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Kidneys and bladder

How a kidney and bladder ultrasound is done

Renal ultrasound is one of the most frequent requests: flank pain, follow-up after lithotripsy, edema, abnormal urinalysis, routine checkups. The scan itself is short. What takes time is the report you have to type afterwards. Here is what the exam covers, which numbers are considered normal and where the minutes go.

What is examined

The patient lies supine, then turns to the side. A curvilinear probe at 3.5-5 MHz is used. Each kidney is found in longitudinal and transverse planes from the flank and along the anterior axillary line. Breathing is adjusted to the plane: on deep inspiration the kidney moves down from under the ribs.

Each kidney is measured in three dimensions, with parenchymal thickness and the collecting system assessed separately. The sonographer checks position, respiratory mobility, contour, corticomedullary differentiation, stones and cysts, perirenal fat and the visible parts of the ureters.

The bladder is examined when full: volume, wall thickness, content, symmetry and the ureteric orifices. The patient is then asked to void, and the post-void residual is measured. This is the step most often skipped, and it gives the urologist the most useful information.

How long it takes

8-12minutes of scanning
+10minutes of typing
0minutes of typing by voice

The scan takes eight to twelve minutes of unhurried work. Then comes the part textbooks skip: the report. Typing it yourself, checking the sides and writing the impression adds about ten minutes. With fifteen patients a day, that is two and a half hours spent on typing alone.

The same study by voice

Now the same exam without a keyboard. The physician says out loud what they would otherwise say to themselves, and the report fills in on its own. Below is a real dictation for this case: play it in full, or click individual lines and watch each value land in its own row.

0:00 / 0:00
Tap a line to jump to that point of the recording.
RENAL AND BLADDER ULTRASOUND0
ParameterValueReference
Right kidney
Right kidney length100-120
Right kidney width50-60
Right kidney thickness40-50
Right kidney parenchyma15-25
Right collecting system
Right kidney stones
Right kidney cysts
Right kidney position
Right kidney mobility
Left kidney
Left kidney length100-120
Left kidney width50-60
Left kidney thickness40-50
Left kidney parenchyma15-25
Left collecting system
Left kidney stones
Left kidney cysts
Left kidney position
Left kidney mobility
Urinary bladder
Bladder volume
Bladder wall≤ 5
Bladder content
Post-void residual< 50
Other
Ureters
Perirenal fat

Numbers are recognized together with their units and go straight into the right rows, not into a block of text. Sides do not get mixed up: once the physician says "left kidney", every value goes to the left column until the next section starts. The reference range next to each value comes from the protocol package, so a deviation is visible right away.

Reference values are for adults and serve as orientation. Final interpretation always belongs to the physician, taking into account height, age and the clinical picture.

What the finished document looks like

The same data produces the finished documents. The default is a table: physicians are used to it, and it makes comparison with a previous study easy. The narrative version is chosen when the report goes into a discharge summary or a referral letter and findings need to be described in words.

RENAL AND BLADDER ULTRASOUNDdocument sample

Right kidney

Right kidney length108 mm100-120
Right kidney width52 mm50-60
Right kidney thickness45 mm40-50
Right kidney parenchyma17 mm15-25
Right collecting systemnot dilated
Right kidney stonesnone
Right kidney cystsnone
Right kidney positionnormal
Right kidney mobilitywithin normal limits

Left kidney

Left kidney length110 mm100-120
Left kidney width54 mm50-60
Left kidney thickness46 mm40-50
Left kidney parenchyma18 mm15-25
Left collecting systemnot dilated
Left kidney stonesnone
Left kidney cystsnone
Left kidney positionnormal
Left kidney mobilitywithin normal limits

Urinary bladder

Bladder volume240 ml
Bladder wall3 mm≤ 5
Bladder contentanechoic, no debris
Post-void residual20 ml< 50

Other

Uretersnot dilated
Perirenal fatunremarkable

Impression

No sonographic evidence of renal or bladder pathology. Post-void residual within normal limits.

RENAL AND BLADDER ULTRASOUNDdocument sample

Right kidney. Right kidney length 108 mm; Right kidney width 52 mm; Right kidney thickness 45 mm; Right kidney parenchyma 17 mm; Right collecting system not dilated; Right kidney stones none; Right kidney cysts none; Right kidney position normal; Right kidney mobility within normal limits.

Left kidney. Left kidney length 110 mm; Left kidney width 54 mm; Left kidney thickness 46 mm; Left kidney parenchyma 18 mm; Left collecting system not dilated; Left kidney stones none; Left kidney cysts none; Left kidney position normal; Left kidney mobility within normal limits.

Urinary bladder. Bladder volume 240 ml; Bladder wall 3 mm; Bladder content anechoic, no debris; Post-void residual 20 ml.

Other. Ureters not dilated; Perirenal fat unremarkable.

Impression

No sonographic evidence of renal or bladder pathology. Post-void residual within normal limits.

RENAL AND BLADDER ULTRASOUNDPDF

The PDF is built from the same report and is ready to print or send to the patient.

Right kidney

Right kidney length108 mm100-120
Right kidney width52 mm50-60
Right kidney thickness45 mm40-50
Right kidney parenchyma17 mm15-25
Right collecting systemnot dilated
Right kidney stonesnone
Right kidney cystsnone
Right kidney positionnormal
Right kidney mobilitywithin normal limits

Left kidney

Left kidney length110 mm100-120
Left kidney width54 mm50-60
Left kidney thickness46 mm40-50
Left kidney parenchyma18 mm15-25
Left collecting systemnot dilated
Left kidney stonesnone
Left kidney cystsnone
Left kidney positionnormal
Left kidney mobilitywithin normal limits

Urinary bladder

Bladder volume240 ml
Bladder wall3 mm≤ 5
Bladder contentanechoic, no debris
Post-void residual20 ml< 50

Other

Uretersnot dilated
Perirenal fatunremarkable

Impression

No sonographic evidence of renal or bladder pathology. Post-void residual within normal limits.

Frequent questions

Does the bladder need to be full before the exam?

Not for the kidneys, but yes for the bladder: a comfortable filling of about 200-300 ml. If a post-void residual is planned, warn the patient in advance that they will be asked to void after the first part of the exam.

What is a normal post-void residual?

In adults, up to 50 ml. In patients over 65, up to 100 ml is often accepted. More than 150 ml deserves a urology opinion, and more than 400 ml suggests urinary retention.

Why is the right kidney often lower than the left?

The liver sits above the right kidney and pushes it down, so a position one to two centimeters lower than the left is considered a normal variant, not pathology.

Does the service make a diagnosis?

No. It turns your dictation into a structured report and adds reference values. Interpretation, the impression and the signature stay with the physician, who checks every value.

What it changes on a shift

A renal scan is short, but the routine around it is long. Take the typing out, and the day no longer ends with a pile of unfinished reports, while the patient gets the document right after the exam.

The first 15 reports are free. After that the price depends on the pack size: from 0.42 to 0.53 USD per report, whatever the length of the dictation. No subscription.

20 reports · 0.53 USD per report50 reports · 0.50 USD per report · -5 %100 reports · 0.48 USD per report · -10 %200 reports · 0.45 USD per report · -15 %500 reports · 0.42 USD per report · -20 %
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