An elderly man presented with haematuria and urinary retention.
Two masses are seen in the distended bladder. An echogenic mass is seen on the left bladder wall which has flow (seen on color and pulse doppler) and did not move when the patient was rolled onto their side. Secondly, there is a more echogenic mass seen in the neck of the bladder, this does not have any flow and is seen to be mobile (moving when the patient is rolled). The first mass is a tumour and the second a clot which caused the retention.
Bladder masses may be clot, neoplastic, inflammatory masses or foreign bodies. Mobility and the presence or absence of flow are important distinguishing features.