Urologic imaging helps your care team see the organs in the urinary and male reproductive systems. These tests give us detailed pictures of what’s happening inside your body. They help us find and treat problems in the body.

Urologic imaging looks at:

• Urinary tract: These organs make urine and move it out of your body. They include the kidneys, ureters, bladder, and urethra.
• Male reproductive system: These organs make semen and move it out of your body. They include the prostate, penis, testicles, scrotum, epididymis, vas deferens, seminal vesicles, bulbourethral glands, and urethra.

We use many tools to image the urinary and reproductive systems.

They include:

• X-rays: This scan uses a small amount of radiation to take quick images. They can check for kidney stones, blockages, or changes in the size or shape of the bladder, kidneys, or ureters.
• Computed tomography (CT) scan: CT scans use X-rays to take detailed pictures from many angles. They can help us find tumors, stones, or signs of infection in the kidneys, bladder, or prostate.
• Magnetic resonance imaging (MRI): This test uses magnets and radio waves to take very detailed pictures of soft tissue. It can see inside the prostate and nearby areas.
• Ultrasound: This test uses sound waves to create real-time images. Ultrasound helps us guide biopsies or check for blockages or fluid buildup in the kidneys, bladder, and prostate.
• Nuclear medicine scans: This scan uses small amounts of radioactive material. These scans show how well your kidneys work and how urine flows through your urinary tract. They can help us find blockages, scarring, or other kidney problems.

You may need urologic imaging to check for problems with your urinary system. Men may also need these tests to look at reproductive or sexual health concerns. 

These imaging tools help us diagnose and treat:

• Trouble with urination, bladder control, or prostate health
• Kidney or bladder stones
• Infertility or erectile dysfunction in men
• Cancer of the bladder, kidneys, prostate, or testicles
• Follow-up after cancer surgery or treatment

Most of the urologic imaging tests we do are when symptoms appear or when lab tests show something unusual. But in some cases, imaging is part of routine screening, especially as people age or if they have some risk factors.

For example, you may have a kidney ultrasound if you have high blood pressure, blood in your urine, or chronic urinary issues, even if you don’t have a kidney condition.

We use imaging tests when symptoms, a physical exam, or other tests show you may have a health issue. They help us better understand what’s going on and help us plan treatments.

Prostate imaging tests

These specialized imaging tests look closely at the prostate gland and nearby tissues. These tests help us find signs of cancer, monitor an enlarged prostate, and plan biopsies or further care.

• Transrectal ultrasound (TRUS): An ultrasound wand in the rectum gives a detailed look at the prostate gland. It can check for signs of prostate cancer, infection, or enlargement. We may also use it to guide a prostate biopsy or see if cancer treatment is working.
• Multiparametric MRI: This test shows the flow of fluid and blood in the prostate, which shows us which parts are cancerous. It gives a clear, detailed view of the prostate and nearby tissues. It helps us find tumors, measure the spread of cancer, plan future care, and see if cancer treatment is working.

Kidneys, bladder, and urinary tract imaging tests

These imaging tests help us examine the kidneys, ureters, and bladder. These tests help us find signs of cancer or other diseases and plan biopsies or further care.

• CT urography: A CT scan of the urinary system, including nearby lymph nodes and organs. We may also use this after prostate surgery or to see an enlarged prostate.
• Intravenous pyelogram (IVP): A special X-ray test that helps see the urinary system. We watch dye travel through your kidneys and collect in your urine. It can help us see stones, injuries, infections and tumors. We may do this test when there is blood in your urine.
• Renal scintigraphy: A radioactive medicine highlights your kidneys, and a special gamma camera takes detailed pictures. We can see how your kidneys work.
• Dual-energy CT scanning: This gives us highly detailed images using 2 types of X-ray energy. It can tell us what type of kidney stones you have, helping guide care.

Bladder and urethra imaging tests

We use these tests to see the shape and function of your bladder and urethra. They help us see blockages, leakage, or other issues that cause problems emptying the bladder. 

• Cystoscopy: We insert a thin, lighted tube with a tiny video camera into the urethra. This helps us see the inside of your bladder and urethra and take tissue samples to check for cancer, if needed.
• Fluorescence cystoscopy: You take a light-activated drug during a cystoscopy to make tumors in the bladder glow.
• Voiding cystourethrogram (VCUG): While you lie on an X-ray table, we add dye into your bladder. We take X-rays while your bladder is full and as it empties.
• Urodynamic testing with fluoroscopy: A special X-ray (fluoroscopy) takes real-time images while your bladder fills with fluid. It helps us see your bladder shape, how the muscles work, and whether urine flows the right way. This can help us diagnose bladder issues. 

We use imaging to safely guide tests and treatments in the urinary and male reproductive systems. These can help manage pain, improve function, and avoid the need for open surgery.

Image-guided bladder procedures

Image-guided bladder treatments for tumors, leakage, and issues with urine flow.

• Bladder Botox injection: We use cystoscopy to inject Botox into your bladder. It relaxes your bladder muscles, so you don’t pee as often or have leaking accidents.
• Suprapubic catheter placement: We use imaging to place a tube to drain urine. It goes through a small hole in your belly into your bladder.
• Transurethral resection of bladder tumor: Using cystoscopy, we cut out and remove bladder tumors. Fluorescence cystoscopy or narrow-band imaging can help us better see the tumors.

Image-guided kidney and ureter procedures

Image-guided treatments for kidney stones, to drain urine and help urine flow.

• Percutaneous nephrostomy: This procedure places a drain to move urine from your kidney through a tube in the skin into a bag. We use imaging to guide the placement of a thin, flexible tube into your kidney.
• Percutaneous stone removal: This is a way to remove kidney stones using a needle through the skin. We use imaging to guide the needle. It’s also called percutaneous nephrostolithotomy or nephrolithotomy.
• Ureteral stenting: We use cystoscopy to insert a thin, flexible tube into the ureter. It connects the kidney to the bladder to help urine flow.

Image-guided embolization procedures

Embolization blocks blood flow with a tube, tiny coil, or liquid. Using image guidance, we can see the veins to place the blockage accurately. It can help with swelling, pain, or an enlarged prostate. 

• Prostate artery embolization: Blocking blood flow helps soften and shrink an enlarged prostate.
• Varicocele embolization: A varicocele is an enlarged vein in a man’s scrotum. The abnormal blood flow causes pain, swelling, and can affect fertility. Blocking the vein can resolve symptoms.

Image-guided tumor treatment

We use imaging to guide a thin needle into tumors to heat and destroy them. This is image-guided tumor ablation, typically using ultrasound, CT, or MRI.

It includes:

• Cryoablation: Freezes the tumor with a thin needle to destroy cancer cells
• Radiofrequency ablation (RFA): Uses heat from electrical energy to destroy the tumor
• Microwave ablation (MWA): Destroys the tumor using high-powered microwave energy

These treatments let us destroy tumors without open surgery.