Computed tomography (CT) of the pelvic organs in men

The method of computed tomography is a technology for scanning the human body with x-rays penetrating it in different directions and projections. Based on the results of a CT scan of the pelvic organs in men, a radiologist can judge the state of organs, tissues, and the bone component of this area of ​​the human body. The data obtained are in the form of x-rays, and can also be recorded digitally on appropriate media. Based on them, as well as on the basis of the conclusion of the diagnostic radiologist, the attending physician will subsequently decide what kind of disease or pathology is found in the patient, and how exactly they need to be treated.

The pelvic area: features of the structure and functioning in men

The small pelvis is a cavity bounded by the pelvic bones. In men, this anatomical space contains the bladder, rectum, prostate, and seminal vesicles.

The bladder is located behind the pubic bone joint, separated from it by a loose tissue. In shape, the organ resembles a ball, anatomically it has the following parts: top, bottom, neck, side, back and front surfaces, which form a bubble, being its walls. The organ functions as a reservoir of urine.

The rectum is the part where the large intestine ends. It accumulates and, in the future, excretes the waste of the digestive process in the form of feces. In the pelvic area, the rectum is located behind the bladder, behind it are the coccyx and sacrum.

The prostate gland is an unpaired organ of the muscular-glandular type of structure. Her task in the body of a man is the development of a special secret, which is part of the sperm. The prostate gland is located in the lower anterior part of the small pelvis, above the bladder, through which the ejaculatory ducts pass.

The seminal vesicles are a paired organ behind the bladder. If we consider them relative to the prostate gland, they are located above it. The name “vesicles” makes it clear the internal structure of the organ – from the inside it looks like a lot of interconnected bubbles. At this point, the vas deferens and vas deferens join to form the ejaculatory duct.

In addition, in the pelvic area there is a large amount of connective tissue, the main function of which is to fix all organs in their places.

What is a “computed tomography” of the pelvis, why is it used

The procedure of computed tomography, or CT, is a diagnostic technique using the properties of the difference in the degree of absorption of x-rays by tissues of different densities. Conducting such an examination results in a highly accurate, informative image of each organ in the form of sections. Scanning occurs in layers, while the rays are passed through the body at different angles, resulting in an image in different projections. The tomograph makes it possible to build a three-dimensional image of each organ on the screen.

CT scan of the pelvic organs in men is prescribed to examine the condition and identify abnormalities in the structure and work:

• Bladder;
• organs of the excretory system;
• reproductive organs.

In addition, diagnostics of this level makes it possible to evaluate the effectiveness of the treatment, to check whether there are grounds for surgical intervention, to assess the patient’s condition during the rehabilitation period after surgery or radiotherapy.

There is also the possibility of performing a CT scan of the pelvic organs with contrast. An iodine-based contrast agent is injected intravenously into the patient to display the contrast on the images. Since the drug has the property of impermeability to X-ray radiation, its visualization in the pictures can make it possible to detect even the most initial changes in the neoplasm.

In fact, computed tomography today opens up the possibility of examining and studying those organs and tissues that could previously only be reached during operations. Classical diagnostic methods do not allow to fully scan the state of all organs in the pelvic area due to their proximity to each other. For example, it is almost impossible to visualize the rectum during an ultrasound scan.

Indications for CT of the pelvic organs in men

The main reasons why doctors prescribe computed tomography to patients are various complaints on their part about atypical symptoms and pain, as well as information obtained as a result of tests or previous examinations. The urologist, and most often it is he, will give the man a referral for a CT scan of the pelvic organs in the following cases:

• suspicion or detection of anomalies and pathologies in the development of these organs;
• injury to the pelvic organs, detection of inflammatory and infectious diseases that affect them;
• pelvic pain of unknown origin;
• suspicion of neoplasms;
• development of ascites (abdominal dropsy);
• the need to assess and study the condition of the lymph nodes in this anatomical region;
• treatment of diseases of the pelvic organs, to assess its effectiveness;
• detection of tumors of the prostate;
• the need to determine the stage and prevalence of rectal cancer, after radiotherapy, surgical treatment of rectal cancer, to assess their success and the general condition of the patient;
• causing injuries and the development of diseases of the iliac vessels and bone structures of the pelvic area.

