In situations where men show signs of infectious and inflammatory diseases of the genitourinary system, doctors must prescribe sonography. Ultrasound examination (ultrasound) is a highly effective method for diagnosing the condition of internal organs. To obtain a reliable result, urological patients should know how to prepare for an ultrasound of the prostate and bladder.

Indications for sonography of the genitourinary system in men

The main indication for prescribing an ultrasound procedure of the prostate and bladder is the presence of diseases of the genitourinary system. Standard signs of urological pathologies are: painful symptoms in the area of ​​the prostate gland and scrotum, an uncomfortable sensation of a spasmodic nature in the sacrum, frequent urges for the natural outflow of urine, cloudy color and strong odor of urine, enuresis, nocturia, erectile dysfunction. All this together not only brings significant discomfort to men, but also disrupts the usual way of life.

At the first signs of illness, you should promptly contact a qualified urologist to avoid worsening the clinical picture. After rectal palpation of the prostate and history taking, the patient must undergo a series of laboratory and bacteriological tests. Ultrasound of the bladder and prostate gland is especially widely used in urology, since this procedure allows us to identify structural changes in the pelvic organs, which will confirm the presence of pathology.

In addition, this examination is carried out in the following situations:

1. For the purpose of diagnosing the natural functioning of the kidneys.
2. Detection of pyelonephritis, which develops against the background of long-term prostatitis of bacterial etiology.
3. In the presence of benign prostatic hyperplasia (adenoma).
4. Patients who are suspected of having kidney stones.
5. For erectile dysfunction, decreased libido and other disorders of sexual life in men.
6. To confirm the presence of a tumor-like neoplasm of a malignant nature.
7. With congestion in the pelvic organs, as a result of which local blood circulation is disrupted.

Types of examination using ultrasound

In modern medicine, there are three ways to perform ultrasound of the bladder and prostate. Each method of examining the genitourinary system has its own characteristics of preparation for the procedure. The choice of technique is made by the attending physician based on the expected diagnosis and existing concomitant diseases.

Doctors identify the following characteristic features of the process of examining the pelvic organs in men:

Type of ultrasound examination	Specifics of the event
Transabdominal	A unique way of conducting an instrumental test, suitable for both men and women. The essence of the procedure is to examine the internal organs with a special sensor, which is placed along the anterior abdominal wall. This manipulation is absolutely painless, but not all categories of urological patients can undergo it. Excessive obesity is a contraindication, since under such conditions the visibility of internal organs and, accordingly, the reliability of the examination result are significantly reduced.
Transrectal (TRUS)	This form of ultrasound involves inserting a special rectal sensor into the rectum, which makes it possible to identify the dependence of prostate pathology on the condition of the hollow organ of the excretory system. Transrectal ultrasound is the most reliable diagnostic method
Transurethral (TUUS)	In this ultrasound test, the doctor inserts a medical probe into the urethra. As a result of the procedure, it is possible to identify the condition of the prostate gland and urethra. The procedure is characterized by increased pain, so painkillers are required. This examination method is characterized by increased efficiency, but at the same time there is a risk of damage to the urethra in patients. Therefore, it is extremely important that the specialist has qualifications and sufficient experience in carrying out such manipulations.

Preparatory activities for the correct completion of the procedure

In order for the examination to be as comfortable as possible and the result to be reliable, patients should know how to properly prepare for an ultrasound of the prostate and bladder.

When a patient is preparing for this procedure, it is important to fully comply with medical recommendations. The main requirement for a transabdominal examination is a full bladder. This need is due to the fact that in this state both the prostate and the hollow organ of the excretory system are better visualized. To do this, urological patients should drink 1-1.5 liters of distilled water one hour before the procedure. It is advisable that at the beginning of the examination the patient does not experience a strong urge to naturally drain urine, since the doctor will put a little pressure on the abdominal cavity.

As a rule, sonography of the hollow organ of the excretory system is carried out in conjunction with an examination of the prostate gland.

