Ultrasound diagnostics of the pelvic organs in males - informative method detection of 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 to diagnose abnormalities and to prevent 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, it is mandatory to determine the volume of urine remaining after emptying it. A prostate examination involves studying the structure of tissues and lymph nodes. The seminal vesicles are examined for sperm viability.

Ultrasound genitourinary system in men it 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.

With planned surgical intervention 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 to be carried out. There are only some restrictions, for example in case of significant damage skin on the surveyed 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 in diagnostic purposes, but also to evaluate the work carried out surgical intervention or move drug treatment

What pathologies does ultrasound of the genitourinary system reveal?

In the pelvic organs of men, many diseases and pathologies can develop 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;
• reasons 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 study, the doctor must make a diagnosis and prescribe effective treatment to resolve any problems that may arise. Ultrasound will also help determine which additional types 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 with a special sensor along the anterior wall 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;
• education of various nature 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 diagnostic procedures, requires that it be carried out special training to carry it out. 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, you need to observe a few days before the study. special diet, which involves eliminating foods that cause increased gas formation. It is advisable to take medicines, helping to get rid of gases.

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 in order to feces, accumulated in the intestines, did not interfere with the study. Thus, preparation for an ultrasound is important stage, contributing to obtaining reliable results.

Urological ultrasound rectally 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.

Often, according to doctor's indications, an ultrasound of the bladder is performed in women and men, thanks to which many diseases are diagnosed. It is done at any age and condition (newborns or people old age, pregnant or after surgery). It is important to prepare properly before the procedure, then you can get an accurate result. And the correctness of diagnosis and treatment depends on this. A urinary ultrasound (UU) is performed to check the result of surgery on the genitourinary system. This is often how complications can be identified.

An ultrasound examination of the bladder provides a good basis for analyzing the state of health or the course of diseases in this organ.

Indications for use

All indications are related to problems in the genitourinary system (GUS).

This study can be very informative. It is carried out in order to determine diseases of the kidneys and genitourinary system. Indications include:

• pain in the lower abdomen;
• frequent urination;
• problems with urination;
• blood in urine;
• symptoms of urolithiasis.

In addition, it is carried out in men if there is a suspicion of prostate disease. This is how an adenoma or inflammation of this organ is detected. Ultrasound of the genitourinary system may show the presence of cystitis or chronic pyelonephritis. In women it is carried out because it detects diseases of the genital organs located in the pelvis. Sometimes an ultrasound examination of the genitourinary system may include examination of the uterus and appendages. Sharp pain in the lower abdomen, accompanied by a strong increase in temperature, is also an indication for research. It is worth doing this procedure for preventive reasons.

Preparing for the study

It is imperative to prepare for the procedure, especially since the algorithm is simple: stick to a diet and drink a lot. A bladder examination involves a full bladder. Preparing a patient for a study is sometimes carried out according to the following scenario: a person should not go to the toilet for 5-6 hours before the procedure. This method is suitable for people who have severe swelling. If you can’t bear it, you can let out a little urine, but then quickly fill the bladder again. When the bladder is empty, its contours are poorly visible, the same applies to the prostate and appendages. The doctor should explain how a prostate ultrasound is performed. It is necessary to prepare not only the patient, but also the equipment: gel is generously applied to sensitive areas of the device. This will give a clear image. During transvaginal examination, a special disposable condom is put on it.

How to fill your bladder? How much fluid for ultrasound?

Preparing for an ultrasound of the bladder during menstruation requires drinking a lot of fluids. Approximately 2 liters of still water (water, compote, tea - it doesn’t matter). The amount of fluid may depend on approximately how much water a person drinks. In children this dose is much less. Carbonated drinks are not allowed because they cause increased gas formation, which closes the internal organs. It is also undesirable to drink alcohol before an ultrasound scan of organs. It is important to take a responsible approach to the preparation process. Otherwise the result will be inaccurate.

How is the procedure done?

