Ultrasound (an ultrasound scan) is the first and most commonly used imaging test in urology. It works with harmless sound waves, involves no radiation, needs no anaesthetic and gives a result on the spot. At Dr Penev’s practice the ultrasound is part of the consultation itself: the doctor who takes your history and examines you holds the probe himself and interprets the image in the light of your symptoms. This means the diagnosis and plan are often clear at the very first visit.
When it is recommended
A urological ultrasound is done for:
- pain in the lower back or groin, renal colic, suspected kidney stones;
- blood in the urine or repeated urinary tract infections;
- difficult, frequent or night-time urination in men – to assess the prostate and residual urine;
- a raised PSA or monitoring of an enlarged prostate;
- swelling, a lump, heaviness or pain in a testicle, enlarged veins in the scrotum;
- monitoring of kidney cysts and known stones, follow-up after stone treatment;
- a chance finding on another test that needs to be clarified;
- a preventive urology check-up in men after the age of 45–50, and earlier if there is a family history.
Two situations should not wait for a booked appointment: sudden severe pain in a testicle, when torsion is possible and every hour counts, and renal colic with a high temperature and shivering. In both cases go to an emergency department straight away or call 112 (the European emergency number).
What happens
You lie on the couch, gel is applied to the skin and Dr Penev uses the probe to examine, in turn, the kidneys – from both sides and through the back – the bladder and, in men, the prostate, which is seen through the full bladder. You then pass urine and the bladder is measured again to find the residual urine. The scrotum and testicles are examined with a finer probe, if needed with Doppler, which shows the blood flow. The scan is completely painless – you feel only light pressure and the coolness of the gel – and takes about 10 to 20 minutes, after which the doctor explains straight away what he has seen.
Preparation
- For an ultrasound of the kidneys, bladder and prostate, come with a full bladder: drink about half a litre to one litre of water an hour beforehand and do not pass urine. The full bladder is the “window” through which the bladder and prostate can be seen.
- Avoid heavy and gas-forming food in the preceding hours; complete fasting is not necessary.
- An ultrasound of the testicles needs no preparation.
- Bring previous ultrasound reports, computed tomography (CT) scans and test results – comparing them over time is often the most valuable information.
- Take your medicines as usual.
What ultrasound shows
In the kidneys it assesses the size, the thickness of the kidney tissue, stones, cysts, tumours and widening of the collecting system – hydronephrosis, which suggests an obstruction to the drainage of urine. In the bladder it looks at the thickness and smoothness of the wall, stones, growths and the amount of residual urine. In the prostate it measures the volume and assesses whether the gland bulges into the bladder – information that guides the choice of treatment. In the scrotum, ultrasound distinguishes fluid around the testicle (hydrocele), enlarged veins (varicocele), inflammation of the epididymis and solid lumps in the testicle itself, which always need to be investigated quickly.
Ultrasound also has its limits: stones in the ureter cannot always be seen, and prostate cancer cannot be ruled out with ultrasound alone. That is why Dr Penev interprets the image together with your symptoms, the examination and the laboratory results and, if needed, arranges a CT scan, an MRI scan or a cystoscopy. You receive a written report, with images if necessary, which you can also use with other specialists.
Where it is done
The ultrasound is done at Dr Penev’s urology practice in Plovdiv, 5 Anri Barbyus St, with modern ultrasound equipment, most often as part of the urology consultation and by appointment. For patients from Karlovo, whether an ultrasound can be done at Vita Med Medical Centre, Karlovo, is confirmed when you book. Inpatients are scanned at the Department of Urology at Kaspela University Hospital (UMBAL Kaspela), Plovdiv.
Price
The ultrasound is most often done as part of the urology consultation: initial consultation €50, follow-up consultation €30. The price of a stand-alone ultrasound scan is confirmed when you book.
A painless test of about ten minutes is often enough to find or rule out a problem in the kidneys, bladder, prostate or testicles. Book a consultation with an ultrasound scan with Dr Penev.
Frequently asked questions
Is ultrasound harmful, and how often can it be done?
Ultrasound uses sound waves, not ionising radiation, and can be repeated as often as necessary – including in children and pregnant women.
Do I need to fast before a kidney ultrasound?
It is not essential. It is enough for your bladder to be full and to avoid heavy, gas-forming food in the hours before the scan, so that the image is clearer.
Can ultrasound detect prostate cancer?
Abdominal ultrasound shows the volume and shape of the prostate, but it cannot rule out a malignant disease. For that, PSA, a rectal examination and, if needed, an MRI scan and a biopsy are used.
Can a stone in the ureter be seen on ultrasound?
Not always. Stones in the kidney and bladder show up well, but those in the middle part of the ureter are often hidden behind the bowel. In that case an indirect sign is looked for – swelling of the kidney – and if needed a CT scan is done.
What is residual urine and why is it measured?
It is the amount of urine left in the bladder after you pass urine. A raised amount shows that the bladder is not emptying well – because of an obstruction or weakened muscle – and is an important guide when choosing treatment.
The information on this website is for general education and does not replace an examination and consultation with a doctor. If you have urgent symptoms, seek medical help immediately or call 112.