OBJECTIVE: To evaluate the effect of a transrectal probe on the opening of internal urethral sphincter. METHOD: Twenty-five patients with a neurogenic bladder dysfunction were included in this study. For the transrectal ultrasonography (TRUS), a transrectal probe was inserted into the rectum before the bladder was filled. Internal urethral sphincter opening was investigated during the filling and voiding phases. The bladder was emptied and the probe was introduced intrarectally after the bladder filling for the investigation of internal urethral sphincter opening. Twelve subjects underwent an additional cystometry for the recording of maximal intravesical pressure with and without transrectal probe. RESULTS: There was no significant difference in the sensitivity of TRUS for the opening of internal urethral sphincter with insertion of the probe before or after the bladder filling. There was no significant change of the maximal intravesical pressure with or without the probe in the rectum. CONCLUSION: The results demonstrate that transrectal probe for TRUS does not cause a reflex effect on the opening of internal urethral sphincter.
Humans ; Rectum ; Reflex ; Ultrasonography ; Urethra* ; Urinary Bladder ; Urinary Bladder, Neurogenic

OBJECTIVE: To compare the sensitivity of transrectal ultrasonography (TRUS) and voiding cystourethrography (VCUG) in assessing the opening of bladder neck and external urethral sphincter during the filling phase and voiding phase. METHOD: TRUS and VCUG were performed for visualizing the opening of bladder neck and external sphincter in 36 patients with a neurogenic bladder dysfunction and the sensitivity of two techniques was compared. The finding was considered to be a true positive when the opening of internal or external sphincter was visualized on either one of TRUS or VCUG. RESULTS: The sensitivity of TRUS was significantly higher than VCUG in visualizing the opening of bladder neck during the filling phase. However, there was no significant difference in the sensitivity of two techniques for the opening of external sphincter during filling phase or the opening of internal and external sphincters during voiding phase. CONCLUSION: The results demonstrate that the TRUS provides a satisfactory information and can be an alternative method to the radiological VCUG in visualizing the opening of bladder neck or external sphincter.
Humans ; Neck* ; Ultrasonography* ; Urethra ; Urinary Bladder* ; Urinary Bladder, Neurogenic

In the neural engineering field, physiological dysfunctions are approached by identifying the target nerves and providing artificial stimulation to restore the function. Neural stimulation and recording technologies play a central role in this approach, and various engineering devices and stimulation techniques have become available to the medical community. For bladder control problems, electrical stimulation has been used as one of the treatments, while only a few emerging neurotechnologies have been used to tackle these problems. In this review, we introduce some recent developments in neural stimulation technologies including microelectrode array, closed-loop neural stimulation, optical stimulation, and ultrasound stimulation.
Electric Stimulation ; Microelectrodes ; Ultrasonography ; Urinary Bladder*

The determination of the residual urine volume is an essential part of the investigation of many urological patients. particularly those with suspected urinary outflow obstruction. In 31 patients, we measured 3 internal bladder diameters ( height, width and depth) by transabdominal ultrasonography and calculated the residual urine volume by formula for ellipsoid (V= phi /6 xH xW xD).The real volume was obtained by the catheterization and compared with the sonographic measurement. There was a best correlation (r=0.9748) between calculated and true volumes provided a correction factor of 1.15 was applied. The advantages of ultrasonography for assessing residual urine volume are that it is simple, quick, harmless, non-invasive and readily repeatable. If the basic equipment is available, the ultrasonography should replace the catheterization.
Catheterization ; Catheters ; Humans ; Ultrasonography* ; Urinary Bladder

Bladder rupture refers to a series of diseases caused by bladder wall laceration and urine flowing into the abdominal cavity.Two cases of bladder rupture diagnosed by retrograde transurethral contrast-enhanced ultrasound were reviewed in this report.We discussed the value of retrograde transurethral contrast-enhanced ultrasound in the diagnosis,classification,and prognosis evaluation of bladder rupture,aiming to provide evidence for clinical diagnosis and treatment.
Humans ; Urinary Bladder/diagnostic imaging* ; Ultrasonography ; Prognosis

PURPOSE: Suprapubic bladder aspiration(SBA) of urine is the most reliable method to obtain urine avoiding contamination in non-toilet trained infants. Ultrasonography is a useful tool for guiding the anatomic location as well as for direct visualization during procedure. We evaluated the success rate and complication of ultrasound(US) assisted SBA. METHODS: Sixty infants who visited Ewha Womans University Mokdong Hospital, with suspected urinary tract infection were randomly divided into the US assisted (n=32) and blind SBA(control, n=28) group. In US assisted SBA group, the anteroposterior(AP), transverse, and sagittal diameters and the volume of the bladder were measured. In the blind SBA group, urine was blindly aspirated when the urinary bladder was palpated at the suprapubic area. The rate of successful urine aspiration, the number of attempts until successful aspiration, aspirated urine volume were compared between the two groups. RESULTS: The success rate was 100%(32/32) in the US assisted group, which was significantly higher than 85.7%(24/28) of the control group (P<0.05). The aspirated urine volume in the US assisted group was 7.4+/-3.7 mL, which was significantly higher than 4.5+/-3.4 mL of the control group (P<0.05). The diameters and volume of bladder in successful aspiration were 2.1+/-0.7 cm in AP diameter, 3.1+/-0.6 cm in transverse diameter, 4.2+/-1.0 cm in sagittal diameter and 15.2+/-10.4 mL in volume, which were significantly higher than those (1.7+/-0.3 cm, 1.8+/-0.7 cm, 2.4+/-0.6 cm, 3.9+/-2.5) of the control group (P<0.05). The correlations between the AP(r=0.78), transverse (r=0.72), sagittal(r=0.91) diameter and bladder volume were significant (P<0.05). SBA was 100% successful in the AP diameter >3 cm, transverse diameter >4 cm, depth >4 cm and bladder volume >5 mL. CONCLUSION: US assistance can significantly improve the success rate of SBA in infant with suspected urinary tract infection.
Female ; Humans ; Infant ; Ultrasonography* ; Urinary Bladder* ; Urinary Tract Infections