When planning TRUS, preparation for manipulation involves the need to empty the intestines of feces naturally. In case of stool disorder in the form of constipation, you can resort to medications that improve peristalsis or perform a microenema. If the rectum is empty, the ultrasound sensor will not cause discomfort when inserted into the anus.

TUUS is the most painful procedure. Therefore, preparing for an ultrasound of the bladder in this way requires a more careful approach. To relieve painful symptoms, doctors use local anesthesia. Before the examination, it is necessary to conduct a preliminary test to identify individual sensitivity to the medication. In addition, you should inform about existing diseases of the cardiovascular system, liver and kidney pathologies.

On the eve of sonography of the prostate gland and the hollow organ of the excretory system, you should stop drinking alcoholic beverages and nicotine. A day before instrumental diagnostics, you should take activated carbon, which is designed to curb excessive gas formation. In most situations, doctors recommend not eating on the morning of the sonography.

To improve visualization, a few days before the procedure, you need to limit the consumption of foods that increase flatulence: milk, yogurt, carbonated drinks, caffeine, cabbage, beans, raw vegetables and fruits.

In situations where preparation for an ultrasound of the prostate gland was not fully completed, the doctor may reschedule the procedure. Otherwise, the sonography results will be unreliable and repeated manipulation will be required.

Conclusion

In modern urology, ultrasound diagnostics is one of the highly effective methods for identifying urological pathologies. It is during this manipulation that the doctor receives comprehensive data on the condition of the genitourinary system. To obtain a good visual picture and reliable results, patients must fully comply with the recommendations regarding preparation for this instrumental examination.

A timely ultrasound allows one to identify pathology of the pelvic organs in men in the early stages and avoid aggravation of the situation.

Ultrasound examination of the pelvic organs in men (ultrasound of the prostate gland, ultrasound of the scrotum) is carried out mainly with a transrectal sensor (TRUS), in some cases with filling of the bladder.

Ultrasound examinations of the pelvic organs in men - TRUS are carried out:

• according to the medical examination program,
• for the diagnosis of diseases of the prostate, scrotum, bladder (prostatitis, prostate adenoma, varicocele, hydrocele, bladder formation, etc.),
• for diagnosing acute inflammatory processes and monitoring during treatment.

Preparing the patient for ultrasound of the pelvic organs.

Preparation for transabdominal ultrasound of the prostate and bladder.
1-2 days before the ultrasound, it is necessary to avoid foods that could potentially increase gas formation in the intestines or cause problems with its functioning. This list is quite individual, but most often it includes fresh fruits and berries, brown bread, pastries, cakes, pastries, alcoholic and carbonated drinks, and juices. On the day before the ultrasound, you need to skip breakfast if it is carried out in the morning, or get by with a light one if it is scheduled for the second half of the day.
1-2 hours before the ultrasound you should drink 1-1.5 liters of non-carbonated liquid. It is best if it is clean drinking water, but it can be replaced with weak unsweetened tea or non-acidic juice diluted with water.
After this, you should not urinate because the ultrasound requires a completely full bladder. If the urge is too strong, you can release some of the urine, but do not empty the bladder completely. Afterwards you should drink another glass of water.

Preparation for transrectal (through the rectum) ultrasound of the bladder and prostate gland.
If you have been prescribed a transrectal ultrasound, preparation for it will be completely different. In this case, there is no need to fill the bladder, but since the access will be through the rectum, it must be cleared of feces, which may interfere with the ultrasound.
Various methods can be used for this:
Taking colon cleansing medications, for example, Fortran. It completely cleanses the intestines without harming the flora necessary for normal digestion. It should be taken on the day before the examination according to the attached diagram. For complete cleansing, you need to drink 3 or 4 packets, dissolving each in a liter of water. If the examination is scheduled for the morning, then all packets should be drunk with water on the same day, but if it is planned for the second half of the day, then the second and third are left for the morning. Fortran provides high-quality cleansing, but requires lengthy preliminary preparation and consumption of large amounts of liquid.
Cleansing enema. A simpler option is to give a small, 200-300 milliliter enema of warm water in the morning, 2-3 hours before the scheduled examination. In some clinics it is included in the cost of the examination and may be carried out immediately before the examination.