The ultrasound technique and algorithm depend on its type. It is important that the patient knows in advance what awaits him and how the study will proceed. The following types are distinguished:

Transabdominal

Transabdominal ultrasound of the bladder is suitable for everyone (children, men, women). Requires patient preparation. It consists of eliminating all foods that cause increased gas formation a few days before the procedure ( bakery products, legumes, dairy and fermented milk products, coffee, mineral waters). For prevention, these days you need to drink 2 tablets “ Activated carbon"(not recommended for children). This is necessary so that gases do not block the view. In the evening, it is advisable to give a cleansing enema. Immediately before the procedure, you need to fill your bladder. During the procedure, the patient lies on his back. It is worth noting that this type is less accurate, but more common.

Transrectal ultrasound of the bladder is more suitable for people with low sexual activity.

Transrectal (TRUS)

TRUS is used to diagnose diseases in women who do not sex life, and men. During the procedure, the patient lies on his side with his back to the doctor (preferably on the left) with his legs pressed to himself. TRUS includes ultrasound of the prostate and bladder. TRUS of the prostate is performed. Going through this examination can be painful. It is necessary to prepare for the study in a special way. To do this, you must select one of the methods:

• drink a laxative;
• give a microenema;
• put a glycerin suppository.

TRUS shows a clearer picture than transabdominal ultrasound.

Transvaginal

Transvaginal ultrasound of the bladder is suitable only for women who are sexually active. The procedure is allowed during menstruation and pregnancy. It is important to inform the doctor about your piquant situation. This method is carried out when the bladder is empty. But preparation for the procedure is mandatory: diet and cleansing the body of gases. During menstruation, an ultrasound of the uterus may show abnormalities.

Transurethral ultrasound of the bladder is performed through the urethra of the male penis.

Transurethral

This method used very rarely. For this study we use local anesthesia, this is due to the fact that insertion of the device into the urethra can be painful. This method is used only in men. Before the procedure, you should not eat heavily, smoke, or drink alcohol. In addition, it is important to tell the doctor what drugs you are allergic to, whether chronic diseases liver and kidneys. Transurethral examination of the bladder and urethra can detect bladder tumors.

Peculiarities of implementation in different groups of patients

Ultrasound in women

Everyone without exception undergoes research. Ultrasound of the genitourinary system in women is performed using both transabdominal and transvaginal methods. In the first case, sometimes an ultrasound of the abdominal cavity is also performed at the same time. Ultrasound can detect many inflammatory diseases, as well as neoplasms, and determine whether they are benign or malignant. Before an ultrasound of the bladder, you need to make sure that the woman has no problems with the central circulation (especially during menstruation). An ultrasound of the kidneys clearly shows the neoplasm.

Ultrasound of the bladder during pregnancy does not have any special restrictions or prohibitions, because does not provide negative influence for the fruit.

During pregnancy

There is an opinion that pelvic ultrasound is contraindicated. This is wrong. Ultrasound does not have a negative effect on the fetus, the same applies to the placenta. Thus, this procedure completely safe for women interesting position. But telling your doctor about pregnancy is very important. In this case (depending on the age and size of the fetus) he will be able to select correct method research. This is important because later or if there is a threat of miscarriage, transvaginal ultrasound is prohibited. This may lead to undesirable consequences. Sometimes the test can detect the presence of a fetus.

Ultrasound in men

An ultrasound of the bladder is performed in men to show a full bladder. There is no need to do an ultrasound of the prostate and bladder separately; both organs are clearly visible in this study. In addition, you can look at the condition of the prostate gland. The most common type of this study is transabdominal. It is ideal for men. It is used to check for bladder tumors.

Ultrasound of the bladder can also be performed on children if problems with the urinary system arise.

Not the last place in the definition of bladder diseases is ultrasound examination. 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 ordered when 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

Preparing for a bladder ultrasound is very important 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 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. From proper preparation The accuracy of the results after the examination depends on 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 an ultrasound can 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).

As they turn forty, many men begin to notice the appearance of problems in the genitourinary system, which is quite natural, since the body’s resources are running out.

However, the majority of the male population is in no hurry to see an andrologist or urologist, because they will have to recognize the approach of old age, and this is quite difficult to do. The completely natural desire to remain as young and strong as possible leads to complete absence treatment, and pathologies developing in the pelvic area become chronic or severe.