PURPOSE: Suprapubic bladder aspiration(SBA) is a widely accepted method of obtaining sterile urine for culture in neonates but has a relatively low success rate and a few serious complications during SBA procedure. To improve the chance of obtaining urine, we determined the ultrasonographic bladder parameters(diameters and volume) to confirm that the bladder is adequately distended for successful aspiration of urine. METHODS: In 94 newborn infants who required sterile collection of urine, ultrasonographic examination and SBA procedure were carried out. On the patient's suprapubic area, the maximal cephalocaudal and anteroposterior diameters were measured by sagittal scanning, and the maximal anteroposterior and transverse diameters by transverse scanning. Bladder volume was calculated using the formula for elliptic volume, and then urine was aspirated to maximum of 10 mL and the amount of urine aspirated was recorded. RESULTS: Sufficient urine for culture(>1 mL) was obtained by SBA in 86(91.5%) of 94 infants. In the sagittal view, when the cephalocaudal diameter of the bladder was greater than 20 mm and the anteroposterior diameter was greater than 15 mm, the success rate was 100%. The cephalocaudal diameter of the bladder in sagittal view showed a more significant positive correlation with aspirated urine amount(r=0.65, P<0.001). CONCLUSION: The ultrasonographic sagittal view improved the success rate of SBA in neonates. A SBA was more likely to be successful when the cephalocaudal diameter of the bladder was above 20 mm and the anteroposterior diameter was above 15 mm.
Humans ; Infant ; Infant, Newborn ; Ultrasonography ; Urinary Bladder* ; Urinary Tract Infections

PURPOSE: This study was designed to determine the diagnostic availability of transperineal ultrasongraphy compared with chain cystourethrography for patients with stress urinary incontinence. MATERIALS AND METHOD: Twenty-seven outpatient women with stress urinary incontinence, who underwent both transperineal ultrasonography and chain cystourethrography for the last ten months, participated in this study. The mean age was 47 years(range 37 to 66 years). The posterior urethrovesical angle(PUVA) at lest and during strain, and both an increment of PUVA and bladder neck descent during strain were measured in the two methods, respectively. Wilcoxon Matched-Pairs Signed-Ranks test was used for the comparative analysis of the results. RESULTS: The mean of PUVAS at rest and during strain were 118.9 degrees and 142.3 degrees, respectively, and the mean of the increment of PUVAS during strain was 23.5 degreesin transperineal ultrasonography. The mean of PUVAS at rest and during strain were 130.7 degrees and 158,0 degrees, respectively, and the mean of the increment of PUVAS during strain was 27.3 in chain cystourethrography. There were statistically significant differences in PUVAS, but no significant differences in the increment of PUVAS during strain between the two methods. During strain condition, the mean descent of bladder neck was 11.8mm in transperineal ultrasonography and 13.7mm in chain cystourethrography, and there were no significant differences between the two methods. CONCLUSIONS: Compared with chain cystourethrography, the transperineal ultrasonography made no significant differences in the diagnosis of stress urinary incontinence using both the increment of PUVAS and the bladder neck descent caused by the increase of abdominal pressure during strain. In addition, the transperineal ultrasonography is considered to be replaceable for chain cystourethrography, as that is noninvasive, devoid of risks of irradiation, and removes the noticeable discomfort or embarrassment for the patient in the diagnosis of stress urinary incontinence.
Diagnosis ; Female ; Humans ; Neck ; Outpatients ; Ultrasonography* ; Urinary Bladder ; Urinary Incontinence

Twinkling artifact, described by Rahmouni et al in 1996, appears as a rapidly alternating red and blue color Doppler signal behind certain stationary objects, such as stone. It has been reported mainly association with urinary calculi in only a handful of studies, showing the usefulness in equivocal case on sonography. For better visualization of distal ureter and ureterovesical junction(UVJ) on transabdominal sonography, full bladder technique by oral fluid ingestion has been usually performed at radiology department. However, it is time consuming work-up with some limitation, therefore not appropriate with many cases in busy urban ED. For rapid bladder distension on sonography, some authors suggested effective alternative approach, rapid intravenous hydration, rarely reported in related English literatures. I report a case with UVJ stone confirmed by twinkling artifact and alternative quick bladder filling with transabdominal ultrasonography.
Artifacts ; Eating ; Hand ; Ultrasonography ; Ureter ; Urinary Bladder* ; Urinary Calculi

Residual urine can be erroneously estimated due to cystic pelvic pathology by portable ultrasound scanning. We report a case involving a false-positive elevated postvoid residual urine result using a bladder ultrasound caused by an ovarian cystadenoma unrelated to the urinary tract.
Cystadenoma* ; Ovarian Neoplasms ; Pathology ; Ultrasonography* ; Urinary Bladder ; Urinary Tract