Ultrasound examination plays an important role in determining bladder diseases. This diagnostic method is prescribed in the presence of symptoms indicating pathology of the genitourinary system. To obtain reliable results, an ultrasound of the bladder should be taken seriously and prepared. All instructions regarding preparation for the examination are given by the doctor and it is very important to follow them. This method has no contraindications and is allowed even for children.

Indications for ultrasound examination

This examination method is distinguished by its simplicity, absence of contraindications, complications, and speed of obtaining results. A study is prescribed for the following symptoms:

• frequent or difficulty urinating;
• incontinence;
• suspicion of kidney stones;
• with cystitis;
• urine laced with blood;
• suspicion of vesicoureteral reflux.

Additionally, a study is prescribed to assess kidney function, diagnose cystitis (both chronic and acute), and pyelonephritis. If adenoma or inflammation is suspected in men, prostate examinations are simultaneously performed. Women may be prescribed additional examinations of the uterus and appendages to fully assess the condition of the genitourinary system.

How to properly prepare for an ultrasound of the bladder

Preparation for a bladder ultrasound plays a very important role. By the time of the procedure, the organ should be filled - this will help determine the thickness of the walls, the shape of the organ and its contour. To do this, approximately 1.5 - 2 hours before the ultrasound, you need to drink about 2 liters of liquid in the form of teas, compotes, still water. There is another way - do not empty the bladder for 5 - 6 hours before the procedure.

If the ultrasound will be performed transrectally, it is necessary to do a cleansing enema on the eve of the procedure and several hours before it. After such preparation, patients have no questions about whether they can eat before an ultrasound of the bladder. After all, it is already clear that it is better to conduct an examination after an enema on an empty stomach or on a diet (for other types of examination: external and transvaginal or transurethral).

Many patients find it difficult to refrain from urinating before the procedure and the question arises of how to prepare then. In this case, it is recommended to partially evacuate, but you will need to drink 1.5 - 2 liters of liquid so that the organ is filled again by the time of the ultrasound. The accuracy of the results after the examination depends on the correct preparation of the patient, because only a full bladder can determine the condition of the organ.

How is the procedure performed?

Ultrasound of the bladder is performed in 3 ways:

1. Abdominal - with this examination, the examination is carried out from the anterior abdominal cavity. This is an external type of research.
2. Transurethral - diagnosis occurs through the urination channel.
3. Transrectally - the organ is examined through the rectum.

The most used is the first method of examination. The other two are necessary to confirm or refute problems that were identified during an external examination. Ultimately, the method of performing an ultrasound is determined by the attending physician, who prescribes this procedure. The patient’s position is determined during the diagnosis; you will be asked to lie on your back or side, in some cases you will be asked to stand up so that the organ can be examined for the presence of formations inside it.

How to do an ultrasound of the bladder in women

Diagnosis sometimes differs depending on the gender of the patient. Women also have their uterus and ovaries examined. The procedure makes it possible to measure these organs, determine their structure, location, and shape. In some cases, women undergo transvaginal ultrasound. This helps to clearly see the picture of the state of the organs inside and accurately diagnose the existence of certain diseases. Pregnancy and menstruation are not an obstacle to diagnosis; it is only important to warn the doctor so that he can choose the right examination method.

Ultrasound of the genitourinary system in men

The examination of male patients has some of its own characteristics, for example, during an ultrasound of the bladder, sometimes there is a need to diagnose the prostate gland. If you suspect diseases associated with the prostate, ultrasound of the bladder with determination of residual urine. To do this, the man is asked to go to the toilet, and then the amount of fluid that is retained in the organ is measured. Otherwise, the diagnosis of a bladder in men and women is no different.

What can an ultrasound scan show?

Organ diagnostics helps to see:

• Patency of the ureteral canals.
• The presence of foreign formations, tumors, stones.
• Sediment in the bladder on ultrasound is visible in the form of salts, crystalline formations, epithelium, erythrocytes and leukocytes.
• Inflammation (acute or chronic).
• Increased tone.
• Atony.
• Wall diverticulosis.
• Organ prolapse.
• Existence of prostate problems (in men).
• Diseases of the ovaries, appendages, uterus (in women).

