Prostate

Tuesday, April 19, 2022 11:08 AM

Anatomy
• Fluid for semen transportation
• Lies inferior to urinary bladder
• Transitional zone is the only thing we could see

Indication
• PSA: prostate specific antigen
○ Enzyme released by the prostatic epithelium
○ In clinical, it is a tumor marker specific for prostate carcinoma
• Benign prostatic hypertrophy, naiipit urethra
○ Possibility to constrict proximal urethra thus why Urinary Tract Symptoms occur

Technique
• Transabdominal and Transrectal
○ To assess the position of the prostate gland.
○ Since it is a small gland (walnut sized)
○ Would be difficult to image in a linear probe
• Transrectal:
• Transabdominal: accurate measurement
• Prostate biopsies are done in transrectal approach
• Orthogonal plane: length, width, height
• Increase vascularity in potential malignancy: cancer cell
• Proliferate: reproduces quickly
○ Needs oxygen to supply

Sonographic Appearance
• Heterogenous and medium level echoes
• Appears inferior to the urinary bladder

Transabdominal
• Should have half full bladder that acts as an acoustic window
• If patient cannot do at least 60mL, it cannot view the prostate gland

Transrectal
• Rectum should be emptied
○ Might need to take laxatives to ensure its clean or make sure before going to the
department, there's no more fecal material
• Probe should be covered using a condom
○ Make sure it's secure
• Make sure tip of probe has a gel
• To know if its longitudinal or transverse:
○ There's a marker on the handle
○ Thumb should be on probe marker
○ If thumb in lateral, longitudinal

Appearance
• Prostate is hyperechoic to seminal vesicles to vas deferens
• If prostate is not used, it enlarges

Pathology

Ultrasonography Page 1
Pathology

Prostitis
• Inflammation of prostate
• Increase flow in color doppler
• Periurethral prostate gland - surrounds urethra part of the

Benign Prostatic Hypertrophy

• Adenomatous growth

Prostate Cancer
• Near the rectum
• Ill defined: not much borders

Ultrasonography Page 2