What ultrasound finding is produced when the bladder wall muscle weakens, resulting in an anechoic outpouching?

• A. Bladder diverticulum
• B. Ureterocele
• C. Vesicoureteral reflux
• D. Urethral stricture

Answer: (A)

When the bladder wall muscle (detrusor) is weak, the mucosa can herniate outward through the muscular layer, creating a pouch that extends from the bladder. On ultrasound, urine-filled spaces are anechoic, so this outpouching appears as a fluid-filled sac connected to the bladder. This is characteristic of a bladder diverticulum. A ureterocele is a dilation of the distal ureter within the bladder, seen as an intravesical cystic structure near the ureteral orifice, not an outward pouch of the bladder wall. Vesicoureteral reflux involves backward flow from the bladder to the ureters during voiding and may lead to hydronephrosis, not an anechoic pouch. A urethral stricture is a narrowing that causes obstruction, not outpouching of the bladder wall.