The article will focus on ultrasound (ultrasound examination) of the organs of the urinary system (kidneys, urinary tract, bladder) and the male reproductive system. Disturbances in the functioning of these complexes affect both a person’s reproductive abilities and his overall health.

Ultrasound of the pelvic organs in men is a non-invasive, highly informative screening and diagnostic method for examining elements contained in the anatomical space of the rectum, bladder, prostate and seminal vesicles. The particular significance of the method lies in its use for diagnosing diseases at the primary stages of their occurrence, that is, it has a powerful preventive effect.

Conducting an ultrasound of the genitourinary system, both in men and women, requires mandatory prior consultation with a doctor. The procedure itself is preceded by careful preparation of the patient.

The set of preparatory measures depends on the type of ultrasound of the male pelvic organs used.

The transabdominal method involves performing the procedure in a state of a full bladder. No later than an hour before the start of the procedure, the patient needs to drink at least one liter of clean still water. If such a condition is difficult to fulfill, then refrain from bowel movements for the next four hours. The filled organ, by moving the intestines, ensures that the correct results of the ultrasound examination are obtained.

If any problems with the lymph nodes are detected, the patient has a bowel movement after the procedure. Subsequently, the residual volume of fluid in the organ is determined, which shows how effective its contractile functions are.

To conduct a transrectal examination, the intestines are first unloaded. For two days before the scan, foods that contribute to the formation of gases (baked goods, cabbage, legumes, tomatoes, etc.) are excluded from the menu. An hour before the procedure, a warm enema is given.

If there is a need to clarify the diagnosis, a biopsy is indicated. In this case, antibacterial drugs are prescribed before the procedure.

If contrast X-ray diagnostics were performed 2 days before the procedure, you must inform the doctor about this, since the remnants of contrast components distort the final scan results.

Indications for ultrasound of the pelvic organs in men

In order for a doctor to prescribe an ultrasound examination of the urinary system, there are a number of relevant indications:

• pain or difficulties during urination, increased frequency, partial emptying of the bladder;
• the occurrence of negative sensations in the lower abdomen, perineum and scrotum;
• the appearance of blood in urine or semen;
• infertility;
• manifestations of erectile dysfunction;
• identification of deviations from standard values ​​in the results of clinical tests;
• the appearance of signs of neoplasms;
• as an auxiliary method when obtaining a puncture;
• as a preventive screening of the health status of the subject.

How is diagnostics carried out?

In practice, using ultrasound, three main types of diagnostics of the male pelvis are prescribed:

• transabdominal examination is done through the wall of the abdominal region. Internal organs are visualized using a special sensor moved along the surface of the abdomen;
• The transrectal method involves inserting the device into the rectum, which makes it possible to directly determine neoplasms at the primary stage of their occurrence. The method is categorically not recommended for inflammatory processes in the organ being examined;
• Dopplerography - allows you to study the condition of the vessels of the organ and identify circulatory disorders. Used to clarify diagnoses and identify vascular anomalies.

Ultrasound, thanks to the sound waves reflected from the body of the organ, allows you to obtain a detailed picture on the monitor screen, which is subsequently studied by a specialist. These images can be stored in various formats (photo, video) for a long time.

Species

Carrying out an ultrasound of the male pelvic organs has a different procedural order.

Transabdominal ultrasound involves placing the patient on a couch, in a supine position, on his back, with the lower abdomen exposed, where a layer of a gel-like substance is applied. Slowly moving the device around the area being examined does not bring any negative sensations to the patient.

With the transrectal method of examination, some discomfort arises, rather of a psychological nature, caused by inserting the device into the rectal area. The procedure itself is absolutely painless, since the diameter of the device is about 1.5 cm. The sensor is treated with a compound to avoid injury to the organ. To carry out the procedure, the patient takes a position with his back to the doctor, lying on his side, with his legs pressed to his stomach. The procedure takes approximately 20 minutes.