When a man visits a specialist such as an andrologist or urologist, it will allow him to identify in time various pathologies and appoint correct treatment. What is included in pelvic ultrasound? Ultrasound of the groin in men includes comprehensive diagnostics internal genital organs:

• bladder;
• prostate;
• seminal vesicles;
• located next to internal organs– blood vessels, tissues and lymph nodes.

Studies of all of the above organs can be done separately. Nevertheless, experts recommend conducting a comprehensive examination, as it helps to see the developing pathology in more detail.

In addition, comprehensive ultrasound diagnostics makes it possible to identify not only the disease, but also determine the extent of its spread to neighboring organs. For example, the inflammatory process of the prostate gland may be accompanied by cystitis, therefore additional examination, makes it possible to identify a large number of pathologies present in the body.

An ultrasound examination is prescribed for the following symptoms:

• detection of blood in urine;
• problems that appear when emptying the bladder;
• feeling of a not empty bladder;
• presence of pain and discomfort in the lower abdomen or in the lumbar region;
• for infertility;
• complete or partial dysfunction of erectile function;
• appearance purulent discharge in urine;
• false night urge to go to the toilet;
• injury to the lower body;
• possible deviations in analyzes;
• suspicion of the appearance of a neoplasm;
• as preventive measures.

Over the past few years medical institutions They are increasingly offering their patients to undergo a comprehensive examination of the pelvic organs. Posting data diagnostic measures It is very advisable, since they help to identify any pathology in time and begin its treatment, and not leave it to chance.

As men age, the risk of developing various ailments in the area of ​​the prostate gland. Ultrasound helps to identify them before they begin to develop and require treatment.

Methods

Ultrasound diagnostics is carried out using two methods:

• Transabdominal. The specialist moves the sensor along the anterior abdominal wall, and the information obtained through its use is displayed on the screen. This type of examination is quite simple and does not cause discomfort to the patient. However, to get the correct answer, a man's bladder must be full.
• Transrectal. This type of diagnosis is quite difficult for a man. Firstly, he experiences strong moral discomfort during the procedure, and secondly, physically, it is quite painful for him, since the sensor is inserted into the rectum.

Transrectal examination is performed only in the most extreme cases. As a rule, it is prescribed if a man, for some reason, is unable to fill his bladder or when transabdominal diagnostics do not provide a complete picture of the condition of the internal organs.

Source: diagnoses.ru

Preparation

Preparatory measures directly depend on the type of sensor insertion. Transabdominal examination requires a well-filled bladder. Before carrying out this procedure, a man should drink about 2 liters of liquid: juice, compote, still water, jelly.

Under no circumstances should urine be filled with milk, alcoholic drinks, sparkling water. A well-filled bladder allows you to make a competent diagnosis, since at this time you can clearly see the condition of the prostate gland, seminal vesicles, as well as those close to the organs, blood vessels and lymph nodes.

If the patient is undergoing transrectal diagnostics, then the day before it is performed, the intestines must be completely cleansed. To do this, an enema is done or they are used special drugs, contributing to the intensive release of feces.

Results

During the diagnosis, the specialist evaluates:

• prostate gland: shape, size and position, as well as the presence of pathological inclusions;
• bladder: presence foreign bodies, wall thickness, size and position;
  urine volumes;
• condition of blood vessels;
• state lymph nodes;
• testicles: their contours, echogenicity, absence of neoplasms, size of the walls, as well as the number of fluid inclusions.

Diagnostic testing allows us to identify the following pathologies:

• prostatitis, which is acute or has already become chronic;
• cystitis;
• urolithiasis;
• inflammatory process occurring in the seminal vesicles;
• the appearance of a cyst or polyp;
• circulatory disorders;
• various anomalies in the structure of organs: congenital or acquired;
• suspect oncology.

Ultrasound of the pelvic organs is one of the most important examinations that every man who has passed the age of forty should undergo. This type of diagnosis is very informative and allows you to diagnose correct diagnosis, and then, if pathologies are identified, prescribe competent treatment, thereby preventing the transition of the disease from light form to very heavy.

On modern stage andrology and urology cannot do without ultrasound diagnostics. Pelvic ultrasound in men, as a highly informative method, is the main one in diagnosing pathology of the urogenital tract in men. The value of the method increases against the background of the growth of this pathology, especially in age group after 50 years. Currently, screening programs have been developed that include ultrasound in the annual examination of men in this age group.

