prostate ultrasound

An ultrasound of the prostate allows one to get an idea of its size, shape, structure, as well as the features of its relationship with other pelvic organs.

Indications for ultrasound examination of the prostate gland

• Determining the size and detecting enlargement of the gland.
• Diagnostics of neoplasms and various diseases.
• Identifying the causes of male infertility.
• Difficulty urinating.

It is necessary to prepare for the examination. The patient is recommended to come in comfortable clothes that do not restrict movement and to do a cleansing enema 2-4 hours before the procedure. The ultrasound itself takes about 20 minutes. The only limitation of such diagnostics is that it is not performed for patients who have had their rectum removed as a result of surgery. The study is carried out in real time, which allows it to be used in various minimally invasive procedures.

Ultrasound signs of prostate pathology

An ultrasound of the prostate allows one to get an idea of its size, shape, structure, as well as the features of its relationship with other pelvic organs.

An ultrasound image of the prostate can be obtained during a non-invasive examination through the anterior abdominal wall with a full bladder, as well as with TRUS. It should be noted that transabdominal prostate sonography often only gives an idea of its shape and size. TRUS is used for a more detailed study of the tissue structure and determination of blood flow characteristics during Dopplerography. An echographically unchanged prostate during frontal scanning is a round symmetrical formation, on a sagittal section it is oval, with a clear, even contour and a well-differentiated capsule separating the gland from the highly echogenic paraprostatic tissue. The prostate tissue is homogeneous, with moderately low echo density. Normally, the gland does not protrude into the lumen of the bladder.

In frontal scanning, the seminal vesicles are visualized on the sides of the prostate, just behind its cranial part. On the echogram, they look like echo-negative formations of an elongated shape with a diameter of up to 1 cm.

An ultrasound image of the prostate can be obtained during a non-invasive examination through the anterior abdominal wall with a full bladder, as well as during transrectal ultrasound. It should be noted that transabdominal prostate echography often only gives an idea of its shape and size. Transrectal ultrasound is used for a more detailed study of the tissue structure and determination of blood flow characteristics during Dopplerography. An echographically unchanged prostate during frontal scanning is a round symmetrical formation, on a sagittal section it is oval, with a clear, smooth contour and a well-differentiated capsule separating the gland from the highly echogenic paraprostatic tissue. The prostate tissue is homogeneous, with moderately low echo density. Normally, the gland does not protrude into the lumen of the bladder.

In frontal scanning, the seminal vesicles are visualized on the sides of the prostate, just behind its cranial part. On the echogram, they look like echo-negative formations of an elongated shape with a diameter of up to 1 cm.

Prostate adenoma on scanograms is a homogeneous formation, different in shape and size, but always with clear even contours and a well-defined capsule. Adenomatous tissue of the gland can develop unevenly and look asymmetrical during frontal echoscanning. With the predominance of glandular elements, edema of the aroma due to adenoma and the accompanying inflammatory process, the echogenicity of the gland can be diffusely reduced: small anechoic rounded formations are sometimes found in the parenchyma. In the case of chronic inflammation, hyperechoic inclusions (sometimes with an acoustic path) appear in the parenchyma, located, as a rule, in the transitory zone and along the surgical capsule or on the border of the central and peripheral zones.

To establish the causes of lower urinary tract obstruction and assess structural changes in the urethra, micturition ultrasound cystourethroscopy (echourodynamic study) is used. The essence of the method is transrectal ultrasound of the prostate, performed during urination. The passage of urine through the urethra allows the latter to be seen during echography, which is impossible when it is in a subsided state. On transrectal echograms at the time of urination, the neck of the bladder is determined as a funnel with a clear and even internal contour, the prostatic and, partially, the membranous sections of the urethra, about 5 mm thick. If the cause of obstruction is prostate adenoma, then the urethra in this place is visualized as a thin anechoic strip less than 5 mm wide. Deviation of the urethra by adenomatous tissue depends on the form of its growth. Micturition ultrasound cystourethroscopy is of great importance in recognizing urethral strictures, especially if the patient has prostate adenoma. It allows determining the condition of the urethra proximal to the site of stenosis, localization and, in some cases, the length of the stricture. During urination, if its violation is not associated with prostate adenoma. with stricture, dilation of the urethra is noted above the stenosis (including the prostatic section). With inflammatory stenosis, the outlines of the urethra are clear, rectilinear, the diameter of the healthy part of the urethra is unchanged.