Doppler examination is implemented similarly to the two previously described methods.

Determination of residual urine amount

The scope of the comprehensive examination also includes the determination of residual urine volumes. To do this, at the end of the main procedure, a short break is taken to empty the organ, after which the volume of residual fluid is diagnosed. The norm of residual urine is no more than 40 ml (10% of the total volume).

Decoding the results: normal and pathological

To interpret the results obtained, a number of criteria are used to assess the condition of the organs. The features of the placement of the organ, its size and shape, and the degree of echogenicity are taken into account. The indicators obtained during the examination, in combination with the patient’s symptoms, are an objective basis for a correct diagnosis.

Standard parameters are expressed for a healthy patient in certain values. Let's look at some examples.

Prostate adenoma

It is characterized by volume hyperplasia and changes in its structure. The degree of enlargement of the gland is recorded using ultrasound, structural changes - using TRUS (transrectal ultrasound). Its condition is assessed by comparison with standard indicators:

• superior anterior size of the prostate – 2.4-4.1 cm;
• anterior-posterior – 1.6-2.3 cm;
• transverse – 2.7-4.3 cm;
• standard prostate volumes are 24-30 cm 3 .

Inflammatory diseases

Inflammatory processes in men are associated with chronic pelvic pain syndrome (CPPS). Possible causes of the syndrome include:

• inflammation of the prostate;
• proctitis;
• orchitis;
• cystitis;
• urethritis;
• pyelonephritis.

In these cases, the complex of instrumental and laboratory studies includes ultrasound of the relevant organs, the condition of which is assessed using standard indicators, for example:

• the normal size of the seminal vesicles (cross section) is 8-10 mm;
• bladder - about 5 mm, symmetrical round shape, without inclusions.

Infertility

Among the numerous causes of male infertility are congenital and acquired pathologies of the genital organs, varicocele and disorders of traumatic origin. In these cases, studies include:

• Ultrasound of the scrotum;
• Doppler scanning of the veins of the testicles and scrotum;
• biopsy of testicular tissue (genetic material for IVF).

The clinician makes a detailed assessment of the structural structure of the organs and their parametric values.

Ultrasound diagnostics of the pelvic organs in males is an informative method for identifying pathologies. Ultrasound is characterized by high reliability of results and accessibility, so it allows you to identify diseases at the very beginning of their development.

Ultrasound of the pelvis in men using ultrasound is performed both for diagnosing abnormalities and for preventing diseases.

As part of prevention, pathologies are prevented, monitoring to ensure that existing diseases do not worsen and preventing their possible complications. Based on the results of the ultrasound, the doctor makes a diagnosis and prescribes adequate treatment for the patient. Ultrasound diagnostics helps to identify pathological processes and diseases and monitor the course of the disease. In addition, ultrasound can be used to monitor how successful the treatment is.

When is ultrasound indicated?

A pelvic ultrasound is a comprehensive urological ultrasound and includes examination of the seminal vesicles, bladder and prostate. When examining the bladder, the volume of urine remaining after emptying must be determined. A prostate examination involves studying the structure of tissues and lymph nodes. The seminal vesicles are examined for sperm viability.

Ultrasound of the genitourinary system in men is a comprehensive examination: it includes examination of the prostate, bladder and seminal vesicles

Indications for referring men for an ultrasound of the pelvic organs are:

• impaired bladder emptying process;
• urination with pain;
• false night urges;
• discomfort in the lower abdomen;
• detection of blood or pus in the urine;
• injuries of the genitourinary system;
• infertility;
• erectile dysfunction;
• detection of neoplasms in the pelvic organs.

When undergoing planned surgery, a preliminary ultrasound examination is required to study the features necessary for a successful operation. After such a medical procedure, an ultrasound examination of the organs of the reproductive system can also be performed to evaluate its results and prevent possible complications.

Since ultrasound examination is a non-invasive and safe procedure, it does not have any absolute contraindications. There are only some restrictions, for example, if there is significant damage to the skin in the examined area. This applies to the transabdominal ultrasound method, since it involves the application of a special gel to the surface of the skin, which is designed to improve the passage of ultrasonic waves. In this case, an examination is carried out with a rectal sensor through the rectum.

