The ultrasound examination of the prostate gland (prostate gland, prostate gland) is performed to assess prostate hypertrophy or detect other diseases and pathological conditions of the prostate gland, including prostate cancer. Thanks to an ultrasound examination, it is possible to determine the cause of urination disorders. Transrectal ultrasound of the prostate (TRUS) allows for accurate visualization of disturbing changes. As part of diagnostics, an ultrasound examination is also performed through the abdominal wall, which is used to assess the structure of the urinary system and to determine the amount of residual urine after voiding. The ultrasound is also used to monitor the prostate biopsy procedure, thanks to which this procedure is completely safe for the patient.
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What is the prostate?
The prostate gland (prostate gland) is an odd gland located under the bladder. The prostate gland surrounds the urethra, through which the urine is led out of the bladder. Normally, the prostate gland is the size of a chestnut. In many pathological conditions, the urethra is compressed by the enlarged prostate, which may cause problems with urination.
What are the indications for a prostate ultrasound examination?
Any man who notices the following symptoms should visit a urologist:
Delayed weak urine stream
A feeling of not fully emptying the bladder after micturition,
Pollakiuria,
Feeling urgent to urinate
Perineal discomfort,
Urinary retention.
Prostate ultrasound - preparation
If your doctor specifically recommends it, you should come to the examination with a full bladder. To do this, drink 4 glasses of still water 1-2 hours before the ultrasound examination.
Prostate ultrasound - what does it look like?
There are two types of ultrasound examinations to assess the prostate gland:
Transrectal ultrasonography (TRUS)
Due to the fact that the prostate is located in front of the rectum, the most accurate assessment of the prostate gland is performed through the rectum ultrasound. During the examination, the patient is lying on his side. A disposable sheath is placed on a special longitudinal ultrasound head and then the head is placed in the rectum. The examination is not painful, but may be accompanied by slight discomfort.
Transabdominal ultrasonography of the prostate (TAUS)
It is a less precise examination than TRUS, but it does not violate the patient's intimacy. In this study, we mainly assess the size of the prostate and the possible degree of residual urine after voiding. Examination of the prostate through the abdominal wall is similar to ultrasound of the abdominal cavity. The patient is lying on his back or side, and the doctor places an ultrasound head on the lower abdomen.
What does prostate ultrasound detect?
Benign prostatic hyperplasia
Benign prostatic hyperplasia is the most common cause of urination disorders in elderly men. Prostate enlargement is not a life-threatening disease, but its effects can significantly reduce your quality of life. Symptoms of an enlarged prostate gland occur in about half of men in their 60s. At 85 years of age, symptoms may affect up to 90% of men.
Prostate disease has the following stages:
I - enlargement of the prostate without the presence of symptoms,
II - prostatic hypertrophy causing pollakiuria,
III - residual urine after micturition,
IV - urinary retention with effects in the urinary system: bladder muscle hypertrophy, dilation of the ureters and the calicopelvic systems in the kidneys, development of renal failure.
Prostate ultrasound examination, in case of suspected prostate enlargement, enables:
assessment of residual urine in the bladder,
assessment of the size of the prostate gland,
evaluation of the bladder, ureters and kidneys.
The parameters obtained during prostate ultrasound are the basis for the choice of treatment method.
Prostatitis
The prostate gland can become inflamed, be it acute or chronic. Acute prostatitis is accompanied by fever, lower abdominal pain and urinary retention. Acute inflammation can become chronic. Inflammation is treated with antibiotics administered orally or in the form of intrathecal injection under 3D ultrasound guidance. A complication of untreated prostatitis may be an abscess that must be drained immediately.
Prostate cancer
Prostate cancer is the second most common cancer diagnosed in men (after lung cancer and colorectal cancer). It is worth noting that the early stages of prostate cancer may have symptoms similar to benign prostatic hyperplasia. Currently, prostate cancer has a chance to be diagnosed at an early stage thanks to the development of ultrasound and MRI techniques and the introduction of the so-called blood PSA tests. PSA is a substance secreted by the prostate gland, the level of which is significantly increased in the course of prostate cancer.
Prostate ultrasound examination is performed at every stage of prostate cancer diagnostics:
Location of suspicious lesions,
The Doppler ultrasound option is particularly useful in diagnosing areas suspected of neoplastic growth. Neoplastic tissue is characterized by increased vascularization with a chaotic course of blood vessels.
Prostate gland biopsy with taking a specimen for histopathological examination.
A biopsy is indicated when:
presence of significant size of tumors palpable during rectal examination,
increased levels of PSA in the blood
changes in ultrasound in the form of neoplastic changes.
Determining the stage of the tumor (infiltration of adjacent tissues).
Source:
Tyloch JF, Wieczorek AP: The standards of an ultrasound examination of the prostate gland. Part 2. J Ultrason 2017; 17: 43–58.
Common questions about prostate ultrasound:
The enlarged prostate puts pressure on the urethra, which drains urine out of the bladder. Typical symptoms of prostate enlargement are: delayed and weakened stream of urine, feeling urgent to urinate, feeling of incomplete emptying of the bladder after urinating, pollakiuria. If these ailments occur, a urologist should be consulted who will perform an ultrasound of the prostate and assess the degree of possible prostatic hyperplasia.
A TRUS test is a type of ultrasound scan performed transrectally. The TRUS examination allows very accurate visualization of changes in the prostate, because the ultrasound head located in the rectum is very close to the prostate. During the examination, the patient lies on his side. The examination takes approximately 20 minutes.
A few hours before the examination, it is advisable to do an enema. This will improve the patient's own comfort and make it easier for the doctor to perform the examination.
