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Patients with suspected bladder abnormalities were examined by noninvasive suprapubic sonography to define the accuracy of ultrasound for detecting and staging bladder carcinomas. In 103 patients, 65 tumors were found by cystoscopy, of which sonography detected 61 (94%). Four lesions less than 2-3 mm were missed at the bladder dome, the ventral wall, and side wall. The sonographic staging was correct in 83% of all tumor stages with the lowest value of 69% for T2/T3a tumors; excluding recurrent tumors, the overall accuracy increased. From these results, suprapubic sonography is considered to be a reliable noninvasive technique for detecting bladder tumors and for preoperative local staging. The staging results are comparable with reports in the literature on the accuracy of intravesical sonography.

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