Ultrasound is a safe, non-invasive method, so it can be used an unlimited number of times. Ultrasound examination is often performed not only for diagnostic purposes, but also to evaluate the surgical intervention performed or the progress of drug treatment.

What pathologies does ultrasound of the genitourinary system reveal?

The pelvic organs of men can develop many diseases and pathologies that require medical intervention. They are diagnosed using ultrasound examination of the reproductive system. An ultrasound of the pelvic organs in men can detect the following diseases and pathologies:

• infectious and inflammatory processes;
• causes of male infertility;
• neoplasms of various origins – cysts, tumors;
• Causes of urolithiasis – sand, stones.

The purpose of ultrasound examination, as a diagnostic procedure, is to determine the reasons that caused the dysfunction of the organs of the genitourinary system. In addition, the condition of the organ with impaired functioning is assessed. Based on the research, the doctor must make a diagnosis and prescribe effective treatment to eliminate the problems that have arisen. Ultrasound will also help determine what additional types of examinations may be required for each specific case of the disease. If the patient is about to undergo a biopsy procedure, then the trajectory of needle insertion is determined using ultrasound.

Preparation and performance of transabdominal ultrasound

Transabdominal ultrasound is performed using a special sensor along the anterior wall of the abdominal cavity. The sensor uses ultrasonic waves to display internal organs on the device’s monitor screen.

Using a transabdominal sensor you can determine:

• the size of the prostate, its shape and structure, as well as existing disorders in the organ;
• structure of seminal vesicles;
• pathologies of the bladder;
• formations of various types in the organs of the genitourinary system.

Transabdominal ultrasound of the genitourinary system allows you to see pathologies of the bladder, various formations in the organ

An important diagnostic value is the volume of urine that remains in the bladder after urination. To determine this indicator, it is necessary to fill the bladder, look at it through ultrasound, then empty it of urine and look at it in the same way - this is how to determine how much urine remains after urination.

Urological ultrasound, like some types of diagnostic procedures, requires special training to perform it. Ultrasound is no exception: for example, for an abdominal ultrasound to function, the bladder must be full. To do this, an hour before the test, a man must drink at least 1 liter of any liquid that does not contain gases. In addition, preparation involves eliminating the symptoms of increased gas formation in the intestines. To do this, it is necessary to follow a special diet for several days before the study, which involves excluding foods that cause increased gas formation from the diet. It is advisable to take medications that help relieve gas.

During the examination procedure, the patient should lie on the couch in a back-down position. A special gel is applied over the skin of the abdominal cavity to facilitate better penetration of ultrasound into organ tissue. Next, the sensor is moved over the area where the gel is applied with light pressing movements. The procedure for such a study is not painful and takes about 20 minutes. After the procedure is completed, the indicators are recorded in the study protocol, where the norms and identified deviations are noted. The document is given to the patient and the doctor who referred him for an ultrasound scan will decipher it.

Features of the examination procedure with a rectal sensor

Ultrasound examination through the rectum is called transrectal. It is also used to examine the pelvic organs in men if examination is not possible otherwise. Its help is resorted to in cases where it is necessary to detect small formations that are not shown by abdominal examination.

If there are doubts about the correctness of the diagnosis, and a more in-depth examination of the condition of the seminal vesicles and ducts is needed, a rectal examination will help. In addition, it allows you to identify prostate adenoma and dysfunction of the genital organs. Transrectal ultrasound is also used when taking a prostate biopsy.

A successful rectal examination also requires some preparation. Preparation consists of emptying the rectum of contents. This is done by using a cleansing enema. This is a completely desirable procedure, which is done so that feces accumulated in the intestines do not interfere with the study. Thus, preparation for ultrasound is an important step in helping to obtain reliable results.

Urological ultrasound using the rectal method may cause minor pain and discomfort. The patient should lie on his side with his knees bent. Before starting the study, the doctor examines the rectum by palpation. After lubricating the sensor with a special substance, the doctor inserts it into the rectum.