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Post void residuals (length x width x height) / 2 (nl < 25 ml). Bladder wall thickening due to bladder outlet obstruction (prostate, posterior urethral valves), neurogenic bladder, cystitis, edema, radiation, neoplasms. Distended bladder wall thickness < 3 mm, non-distended < 5 mm. Pediatric distended 1-3 mm, non-distended 2-4 mm.

Transitional Cell Carcinoma

90%, arise along the posterior wall in the region of trigone. Polypoid into the bladder lumen, or infiltrative with wall thickening. Smoking, analgesics.

Squamous Cell Carcinoma

5% (schistosomiasis, neurogenic bladder, chronic inflammations)


2%, in urachal remnants and in bladder extrophy; bladder ca M >> F

DDx: blood Clots, Stones, Fungus balls, Invasion from adjacent tumors (prostate, rectum, cervix, uterus), adjacent Inflammatory processes (diverticulitis, appendicitis, Crohn’s, PID), Ureteroceles, Urachal cyst, Fistulas, Wall Trabeculation, BPH, Endometriosis, malakoplakia, leukoplakia, TB, Schistosomiasis

Bladder diverticula

Due to outlet obstruction, fluid filled structure adjacent to the bladder

Urachal diverticulum or cyst

Incomplete closure of the urachus, if umbilical segment closes but vesicular don’t - diverticulum; if incomplete closure between vesicle and umbilicus - cyst


Dilatation of the intramural portion of the distal ureter protruding into bladder

Urethral diverticulum in females

TV and trans-perineal US