How to do prostate ultrasound

Many men suffer from prostate disease, which is very difficult to treat and can cause serious interference to men's sexual life and urinary system. However, most people with prostate disease are older men. When they go to the hospital for treatment, doctors usually recommend that patients undergo a color Doppler ultrasound to determine the extent of the disease. So how is a prostate color Doppler ultrasound performed?

1. The patient drinks water, holds urine, and then checks the prostate with a full bladder, which is mainly used for screening;

2. When the patient urinates, the prostate is checked through the transrectal probe. For patients diagnosed with prostatitis or hematospermia, the transrectal probe can accurately measure the size and shape of the prostate, the calcification status, and the presence of cysts and nodules. The condition of the bilateral seminal vesicles can also be checked. If there is bilateral seminal vesiculitis combined with hematospermia, it can be seen that the bilateral seminal vesicles are enlarged, the ducts inside are dilated, and in severe cases there is a lot of fluid accumulation.

The contour and shape of the normal prostate vary depending on the ultrasound examination route. For example, when scanning transversely through the abdominal wall, the normal prostate is in the shape of an inverted chestnut or triangle, with blunt edges, clear and neat capsule echoes, uniform internal echoes, and a high-echo urethra in the center; when scanning longitudinally, the prostate segment of the urethra is an oblique high-echo band. Scanning through the rectum in the sagittal plane can show the anterior wall of the rectum, the seminal vesicle in front, the bladder in the front and upper part, and the prostate in the front and lower part. The posterior urethra and the ejaculatory duct that flows into it can be shown in the center of the prostate; the transverse section can clearly show the adjacent relationship between the prostate and the bladder. The normal values ​​of the prostate are 3.1cm, 3cm, and 2.3cm in transverse diameter, superior and inferior diameter, and anterior-posterior diameter, respectively.

Ultrasound screening of the prostate mainly includes transabdominal scanning, transperineal scanning, transrectal scanning, and transurethral bladder screening. Currently, transrectal screening is the most commonly used in clinical practice. The cross-section of the prostate looks like an inverted chestnut, with clear outlines, intact capsule, a depression in the middle of the rectal surface, and bilateral symmetry. The normal anterior-posterior diameter is about 2cm, the left-right diameter is about 4cm, and the upper and lower diameters are about 3cm. The prostate is divided into the inner gland and the outer gland. The inner gland is smaller, round or elliptical, with low and uniform echo; the outer gland is larger, surrounds the inner gland, and has a fine dot-like strong echo. The inner gland is located around the urethra above the seminal fossa, and it includes the transitional zone and periurethral tissue. The external gland consists of two parts: the peripheral area has a strong echo and the boundary between it and the internal gland is not very clear. In case of prostatic hyperplasia, the boundary between them is very clear, which is the surgical capsule; the central area has a strong echo and the boundary between it and the internal gland is clear. It mainly shows the relationship between the peripheral area and the distal urethra.

You need to hold your urine when doing a prostate color Doppler ultrasound. The purpose of holding your urine is to use the bladder as a sound window to examine the prostate. If the bladder is not full, the prostate cannot be seen, and prostate hyperplasia or thickening of the texture cannot be detected.