Renal and Bladder Ultrasound Report Template: Normal and Abnormal Examples

Renal and bladder ultrasound: scope and complete report example

A renal and bladder ultrasound report should make clear which organs were examined, how well they were seen, and which measurements were obtained. A focused renal study, a complete urinary tract ultrasound, and point-of-care ultrasound do not have identical scope. This guide describes a diagnostic renal and bladder examination; adapt it to the actual request and local protocol.

When a complete urinary tract examination is performed, assess both kidneys in long and transverse planes and evaluate the distended bladder when possible. Document renal length for each kidney, cortical appearance and collecting systems. Describe visible ureters when dilated. If postvoid residual (PVR) is requested and measured, record the prevoid bladder volume, postvoid residual, and examination conditions. Kidney length and cortical thickness vary with age, body size, technique, and clinical setting; use local reference practice rather than a single threshold.

Normal renal and bladder ultrasound report

Fictional teaching example. The measurements illustrate report structure and are not universal normal cutoffs. This example assumes an adequately performed diagnostic examination with prevoid and postvoid images.

Examination: Ultrasound of the kidneys and urinary bladder.

Indication: [Clinical question, such as flank pain, hematuria, recurrent urinary infection, or incomplete bladder emptying.]

Comparison: [Date and modality, or none available.]

Technique and limitations: Grayscale ultrasound of both kidneys and the urinary bladder in longitudinal and transverse planes. [Color Doppler / ureteral jets / postvoid images] obtained as indicated. [State any limitation from body habitus, bowel gas, pain, incomplete bladder filling, or limited patient positioning.]

Findings:
Right kidney: Measures [ ] cm in longitudinal length. [Describe contour, cortical thickness and echogenicity, collecting system, stones, focal lesions, and perirenal region.]

Left kidney: Measures [ ] cm in longitudinal length. [Describe contour, cortical thickness and echogenicity, collecting system, stones, focal lesions, and perirenal region.]

Ureters: [No visible dilatation / describe visible dilated segment; distal ureters may not be seen.]

Urinary bladder: [Degree of distention.] [Describe wall and lumen; state whether a focal lesion or mobile debris is seen.] Prevoid volume: [ ] mL, if measured. Postvoid residual: [ ] mL, if measured after voiding.

Prostate or adjacent pelvic structures: [Measure and describe only when included and adequately seen.]

Impression:
1. [No hydronephrosis or other relevant urinary tract abnormality / describe the key finding.]
2. [Postvoid residual and measurement conditions, if obtained.]
3. [Relevant limitation or recommended next evaluation, if clinically appropriate.]

Examination: Ultrasound of the kidneys and urinary bladder.

Indication: Recurrent lower urinary tract symptoms and assessment of bladder emptying.

Comparison: None available.

Technique: Diagnostic grayscale ultrasound of both kidneys and the urinary bladder in longitudinal and transverse planes. Prevoid and immediate postvoid bladder images were obtained. The study is technically adequate.

Findings:
The right kidney measures 10.8 cm and the left kidney 10.6 cm in longitudinal length. Both kidneys have preserved contour and cortical appearance. No collecting system dilatation, shadowing calculus, or focal renal lesion is identified. No perirenal collection is seen. The visualized portions of the ureters are not dilated.

The urinary bladder is adequately distended before voiding, with smooth wall contour and no focal intraluminal lesion. Prevoid volume is approximately 310 mL. Postvoid residual volume is approximately 32 mL. The prostate is not included in this examination.

Impression:
1. No hydronephrosis or focal renal abnormality identified.
2. Postvoid residual volume is approximately 32 mL, measured immediately after voiding.

The normal example does not establish a universal reference range for renal size or PVR. Interpret measurements using the patient’s age, body habitus, indication, timing, and local practice.

Systematic review checklist

Kidneys

• Confirm laterality and record the maximum longitudinal length of each kidney.
• Assess contour, cortical appearance and thickness, corticomedullary differentiation where visible, renal sinus, collecting system, and perirenal tissues.
• State whether hydronephrosis or collecting system dilatation is present, and describe side and extent.
• Describe a suspected calculus by side, location, size if measurable, posterior shadowing or twinkling when present, and associated dilatation. Ultrasound may not show a small stone or a ureteral stone.
• Describe focal lesions by location, size, cystic or solid appearance, internal echoes, wall, septa, calcification, and Doppler findings if acquired. Do not assign a Bosniak category from standard grayscale ultrasound.
• If echogenicity is compared with the liver or spleen, state the comparison and recognize that a complete abdominal examination may not have been performed.

