Transabdominal ultrasonography of bladder focal lesions in patients with haematuria

Objectives: In this study we analysed role of transabdominal ultrasonography (US) of urinary bladder in patients with haematuria.

Methods: Three hundred twenty eight patients (age 18–94 years) with haematuria were prospectively evaluated from January 2001 to December 2004. All patients underwent sonography with transabdominal multifrequency probes (2.7–5MHz) BK 8803 or BK 8665 on 2102 Hawk imaging system (BK-Medical, Denmark). Patients with other cause of haematuria than focal bladder lesion(s) were excluded by US, intravenous urography and computer tomography. Accuracy of US was compared to gold standard method – cystoscopy in white light.

Results: In all patients we performed 493 sonographic examinations (337 in males and 156 in females) and 457 (92,8%) were evaluable. Sensitivity, specificity, positive and negative predictive value and overall accuracy of bladder lesion detection by transbdominal US was 60%, 91%, 94%, 54% and 73%, respectively. Multivariate analysis of evaluated parameters showed that exophytic or solid growth pattern, multiplicity and size greater than 15mm irrespective of location within the bladder were identified as important diagnostic signs.

Conclusions: We recorded that transabdominal US is an appropriate imaging technique for investigating adult patients with haematuria. Due to limited sensitivity and negative predictive value US cannot be a single diagnostic method and cystoscopy remains the gold standard. Good specificity and positive predictive value otherwise allow direct indication of cystoscopy in general or spinal anesthesia without confirmation by outpatient cystoscopy.