In addition to diagnosing structural changes in the urethra, micturition ultrasound cystourethroscopy in combination with UFM or Doppler ultrasound of the urine flow allows detecting functional changes in the urethra and bladder.

IVO in prostate adenoma leads to structural and functional changes in the urinary tract (e.g., bladder). Determining the volume of residual urine using ultrasound is an important method for diagnosing and staging prostate adenoma.

Prostate cancer is characterized by echographic features in the form of the formation of heterogeneous hypoechoic nodes in the peripheral zone.

Depending on the stage, symmetry disturbances, uneven contours and thinning of the capsule are observed. In 13% of cases, ultrasound shows that cancerous nodes have a more pronounced echogenicity than the gland tissue, and in 9% they are isoechoic or not detectable at all.

Echographic changes in prostatitis depend on the form of inflammation and are extremely diverse. Thus, in acute prostatitis, an increase in the size of the gland and a decrease in its echo density are noted both in individual areas and in the entire gland. An organ abscess is quite easily diagnosed using transrectal ultrasound. The echographic picture has characteristic features. An abscess looks like a round or irregular formation of significantly reduced echogenicity, almost approaching that of a liquid structure (anechoic in nature). The structure of the prostate abscess is heterogeneous due to the content of purulent-necrotic masses in it; anechoic (liquid) inclusions are often observed. With color Doppler mapping, there is no blood circulation in the abscess area, and a clearly defined vascular network is found around it.

In chronic inflammatory process in the prostate outside of exacerbation, changes in the structure of the organ associated with sclerotic changes come to the fore, which in echography look like hyperechoic areas without an acoustic effect. Stones in the prostate look like hyperechoic, often multiple formations with a clear acoustic path. Echo-Dopplerography of the prostate allows to study the features of blood circulation in it in various diseases, which increases the diagnostic value of the method.

Where can I get a prostate ultrasound?

Where to do an ultrasound of the prostate gland and what are the main indications for its implementation, we will consider these questions. Ultrasound scanning of the prostate or ultrasonography is a diagnostic method that can be used to identify a number of diseases and pathologies. The transrectal method is used for the study, that is, the introduction of an ultrasound sensor into the patient's rectum.

Kyiv:

• ACMD "Medox" - st. Petropavlovskaya, 14D, tel. [phone].
• Clinic "Medicom" - 6D Heroy Stalingrad Avenue, tel. [phone].
• Multidisciplinary medical center "Harmony of Health" - st. O. Pchilki, 2, tel. [phone].
• Network of medical clinics "Viva" - Lavrukhin St., 6, tel. [phone].
• Medical and diagnostic center "My family" - Voloshskaya st., 50/38, tel. [phone].

Moscow:

• Clinical Hospital No. 122 named after L.G. Sokolov (oncology department) – Prospekt Kultury, 4, tel. [phone].
• Polyclinic "Expert" - st. Pionerskaya, 63, tel. [phone].
• Medical center "Teiya" - st. 11th line V.O., 40, tel. [phone].
• Clinic "A-Media" - Prosveshcheniya Avenue, 33, tel. [phone].
• Medical and genetic center "Life" - Kolomyazhsky Avenue, 28/2, tel. [phone].

Saint Petersburg:

• Medical center "MedSwiss" - st. Gakkelevskaya, 21, tel. [phone].
• SM-Clinic – Udarnikov Avenue, 19/1, tel. [phone].
• MMC "Union Clinic" - st. Marata, 69/71, tel. [phone].
• Clinic "AndroMeda" - st. Zvenigorodskaya, 12, tel. [phone].
• Medical and diagnostic center "Kivach" - line 26th V.O., 15.