Ultrasound diagnosis is the gold standard for determining and confirming the pathologies of internal organs. The technique visualizes the organs in normal and in such pathological states as abscesses, tumors, cystic formations and helps to determine the amount of fluid (inflammatory exudate) in various cavities inside the body.
What organs are being examined?
Diagnostic examination of the pelvis and its organs includes visualization of:
- parietal peritoneum of the pelvis;
- seminal vesicles;
- pelvic lymph nodes;
- prostate gland.
In the study determine the size, location of organs and their pathological conditions. The organs of the genitourinary and reproductive systems are located in the pelvic cavity and are anatomically connected. That is why a comprehensive ultrasound examination of all the pelvic organs is carried out.
Indications for ultrasound
Ultrasound diagnosis in men is carried out to confirm diseases of the genitourinary and reproductive systems. The data obtained by ultrasound diagnostics help to clarify the diagnosis and conduct differential diagnostics in difficult cases. In addition, an ultrasound scan is performed to prevent the detection of chronic diseases and hidden genital infections in men .
Frequent indications for ultrasound of the pelvic organs of men are:
- hematuria - the presence of blood (red blood cells) in the urine;
- spermaturia - determination of ejaculate in the urine;
- male infertility or suspicion of it;
- pain in the suprapubic, inguinal and perineal regions ;
- erectile dysfunction or, on the contrary, pathologically prolonged erection of the penis (priapism);
- dysuria - a violation of the process of urination, which may cause pain during emptying of the bladder, a high frequency of urination, difficulty or vice versa incontinence of urine ;
- neoplasm detection;
- prophylactic diagnostics for urogenital diseases;
- puncturing and taking biopsy of any formations localized in the pelvis, under the control of ultrasound.
Preventive studies have significantly reduced the mortality from the oncology of the male reproductive organs. They allow you to identify diseases in the early stages, which increases the effectiveness of treatment and the speed of recovery.
Types of ultrasound diagnosis of the small pelvis
When ultrasound of the male pelvis, there are two main areas:
- transabdominal ultrasound;
- transrectal ultrasound (TRUS).
Each method has found its rationale and has its own strengths in the diagnosis of diseases.
The method consists in conducting ultrasound waves through the anterior abdominal wall. To do this, use the external sensor, which is installed in the suprapubic area (see Fig. 1). The area of the sensing element allows you to capture a larger number of reflected ultrasonic waves. This method is great for preventive research and does not cause discomfort to the man.
Fig. 1 - Performing transabdominal ultrasound.
Unlike TRUS, the accuracy of the transabdominal technique is somewhat lower. In this regard, the method is suitable for determining the volume of pathological formations in the pelvic cavity and bladder. It is worth noting that during transabdominal ultrasound, the bladder must be in a filled state.
Transrectal ultrasound (TRUS) is performed using a miniature ultrasound transducer to cause discomfort to the patient as little as possible. The sensor is inserted into the previously prepared and cleaned rectum.
Fig. 2 - Conducting transrectal ultrasound (TRUS).
In most cases, TRUS is used for a detailed examination of the prostate and determining the severity of the pathology in its tissues. Although the sensor has a small area of an ultrasound-sensitive element, it allows the study to be carried out in close proximity to the prostate gland (see Fig. 2). This increases the accuracy of the data: TRUS allows you to identify even the smallest cystic formations in the prostate gland - up to 0.2 cm.
TRUS is also the method of choice for such pathologies as incontinence or a small volume of the bladder, which makes it difficult to carry out standard ultrasound diagnostics.
Color Doppler study is an addition to the two methods described above. Doppler sonography allows to assess the degree of blood flow. To do this, get the image of the color pattern of blood flow in the vessels of the pelvic organs. Most modern ultrasound machines have this mode and help to identify the vascular pathology of the urinary and reproductive systems.
Preparation for pelvic ultrasound
The procedure for preparing a patient for a diagnostic study depends on the method of ultrasound diagnostics.
Preparation for transabdominal ultrasound:
- Refusal to eat high-fiber foods and legumes 2-3 days before the study, in order to minimize gas formation;
- it is advisable to refrain from eating 5-6 hours before the study;
- drink one and a half liters of water without gas 2 hours before the study;
- 2 hours before the ultrasound should refrain from urinating. In the case of strong urges, you can urinate a little, but not completely. After that, drink an extra glass of water.
For the TRUS , all the above stages of preparation are used, but the following are added to them:
- the use of preparations of intestinal cleansing (FORTRAN and analogues). To do this, the patient on the eve of the study drinks 3-4 packets. If the test is scheduled for the afternoon, two packages are drunk on the morning of the test;
- cleansing enema is an alternative method and is performed on the morning of the study. The volume of fluid injected into the rectum should be at least 200 ml.