Ultrasound of the pelvic organs in men includes:

• bladder and ureters
• prostate gland
• seminal vesicles
• regional lymph nodes

Ultrasound examination is carried out using two methods: transabdominal and transrectal.

Transabdominal examination is performed with a convex sensor with a range of 3-5 MHz through abdominal wall. This procedure is painless and safe; to undergo such an ultrasound examination, it is necessary to first fill the bladder.

An hour before the scheduled procedure, you need to drink at least a liter of liquid. An ultrasound is performed if there is a persistent urge to urinate. With the patient lying on his back, the bladder is assessed (filling, thickness and structure of the wall, structure of the contents, distal parts of the ureter), prostate gland (approximate size, parenchyma structure, presence volumetric formations), seminal vesicles and adjacent soft tissue.

When detecting pathology from the lymph nodes, a linear sensor is used for a more detailed examination. After this, the patient is asked to go to the toilet and the bladder is then examined after miction. At this stage, residual urine is assessed, which makes it possible to judge contractile function bladder.

Transrectal ultrasound (TRUS) is performed with a transrectal probe with an ultrasound frequency of 7.5-10 MHz through the rectum with the patient in the left lateral position.

The study is preceded by a digital examination of the rectum to detect cracks and space-occupying formations that may interfere with the procedure. A sensor, dressed in a condom and lubricated with gel, is inserted into the rectum 8-10 cm. The study is carried out if it is impossible to sufficiently fill the bladder (cystitis, urinary incontinence) and in the presence of special indications.

This study makes it possible to evaluate in detail the structure of the prostate gland and detect small formations. TRUSI is also used for needle biopsy prostate.

Preparing for this species The study consists of bowel movements. To do this, a few hours before the study it is necessary to perform a cleansing enema or use special microenemas. A moderately full bladder also improves visualization.

If TRUS with a puncture biopsy is planned, tests will be taken first ( general blood and urine, blood coagulation test). Such preparation helps to identify the category of people who may have complications after a puncture.

A number of authors believe that preparation for TRUS is not required, and when performing a puncture biopsy, antibiotic prophylaxis is of primary importance. In confirmation of this, the data from studies without preparation are not inferior in information content to the results from trained patients.

Pathology determined by ultrasound of the pelvic organs in men.

Bladder.

Normally, the bladder is defined as a round anechoic formation in transverse scanning and triangular in shape in longitudinal projection. The contents are homogeneous, the wall is of uniform thickness and does not exceed 3 mm when the bladder is filled, and no more than 5 mm after emptying.

A diverticulum is found as a sac-like protrusion of all layers of the bladder wall outward. This protrusion communicates with the bladder itself through a narrow channel. Pathology can be congenital or acquired. Management tactics depend on the presence of urine in the diverticulum after miction: if there is residual urine, surgical treatment is indicated. Prolonged stagnation of urine in a diverticulum can lead to inflammatory processes (diverticulitis), the formation of stones and tumors.

Stones are visualized as oval-shaped hyperechoic structures, displaced during polypositional examination and having an acoustic shadow. Stones may remain motionless large sizes and located in the diverticulum. Displacement of a stone into the neck of the bladder or jamming of a small stone in the urethra leads to acute delay urine.

Cystitis, both acute and chronic, has the same ultrasound picture. Inflammatory process on ultrasound it is characterized by thickening of the walls, asymmetry of the contour, the appearance of a hyperechoic suspension in the lumen, and the appearance of the urge to urinate when the bladder is not full.

Limited wall thickening ( bullous cystitis) occurs due to prolonged standing of the stone.
Papilloma (benign epithelial tumor) is often an incidental finding during ultrasound examination, as it often has no clinical manifestations. During the study, they are visualized as a polypoid parietal formation on a thin stalk, growing into the lumen of the bladder. When the Doppler mode is turned on, the only feeding vessel in the area of ​​attachment to the wall is determined.

Papillomas can be single or multiple (generalized papillomatosis).

Bladder cancer requires a comprehensive diagnostic approach (ultrasound, cystoscopy, excretory urography, CT and MRI). Ultrasonic method at the same time, it is starting and allows you to diagnose 70-90% of tumors, even without large size.

