Although the diagnosis is considered informative and reliable, it has contraindications. Cystography should not be performed on pregnant women; patients who have an inflammatory process in the bladder or ureters (the catheter tube can injure the urethra, which leads to an aggravation of the inflammatory process); people who pass urine with blood clots (clots can distort x-ray images and the results of the study will be incorrect).
Alternative Research Methods
If there are contraindications, the patient can undergo alternative diagnostics, for example, magnetic resonance imaging or pneumocystography. Features of pneumocystography are that gas is injected instead of a contrast solution. Sometimes lacunar cystography is prescribed – a combined procedure during which a specialist injects 15-20 milliliters of contrast and 180-200 cubic centimeters of gas.
Another effective diagnostic method is voiding cystography, which is performed during urination. During the procedure, the work of urine is tracedtochnikov, leaks of the contrast medium can be detected.
Cystography and other manipulations are needed in order to determine in detail the parameters and location of the bladder, to identify pathologies and anomalies, stones and sand, ruptures, thickening of the walls of the internal organ, disruption of the urinary system and other dysfunctions.
An x-ray of the bladder is done if ultrasound and cystoscopy fail to help make the diagnosis. The procedure is not recommended without indications, because it is painful, and during its implementation the patient often feels discomfort.
X-ray of the bladder in children
X-rays are done to children from the age of five months. Parents are afraid of such an examination, since the child’s body is exposed to radiation and a special solution is introduced. But if the attending physician insists on the procedure, you should prepare your child for the upcoming diagnosis.
For 1-2 weeks, the child should not use foods that can cause excessive gas and flatulence. In the morning before cystography, it is recommended to give the child a cleansing enema. To avoid an allergic reaction to the medications that will be administered, it is advisable to conduct an allergic test.
Features of cystography of the child’s bladder:
- a catheter tube will be inserted through the urethra, through which contrast is injected;
- the drug can be prescribed before and after urination;
- for small children, for the painlessness of the procedure, anesthesia is introduced;
- you can not eat and drink 4-6 hours before the study;
- examination takes no more than 10-15 minutes;
- after the x-ray, the child is under the supervision of the medical staff for 2 hours (during this time the bladder should empty).
After the procedure, the baby should drink a furagin tablet to prevent the occurrence of an inflammatory process in the genitourinary system. Adverse reactions rarely occur. During the day, the child needs to drink plenty of fluids so that the medication is excreted faster.
How is cystography performed in adults?
Prepare for x-rays. 4-5 days before the study, you must stop eating food that causes gas and flatulence. It is forbidden to drink strong coffee and tea, sparkling water. You should refrain from eating fermented milk products, whole milk, corn, cabbage, grapes and legumes. Before manipulation, you need to do a cleansing enema.
In the ascending method of diagnosis, the patient takes a horizontal position, then X-ray technician injects 200 milliliters of a special solution into his bladder. After the complete introduction of the substance, the doctor clamps the catheter so that the injected liquid does not flow back. Next, you need to listen to the commands of a specialist so that the pictures are detailed and accurate.
Images are taken in different positions: lying on your back, on your side, during and after urination. When the bladder is empty, comparison pictures will be taken. Diagnosis will be made based on x-ray images.
Top-down diagnostics is carried out 30-60 minutes after the injection of the drug into a vein. During this time, the contrast fills the bladder and provides a detailed visualization of the contours of the internal organ. Next, pictures are taken.
The medical staff warns the patient in advance that the study may be accompanied by painful sensations and unpleasant discomfort. If the patient has an increased pain threshold, for example, a child, the examination will be carried out with simultaneous anesthesia. Before cystography, it is recommended to consult with a nephrologist, urologist and radiologist. They will be able to give recommendations on the manipulation.
To protect yourself from side effects, after x-rays, the patient must remain in bed for 24 hours and drink plenty of fluids.
Image interpretation
On imaging, a normal bladder should be pyramidal or oblong in shape with round or oval contours. In women, an oval bladder is most often present; the concavity of the outer contour is visualized on the x-ray. The pear-shaped bladder is inherent in children. When diagnosing with contrast, you can monitor the state of the organ and identify diverticula, calculi (stones) and education (benign or malignant). In men, the internal organ has a triangular shape.
If the organs of the genitourinary system are asymmetric, they differ difference structure, the radiologist writes it down in his report. During the decoding of cystography, pathological displacements of the bladder, which are called cystocele, can be detected.
A qualified radiologist will be able to decipher the images and describe them in 15-30 minutes. Next, the patient is sent with a conclusion to the attending physician, who sent him for diagnosis. With a correct diagnosis, serious diseases can be prevented and effective treatment can begin.