Observation of the interureteric ridge and ureteral orifice in a patient with a cystocele using color Doppler ultrasonography via the prolapsed bladder

摘要

The presented patient was a 61-year-old female who was diagnosed with a cystocele (stage IV), and we performed transvaginal reconstructive surgery. Before the surgery, cystography and ultrasonography via the prolapsed bladder were performed. Cystography was done in the standing position with the lateral view. Ultrasonography was also done in the standing position. The ultrasound examination was performed with the HITACH HI VISION Preirus (Hitachi Medical, Tokyo, Japan) equipped with a linear probe (5–18 Hz). The probe was attached to the vaginal wall over the prolapsed bladder in the sagittal and transverse sections. Color Doppler ultrasonography was also done. Cystography detected a ridge passing transversely across the prolapsed bladder in the standing position (Fig. 1a). Likewise, ultrasonography revealed the ridge dividing the inside of the prolapsed bladder transversely (Fig. 1b). In addition, ultrasonography revealed a pair of hollows on the top of the ridge (Fig. 2a). Color Doppler ultrasonography revealed intermittent urine flow from the pair of hollows and contraction of the hollows synchronized with the urine flow (Fig. 2b).