Most tumors are of epithelial origin and visually resemble papillomas. The difference in the ultrasound picture is a wider base and increased vascularization at the base of the formation. Tumors with diffusely infiltrating growth grow into the wall of the bladder, causing its significant thickening and a decrease in the volume of the hollow organ. If an infiltrating tumor grows into adjacent organs and tissues, the outer contour of the bladder loses its clarity and structure.

After micturition, a small amount of urine may be present (residual urine). Acceptable volumes: for children up to 10 ml, for adults up to 20 ml or no more than 10% of the original volume. Exceeding the permissible values ​​of residual urine is possible with bladder outlet obstruction and a neurogenic bladder.

Prostate.

Transabdominal examination of the prostate is indicative in nature, allows you to determine the approximate size, shows the dynamics of growth of adenomatous nodes. To identify malignant growth and determine the exact volume, a transrectal examination is performed. The main indication for TRUS is an increase in prostate specific antigen (PSA) in the blood, which should be determined annually in all men over 40 years of age.

When scanning transversely at the level of the base, the prostate has a crescent shape, the peripheral zone is located closer to the sensor, then the central zone, inner part, anterior fibromuscular zone.

Prostatitis does not have a specific ultrasound picture, so TRUS is usually not required . Many experts even consider it contraindicated this study due to the risk of spreading infection and bacteremia. The examination reveals a heterogeneous enlarged gland with areas of reduced echogenicity and lack of differentiation of zones. Hypoechoic areas have clear contours and an unchanged type of blood flow during CDK.

The indication for mandatory ultrasound examination is the suspicion of complications of prostatitis - a gland abscess.

A prostate abscess at the stage of formation is characterized as a hypoechoic formation with a hyperechoic rim; with CDK, increased blood flow is recorded along the periphery in the form of a ring. The formed abscess has the appearance of a round formation with a dense capsule and liquid heterogeneous contents. There is an acoustic amplification effect, as well as the appearance of a “flaming ring” with color Doppler mapping. Detection of an abscess at any stage is an indication for emergency drainage.

Benign prostatic hyperplasia is the most common pathology in older men. Ultrasound transrectal examination shows an increase in the gland and its volume, as well as a change in shape (spherical, cone-shaped, “trefoil-shaped”). On initial stages echogenicity is increased while tissue structure is preserved, blood flow rates in the feeding vessels increase.

On late stages the structure of the tissue changes, nodes with a fine-cell structure and multiple cystic cavities up to 5 mm in diameter appear. Against the background of prostatic hyperplasia, bladder outlet obstruction occurs and trabecularity of the bladder walls appears.
A malignant prostate tumor (carcinoma) is diagnosed based on comprehensive survey, including digital examination, PSA blood test, TRUS with biopsy. The ultrasound picture is variable; the tumor can have a hyperechoic, hypoechoic and isoechoic structure.

In more than 55% of cases, it is defined as a hypoechoic formation with unclear contours located in the peripheral zone. Hyperechoic nodes often have a heterogeneous structure and include areas of reduced echogenicity and microcalcification. Isoechogenic nodules are the most difficult to diagnose and are often found histologically after biopsy or surgical treatment. Increased blood flow is not specific sign, since small tumors (up to 1 cm) have only one feeding vessel, and large tumors with decay in the center have only increased blood flow along the periphery.

Seminal vesicles.

Independent pathology of the seminal vesicles is extremely rare; spread occurs more often pathological process With adjacent organs.

Vesiculitis - inflammation of the seminal vesicles occurs against the background of prostatitis, epididymitis or orchitis. The ultrasound picture is characterized by an increase in the size of the bubbles, most often the increase is symmetrical.

Benign and malignant formations appear due to the spread tumor process from adjacent organs (rectum, prostate gland). The ultrasound picture depends on the type and structure of the primary lesion.

Ultrasound of the pelvis in men - important method diagnostics and annual screening will help identify diseases at a more advanced stage early stages. However, transrectal ultrasound examination is advisable to carry out if there are indications: increased PSA, changes in digital examination, questionable results transabdominal ultrasound examination.