Abdo: bladder,prostat,ureters & urethra

Playlist contributed by: Dr Annabelle Skelley

Abnormal Bladder Wall

  1. Underfilled/underdistended -> pseudothickening
  2. Bacterial cystitis - smooth diffuse thickening 
  3. Chronic cystitis
  4. Radiation cystitis: small volume and diffusely thickened 
  5. Neurogenic bladder: dysfunction secondary to neural injury; diffuse thickening & trabeculations (Christmas tree bladder) 
  6. Chronic bladder outlet obstruction (eg. big prostate)
  7. Bladder cancer -> focal wall thickening, immobile mass 
  8. TB -> thimble bladder (small volume, diffusely thickening, may have calcification) 
  9. Schistosomiasis -> thick walled & calcified 
  10. Emphysematous cystitis (diabetics) 

Urachal Remnants​

  1. Patent urachus (50%) 
    • Communication between bladder and umbilicus
  2. Urachal cyst (30%)
    • Dilatation of the mid-urachus
  3. Umbilical-urachal sinus (15%) 
    • Dilatation of umbilical end of urachus
  4. Vesicourachal diverticulum (5%)
    • Dilatation of bladder end of urachus

Note: risk of adenocarcinoma 

Bladder Trauma

  1. Intraperitoneal (15%) -> direct blow on distended bladder 
    • Surgical treatment 
  2. Extraperitoneal (85%) -> pelvic fracture/penetrating trauma 
    • May just treat conservatively 
  3. Combined 

Ureteral Filling Defect or Stricture

  1. ​Urolithiasis
    • Hyperdense (>200 HU), periureteric stranding 
    • May appear hypodense relative to contrast on IVP 
  2. Ureteral clot 
    • 50-90HU, non-enhancing 
    • History of haematuria 
    • Resolves with follow-up 
  3. Air bubbles 
    • Mobile, multiple
    • Patient with nephrostomy or JJ stent 
  4. TCC 
    • Soft tissue density (30-60 HU) on non-con -> variable enhancement 
    • Wall thickening 
    • Distal ureter more common 
  5. Stricture (iatrogenic/post-operative)
    • History important -> no soft tissue component 
  6. Extrinsic compression
    • Vascular, diverticulitis, Crohn disease, endometriosis 
  7. Ureteral metastases/direct invasion
    • Lymphoma is smooth, circumferential wall thickening 
    • Primaries: lung, breast & GIT 
  8. Malakoplakia 
    • Rare chronic granulomatous condition 
    • Variable appearance -> may overlap with TCC
    • Middle-aged women 
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Playlist information

rID: 21664
Visibility: public

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