Bladder masses are generally echogenic, irregularly shaped, and are found either mounted on the bladder wall or in areas of irregularly increased bladder wall thickness.
The majority of bladder masses are from transitional cell carcinoma. However, other causes include bladder diverticulitis, congenital outpouching of the bladder wall, and bladder wall thickening. Any sign of a bladder mass requires further urologic evaluation, and possibly cystoscopy and further imaging.
Since blood clots can be mistaken for bladder masses, irrigation of the bladder followed by another ultrasound scan is recommended (Geertsma et al). Blood masses are often mobile so it is recommended to have the patient roll onto their sides during the follow-up scan. If a blood clot is present, it should move as the patient changes position.