Ureters and urinary bladder

• The full ureter is often not seen. If a segment is visible, describe its location and whether it is dilated; do not infer the entire ureter is normal from a short visible segment.
• Assess bladder distention, wall contour, lumen, focal lesion, mobile debris, and any visible ureteral jets when they are relevant to the question.
• An underfilled bladder can limit evaluation and make the wall appear prominent. State this instead of calling wall thickening.
• If PVR is requested, obtain a documented postvoid measurement after the patient voids. Record prevoid and postvoid volumes when both are acquired, and note catheterization or other factors affecting measurement.
• Measure the prostate or other adjacent structures only when included in the request and adequately visualized. A renal/bladder ultrasound does not automatically constitute a complete pelvic examination.

Technique, comparison, and limits

• Name the examination as renal, renal and bladder, or complete urinary tract ultrasound according to what was actually performed.
• State relevant preparation or conditions: bladder fullness, ability to void, patient position, and whether the study was limited.
• Compare renal size, collecting system dilatation, cysts, and bladder residual with prior studies when available.
• Use color Doppler or other additional techniques only when acquired and relevant; do not imply Doppler evaluation if it was not done.
• Keep the impression focused on the clinical question and observed findings.

Selected abnormal examples

Fictional example: collecting system dilatation

The right renal pelvis and central calyces are mildly dilated. No shadowing calculus is identified in the visualized kidney or proximal ureter. The distal right ureter is not visualized. The left collecting system is not dilated.
Impression: Mild right hydronephrosis. No obstructing cause is identified on this examination; the distal right ureter is not visualized.

This wording reports the observed dilatation without asserting a cause or excluding a ureteral calculus that was not seen.

Fictional example: nonobstructing calculus

A 6 mm echogenic focus with posterior acoustic shadowing is present in the lower pole of the left kidney. No left collecting system dilatation is identified.
Impression: 6 mm left lower-pole renal calculus without hydronephrosis.

Use the term calculus when the appearance supports it. If a focus is equivocal, describe its appearance and limitation rather than stating a definite stone.

Fictional example: simple-appearing renal cyst

A 2.1 cm anechoic lesion with a thin smooth wall and posterior acoustic enhancement is present in the upper pole of the right kidney. No internal vascularity is detected on the acquired Doppler images.
Impression: Simple-appearing right renal cyst.

This example describes a classic simple cyst appearance on ultrasound. A complex lesion or an incompletely characterized mass should be described and, when appropriate, evaluated with a dedicated contrast-enhanced renal CT, MRI, or another locally appropriate examination. Standard ultrasound alone does not support Bosniak v2019 classification.

Fictional example: limited bladder assessment

The urinary bladder is underdistended, limiting evaluation of the wall and lumen. A reliable postvoid residual measurement could not be obtained.
Impression: Limited bladder assessment due to underdistention. Postvoid residual was not measured.

Common wording pitfalls

• Calling a partially seen kidney normal: State which kidney or region was incompletely visualized and how that affects the examination.
• Overcalling a stone from echogenicity alone: Shadowing, location, Doppler findings when acquired, and associated dilatation can support interpretation. Ultrasound has limits for small and ureteral stones.
• Reporting bladder wall thickness without documenting distention: An underfilled bladder limits wall assessment.
• Giving a PVR without timing: State that the measurement was obtained after voiding and document the measured volume; use local protocol for interpretation.
• Using a single “normal kidney length” cutoff: Length depends on patient and measurement context. Report the value and compare appropriately.
• Treating renal/bladder ultrasound as a whole-abdomen examination: Do not make negative statements about organs outside the actual study scope.
• Assigning Bosniak from standard ultrasound: Bosniak v2019 is a CT/MRI cystic renal mass classification. Use an appropriate cross-sectional study when classification is needed.

For organ-by-organ abdominal ultrasound scope, see the normal complete abdominal ultrasound report. For measurement context, see abdominal ultrasound measurements and organ-based reporting.

References

• American Institute of Ultrasound in Medicine. AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum, 2026 Revision. Journal of Ultrasound in Medicine. Article (opens in a new tab)
• American College of Radiology, American Institute of Ultrasound in Medicine, Society for Pediatric Radiology, and Society of Radiologists in Ultrasound. Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum. Revised 2021. Document (opens in a new tab)

Educational note: This article is a reporting aid, not a substitute for real-time image review, an appropriate examination protocol, or patient-specific interpretation.