What contraindications exclude the possibility of CT scan of the pelvis in men

It has been proven that the tomography procedure is much more harmless to humans than conventional radiography. However, this does not mean that it can be prescribed to all patients without exception. Like any medical manipulation, CT for men has its own list of contraindications:

• the serious condition of the patient, for example, if he is connected to resuscitation life support equipment;
• obesity, since most tomographs are simply not able to accommodate a person weighing more than 140-180 kg;
• allergic reactions to iodine, severe bronchial asthma;
• diabetes;
• renal and hepatic insufficiency;
• age restriction: children under 3 years old are prohibited from undergoing tomography, an older child can undergo such a scan at the discretion of the attending physician;
• diseases associated with the presence of hyperkinesis or convulsive conditions: sudden movements that the patient is unable to restrain and control make the effectiveness of CT scans uninformative, since the subject must lie absolutely still to obtain informative images.

In some cases, the inability to perform computed tomography in patients includes the presence of claustrophobia. For such cases, special open tomographs have been developed, although it should be noted that they are not available in every medical diagnostic institution.

Basic requirements for preparing for tomography of the pelvic organs

Considering that during the study, a part of the intestine will be visualized on tomography, preparation for scanning includes dieting 2-3 days before the scheduled procedure. During this period, it is recommended to completely exclude foods that increase gas formation in the intestines:

• sour milk and milk;
• bakery products;
• carbonated drinks;
• all food rich in coarse fiber.

Otherwise, filled with gases, swollen intestines will reduce the objectivity of the scan to a minimum value. Alcohol in preparation for CT is also excluded from the patient’s menu.

2-4 hours before the start of the procedure, you can take medications against flatulence, as well as antispasmodics, but only with the permission of the doctor. Scanning is carried out on an empty stomach, so a snack shortly before the start will not work.

The peculiarity of this type of computed tomography is that it is carried out with a full bladder, so half an hour before the start, you should drink 2-3 glasses of clean water without gas, after which you can not urinate.

If a contrast agent is scheduled during the process, the doctor will first send the patient for a creatinine test.

Survey procedure

When the patient lies down on the tomography table, there should not be any metal decorations and elements on it, and all gadgets remain outside the door, in the next room, where they will be observed by an X-ray laboratory technician and a radiologist. The patient is given special clothing that he puts on during the scan – it does not restrict movement, does not have coarse seams. It can also be the patient’s personal clothing, as long as it is loose, comfortable, and made of cotton.

Having settled down on the retractable table of the tomograph, the subject takes the most relaxed, free and comfortable position, and prepares to freeze in it for the entire time he is in the tomograph. The doctor watches him, from time to time gives instructions to hold his breath for a while.

During the examination, while the patient is on the table, the scanner ring rotates around him, which produces x-rays at a certain interval. The rotation has a duration of 1 second, and produces a series of layered images of the area being studied. Further, a special computer program, using the obtained images, simulates the pelvic area on the monitor.

The procedure with contrasting practically does not differ in technology. The only difference is that after the initial scan, before the subject enters the tomograph space again, a contrast agent is injected intravenously. A syringe or an automatic injector can be used for this purpose. Ingestion of a coloring drug can cause burning, dizziness, fever, increased pressure, nausea, which should be immediately reported to the doctor.

During scanning, the device makes specific sounds – crackling, buzzing. If they cause discomfort to the subject, he is given earplugs or headphones. Children are given them, as a rule, always.

What happens after a tomography

When the scan is completed, the radiologist takes over the study of the material obtained. Usually, within an hour or two, he is ready to give the patient a conclusion on the results of a tomographic scan. In addition to the conclusion, the person receives printed images, if necessary – digital media with the recorded results of the examination.

Normal sensations after CT with contrast are nausea, weakness, dizziness, which disappear after about a day. If the discomfort does not go away after a day or two, you need to appear for a consultation with a doctor. To speed up the excretion of the contrast, it is recommended to take plenty of fluids.

The results of CT of the pelvic organs, drawn up in the form of images and a conclusion, are then passed on to the attending physician, who initially sent the patient for examination – to a general practitioner, urologist, andrologist, and oncologist.

Computed tomography of the pelvic organs in men is often prescribed as a way to refine the data obtained in the course of other studies. We are talking, first of all, about ultrasound – an examination method that provides only general information about the state of the patient’s internal organs, shows the shape, size, location, surface structure, but does not allow looking into deep textures and tissues.

CT, along with MRI, is considered more effective and informative for the physician. In some cases, they are prescribed in a complex way, as complementary methods for scanning the human body.