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Ultrasound (ultrasound examination) of the pelvic organs in men is a medical imaging technique that allows you to view the insides of the human body. This is done using a transducer, also called a transducer, which emits high frequency sound waves (ultrasounds). When reflected from the internal structures of the body, these waves create images. Ultrasound may also be useful for determining organ function, for guiding an injection, or for a biopsy.
Ultrasound is considered the gold standard for diagnosing pathologies of the internal organs that are in the small pelvis. Using this method, it is possible to visualize organs both in normal and pathological conditions, for example, ultrasound can diagnose an abscess, tumor, cysts and helps determine the presence and amount of inflammatory exudate.
Diagnostic examination of the small pelvis and its organs in men includes the diagnosis of diseases: the bladder, seminal vesicles, peritoneum, pelvic lymph nodes, and the prostate gland. The study determines the size, placement of organs and the presence of pathological conditions in them. The organs of the urinary and reproductive systems are located in the pelvis and are anatomically connected to each other. In this regard, most often, a comprehensive ultrasound of all organs that enter the small pelvis is performed.
A pelvic ultrasound in men mainly evaluates the bladder and prostate. Bladder: shape, fill size, empty size, residual urine volume, wall, urinary reflux. Prostate: size, shape, signs of infections, tumors, calcifications. Sonography can also help identify abnormal lymph nodes (lymphadenopathy) or the presence of free fluid and suspicious masses.
Organs and structures that are solid and homogeneous, or if they are filled like the bladder with fluid, show up clearly on a pelvic ultrasound. Bones, as well as organs that are filled with air, such as the intestines, do not show up well on ultrasound and can obstruct the visibility of other organs.
What happens during research?
During a transrectal ultrasound, the patient will be asked to lie on their left side with their knees bent. A digital rectal examination will be performed before the ultrasound. The lubricated transducer will then be gently inserted into the rectum and moved slowly to take pictures from different angles. The patient may feel some pressure.
How does it feel?
If a transabdominal ultrasound is performed, the patient will likely feel bladder pressure and a strong urge to urinate because the bladder is full. Gel applied to the abdomen may feel cold. The patient will feel a slight pressure from the transducer as it passes over the abdomen. If the patient has trauma or pelvic pain, the transducer transducer pressure may be painful.
There is usually mild discomfort during the transrectal examination. The patient feels pressure from the transducer as it is placed in the rectum.
If a biopsy is performed during an ultrasound, pain may occur when the sample is taken.
Indications for holding
An ultrasound diagnostic method in men is performed to identify and confirm various diseases of the reproductive and urinary systems. The data that is obtained using ultrasound helps to accurately determine the diagnosis and make differential diagnosis of various diseases in complex cases. In addition, ultrasound diagnostics is performed to identify signs of some latent and chronic genital infections.
Often indications for this diagnostic method in men can be:
- blood (erythrocytes) in the urine;
- spermaturia – the presence of sperm in the urine;
- suspicion or presence of male infertility;
- pain of varying intensity in the pelvic area;
- erectile dysfunction or vice versa, pathologically prolonged arousal (priapism);
- dysuric phenomena, which can lead to pain in the bladder during its emptying, a high frequency of urination, difficulty, or vice versa, urinary incontinence;
- to detect neoplasms;
- preventive diagnostics, screening of diseases;
- biopsy under ultrasound supervision.
Preventive research significantly helps to reduce mortality from oncological diseases of the genitourinary system in men. They make it possible to detect the disease at an early stage, which increases the efficiency and speed of treatment and recovery.
It can be concluded that for the diagnosis of reproductive, urogenital problems, ultrasound is highly informative. Ultrasound is one of the most reliable and accurate methods for diagnosing and detecting various pathologies in the pelvic area.
A pelvic ultrasound may be done for:
- identifying the cause of dysuric problems;
- assessment of the size of the bladder depending on its filling;
- checking whether the bladder is completely emptied during urination;
- the direction of needle placement during a biopsy or when draining fluid from a cyst or abscess;
- detection of rectal cancer and its response to treatment.
Preparation for research
Preparation of the patient for this diagnostic examination depends on the method of ultrasound diagnostics. Tell the doctor if the patient has had an x-ray with a contrast material (such as barium) in the last 2 days. Barium, which still remains in the intestine, may subsequently interfere with the ultrasound examination.
The patient may have to remove or lower clothing below the waist prior to the examination.
Preparation for the transabdominal method:
- avoiding foods high in fiber and legumes 2-3 days before the start of the study to minimize gas production;
- it is advisable to refrain from eating for 5-6 hours before the start of the study;
- drink half a liter of non-carbonated water 2 hours before the start of the study;
- 2 hours before the ultrasound, you should refrain from urinating;
- in case of strong desire, you can urinate a little, but not completely, and after that you need to drink an additional glass of water;
- if the patient cannot drink the required amount of water, it is possible to fill the bladder with water through a thin flexible tube (catheter) inserted into the bladder.
To prepare for the transrectal method, all the above preparation steps are used, but they are added:
- the use of drugs that cleanse the intestines, for this the patient drinks 3-4 packs on the eve of the study;
- if the study is scheduled for the second half of the day, then two packets are drunk on the morning of the study;
- a cleansing enema is an alternative method and is performed in the morning before the examination itself, and the volume of liquid that is injected into the rectum must be at least 200 ml;
- if a person is going to have a prostate biopsy, they may be given antibiotics the day before the test.
Types of Ultrasound
In pelvic ultrasound in men, there are two main areas: transabdominal ultrasound and transrectal ultrasound. Each method has found its justification and has its own strengths in the diagnosis of diseases.
Transabdominal method
During a transabdominal ultrasound, a transducer is placed on the anterior abdominal wall. By moving and turning it at different angles, the doctor can examine the structure of the patient’s internal organs in as much detail as possible, assess their condition, blood supply (with additional Doppler examination) and the presence of any changes.
This method is best suited for preventive research and does not cause discomfort to the person. Unlike transrectal, the accuracy of the transabdominal examination technique is somewhat lower. In this regard, this method is suitable for determining the presence of a volumetric pathological formation in the pelvis and bladder. It is worth noting that during the transabdominal diagnostic method, the bladder must be in a filled state. A full bladder is an organ that conducts ultrasonic waves well, and allows you to make the study more effective. If an ultrasound is performed in an emergency, the bladder may be filled with water through a thin, flexible tube (catheter) inserted into the bladder.
Transrectal method
Transrectal ultrasound is performed using a miniature ultrasound transducer to minimize patient discomfort. The sensor is inserted directly into the rectum, which must first be cleaned and prepared.
In most cases, the transrectal ultrasound method is used for a detailed examination of the prostate gland and determining the severity of the pathology in its tissues. The transducer sends and receives sound waves through the rectal wall to the prostate gland, which is located just in front of the rectum. This improves the accuracy of the results. This method allows to identify even the smallest cysts in the prostate gland – up to 0,2 cm. In addition, this method is the best choice in situations such as urinary incontinence or a small bladder volume, which usually makes transabdominal ultrasound diagnosis very difficult.
Doppler ultrasound
Color Doppler examination is performed in addition to the two methods described above. Dopplerography makes it possible to assess the degree of blood flow of organs. For this, an image of a color picture is obtained, which displays the course of blood flow in the vessels of the pelvic organs. Modern ultrasound devices have this mode and make it possible to detect vascular pathology in the urinary and reproductive systems.