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 sensor, which emits high-frequency sound waves (ultrasounds). Reflected from the internal structures of the body, these waves create images. Ultrasound imaging can also be useful for determining organ function, for directing an injection or biopsy.
Ultrasound is considered the gold standard for diagnosing abnormalities of internal organs that are located in the pelvis. Using this method, it is possible to visualize organs in both normal and pathological conditions, for example, ultrasound can diagnose abscess, tumor, cysts, and help determine the presence and amount of inflammatory exudate.
Diagnostic study of the pelvis and its organs in men includes the diagnosis of diseases of the bladder, seminal vesicles, peritoneum, pelvic lymph nodes, and prostate cancer. The study determines the size, placement of organs and the presence of pathological conditions in them. Organs of the urinary and reproductive systems are located in the pelvis and are connected anatomically to each other. In this regard, most often, a comprehensive ultrasound of all organs, which are included in the pelvis.
Ultrasound examination of the pelvis in men mainly examines the bladder and prostate. Bladder: shape, size when filling, size when emptying, post-emptiness, wall, urinary streams. Prostate: size, shape, signs of infections, tumors, calcifications. Sonography can also help identify abnormal lymph nodes (lymphadenopathy) or the presence of free fluids, blood, and suspicious masses.
Organs and structures that are solid and homogeneous, or if they are filled, like a bladder, with fluid, are clearly manifested in pelvic ultrasound. Bones, as well as organs that are filled with air, such as the intestines, do not show well on ultrasound and can interfere with the visibility of other organs.
What happens during the study?
During transrectal ultrasound, the patient will be asked to lie on the left side, bending his knees. A digital rectal examination will be performed before the ultrasound. Then the oiled sensor will be gently inserted into the rectum. The sensor will then move slowly to take pictures at different angles. The patient may feel some pressure. Water can be placed in the rectum to clear the end of the sensor so that you can see clear pictures.
How does it feel?
If transabdominal ultrasound is performed, the patient is likely to feel pressure in the bladder and a strong urge to urinate because the bladder is full. A gel applied to the stomach may feel cold. The patient will feel a slight pressure from the sensor when it passes over the stomach. If the patient has an injury or pelvic pain, the light pressure from the transducer can be painful. The patient will not hear or feel the sound waves.
There is usually a slight pain during transrectal ultrasound. The patient will feel pressure from the sensor as it is placed in the rectum.
If a biopsy is performed during ultrasound, pain may occur when taking a sample.
Ultrasound diagnostic method in men is performed to diagnose, identify and confirm various diseases of the reproductive and urinary systems. Data obtained using ultrasound, help to accurately determine the diagnosis and make in difficult cases the differential diagnosis of various diseases. In addition, ultrasound diagnostics are performed to prevent the detection of some latent and chronic genital infections.
Often, indications for this method of diagnosis in men can be:
- blood (red blood cells) in the urine;
- spermaturia - the presence of sperm in the urine;
- suspicion or the presence of male infertility;
- pain of varying intensity in the pelvic region;
- erectile dysfunction or vice versa, pathologically prolonged arousal (priapism);
- dysuric phenomena that can lead to pain in the bladder during emptying, high frequency of urination, difficulty, or vice versa incontinence;
- for the detection of tumors;
- preventive diagnostics, screening of diseases;
- puncture and biopsy under the supervision of ultrasound.
Preventive studies significantly help to reduce mortality from cancer of the organs of the genitourinary system in men. They provide an opportunity to identify in the early stages of the disease, which increases the efficiency and speed of treatment and recovery.
It can be concluded that for the diagnosis of reproductive, urogenital systems, ultrasound examination of the urogenital tract is the most reliable and accurate method for diagnosing and detecting various pathologies in the pelvic region.
A pelvic ultrasound can be done:
- to determine the cause of dysuric problems;
- look at the size of the bladder, depending on its filling, it can determine whether the bladder is completely empty during urination;
- to guide needle placement during a biopsy or when draining a fluid from a cyst or abscess;
- for the detection of colorectal cancer and its response to treatment.
Preparation for the study
Preparation of the patient for this diagnostic examination depends on the method of ultrasound diagnosis. You must tell the doctor if the patient has had an x-ray with a contrasting material (for example, barium) in the last 2 days. Barium, which still remains in the intestine, may subsequently interfere with ultrasound.
The patient may have to remove clothes below the waist and put on a dress before the examination.
Preparing for the transabdominal method:
- Refusal of food, which contains a large amount of fiber and legumes, 2-3 days before the start of the study, in order to minimize gas production;
- it is advisable to abstain from eating for 5-6 hours before the start of the study;
- drink half a liter of carbonated water 2 hours before the start of the study;
- 2 hours before ultrasound should refrain from urinating;
- in case of a strong desire, you can urinate a little, but not completely, and after that you need to drink an extra glass of water;
- if the patient cannot drink the required amount of water, then the bladder can be filled with water through a thin flexible tube (catheter) inserted into the bladder;
- when research is done, the gel is cleared from the skin. The patient may then urinate as soon as the examination is completed.
To prepare for the transrectal method, all the above preparation steps are used, but to them are added:
- the use of drugs that clean the intestines, for this the patient drinks 3-4 packages on the eve of the study;
- if the study is scheduled for the afternoon, then in the morning, two packages are drunk on the day of the study;
- cleansing enema - an alternative method and is carried out in the morning, just before the examination, the volume of fluid that is injected into the rectum should be at least 200 ml;
- It is important to tell your doctor if you are allergic to latex so that the sensor cannot be applied to the latex cap before using it;
- if a person has a prostate biopsy, antibiotics may be given the day before the test begins.
Types of ultrasound
Ultrasound of the pelvis in men highlights two main areas: transabdominal ultrasound and transrectal ultrasound. Each method has found its justification and has its strengths in the diagnosis of diseases.
A small portable device, called a transducer, is transmitted back and forth through the lower abdomen.
The method consists in the fact that ultrasonic waves are conducted through the anterior abdominal wall. To do this, use an external sensor that is installed in the suprapubic area. The area of the sensing element allows you to capture more reflected ultrasonic waves. This method is best suited for preventive research and does not cause discomfort in humans. Unlike transrectal, the accuracy of transabdominal technology is somewhat lower. In this regard, this method is suitable for determining the presence of a pathological mass in the pelvis and bladder. It is worth noting that during the transabdominal diagnosis of the bladder should be in a filled state. The full bladder pushes the intestine (which contains air) from the pelvic organs. This makes the ultrasound image clearer. If an ultrasound is performed in an emergency, the bladder can be filled with water through a thin flexible tube (catheter) inserted into the bladder.
Transrectal ultrasound is performed using a miniature ultrasound transducer to minimize patient discomfort. The sensor is inserted directly into the rectum, which must be pre-cleaned and prepared.
In most cases, the transrectal ultrasound method is used for a detailed examination of the prostate gland and to determine the severity of the pathology in its tissues. Although the sensor has a small area of the element, which is sensitive to ultrasound, it allows for studies directly close to the prostate gland. This improves the accuracy of the results. This method allows you to identify even the smallest cysts in the prostate gland - up to 0.2 cm. In addition, this method is the best choice for pathologies such as incontinence or a small volume of the bladder, which usually makes it very difficult standard ultrasound diagnosis.
A study using color doppler is performed in addition to the two methods described above. Doppler sonography makes it possible to assess the degree of blood flow to the organs. For this, an image of a colored picture is obtained that displays the flow of blood 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.