**6.9 Prostate TRUS**

362 Chronic Kidney Disease

Koch *et* al., performed renal ultrasound scans in a consecutive series of 556 elderly men with LUTS. 14 (2.5%) had hydronephrosis and serum creatinine levels appeared to be correlated with dilatation of the renal pelvis. The authors concluded that renal ultrasound is only indicated in patients with an elevated serum creatinine level and/or post-void residual urine volume (Koch, Ezz el Din et al. 1996). Renal ultrasonography has many advantages over intravenous urography (IVU) for upper urinary tract imaging: simultaneous evaluation of the bladder, post-void residual urine volume and prostate, better characterization of

 Fig. 2. Renal Ultrassound. Two ultrasound scans in BPH patient showing bilateral (right and

Chronic urinary retention leads to bladder wall thickening with trabeculations via smooth muscle hypertrophy and connective tissue infiltrates (Jones, Gilpin et al. 1991). This can lead in to a decline in bladder compliance with consequent functional or mechanical obstruction at the ureterovesical junction (Sutaria and Staskin 2000). More recently, the measurement of bladder wall thickness by transabdominal ultrasound has gained considerable interest as a noninvasive tool to assess bladder outflow obstruction (Kojima, Inui et al. 1997). Ultrasonic measurement of detrusor wall thickness at the anterior wall of bladders filled with ≥ 250 mL can securely detect bladder outlet obstruction if the value is ≥ 2 mm (Gabuev and Oelke 2011).

 Fig. 3. Bladder Ultrassound. Two ultrasound scans in BPH patient. It is possible to observe

the trabecullation, bladder wall thickening and diverticulum.

eventual renal masses, no radiation, no side-effects and lower cost.

left kidney respectively) ureterohydronephrosis.

**6.7 Bladder ultrasonography** 

**6.6 Renal ultrasonography** 

Prostate transrectal ultrasonography (TRUS) is performed to assess prostate size and shape, tissue characterization and occult carcinoma. There is no relationship between prostatic enlargement measures and CKD (Rule, Jacobson et al. 2005).
