1 / 33

Bladder Diverticuli

Bladder Diverticuli. May be congenital Usually secondary to chronic obstruction of bladder outflow. There will be urinary stasis: - infection. - stone formation. - tumor. Readily seen on all imaging , may deform the adjacent bladder or ureter.

rossa
Download Presentation

Bladder Diverticuli

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Bladder Diverticuli • May be congenital • Usually secondary to chronic obstruction of bladder outflow. • There will be urinary stasis: - infection. - stone formation. - tumor. • Readily seen on all imaging , may deform the adjacent bladder or ureter.

  2. Bladder calcification

  3. Bladder Calcification • Most are bladder calculi. • Usually large and laminated. • Rarely calcification seen in the wall : -Schistosomiasis -Bladder tuumour

  4. Neurogenic bladder

  5. Neurogenic bladder 2 type : • The atonic type: large, smooth-walled baladder , poor or absent contraction and large residual volume. • The Hypertrophic type : regarded as neurologically induced bladder outflow obstruction. small volume, very thick , grossly trabeculated wall and marked sacculation , ureter and PCS may be dilated • Full assessment is by videourodynamics.

  6. Trauma to the Bladder and urethra

  7. Intraperitoneal rupture: - direct blow to the distended UB . - contrast will leak out into peritoneal cavity. • Extraperitoneal rupture: - as part of an extensive injury of fracture of pelvis. - usually in the bladder base. - contrast and hematoma accumulated outside peritoneal cavity and may elevate and compress bladder base

  8. US may show perivesical fluid collection . • Cystography remains the best way of demonstrating actual site of leakage. • If urethral injury suspected , ascending urethrogram should be done before passing any catheter. • CT : demonstrate fresh hematomas or urine collection , and associated fracture.

  9. Prostate and Urethra

  10. Prostatic enlargement • Very common in elderly man • Usually benign hypertrophy but may be CA. • Prostatic US: -Transrectal Ultrasound ( TRUS) : can measure the volume and detect relatively small mass. - masses in peripheral zone are usually malignant and in central zone are benign

  11. Transrectal ultrasound guided biopsy is used for diagnoses of prostatic CA. • CT can't demonstrate internal structure , its used for assessing local spread and LNs

  12. MRI : in assessment of early stage of prostatic cancer. • Tumor appear as low signal in the peripheral zone which is high signal on T2 . • It shows extracapsular spread , seminal vesicle invasion and LN metastases

  13. Prostatic calcificaiton • Numerous prostatic claculi. • Very common , that it can be regarded as a normal finding in older men. • No relation to symptoms of BPH or prostatic carcinoma.

  14. Bladder outflow obstruction • Commonest cause of BPH • Other cause : - tumors - Urethral strictures - posterior urethral valve (male infants) - neurogenic obstruction.

  15. US in bladder outflow obstruction • Increased trabeculation and thickness of the bladder wall , with diverticula formation. • PVRU ( residual urine). • Dilatation of collecting system.

  16. Urethral stricture • Usually due to previous trauma or infection • Imaging is by urethrography . • Traumatic stricture : - usually in proximal penile urethra - smooth in outline, relatively short. • Inflammatory stricture ( gonococcal) : - may be seen in any portion of urthera. - usually in anterior urethra

  17. Posterior urethral valve • Commonest cause of BOO in male children . • May be seen antenatally(bilateral hydronephrosis) • US show bilateral hydronephrosis and hydroureter with thick wall bladder. • Can not be diagnoses by retrograde rethrography. • Easily seen on micturatingcystourethrography, as dilatation of posterior urethra terminates abruptly in a convex border formed by the valve

  18. Scrotum and testes

  19. Usually imaging by US , some times MRI. • Scrotal US is done for : > scrotal swelling : - intratesticular ( tumor ) - extratesticular varicocele hydrocele infection (epididymitis,epididmoorchitis) benign epididymal cyst ( common)

  20. Acute testicualr pain and/or swelling: - testicular torsion : dramatic reduction in perfusion on Doppler - acute epididymitis/orchitis: normal or increased perfusion

  21. Ectopic testis ( undescended testis) : - commonest site is in the inguinal canal - MRI used if US inconclusive or ectopic testis lies within the abdomen. MRI produce highly detailed images of scrotal contents and is used in problem solving cases.

  22. Questions

More Related