What does uneven prostate contour mean

Results of ultrasound of the prostate. Question from Sergey.

Good afternoon! today was on ultrasound, the prostate gland is 5.3 x 4.1 x 4.4

V51.2 ml, enlarged. The outline is uneven. The echostructure is heterogeneous, areas of fibrosis and calcifications in the right lateral lobe up to 0.49-0.63 cm. In the central zone, the cyst is 0.6 cm.

Please tell me how dangerous it is. the doctor is on vacation for a month, I would like to know what to prepare for.

Ultrasound fully and diagnostically accurately allows you to identify changes in the prostate and other glandular organs, which is important, this is a harmless technique. The picture of ultrasound of the prostate in this case consists of several points that require explanation and decoding:

A normal prostate has a volume of up to 27 ml, a value of 30 is considered critical, above it we can already talk about enlargement and adenoma. Since the prostate increases with age (a manifestation of male menopause), sometimes the volume norm is calculated according to the Gromov formula, making an adjustment for age:

V, ml0.13V, years + 16.4

The value of 51.2 ml is already clearly critical, and with a volume of more than 40 ml, there is usually a question about the use of minimally invasive methods for removing adenomas (laser, TUR), while drugs can still be dispensed with up to 40 ml. It is necessary to treat adenoma because its long course leads to changes in libido and erection, recurrence of urogenital infections, and kidney failure.

Uneven contours are usually a sign of chronic prostatitis, rarely - prostate cancer, with adenoma, the borders of the gland are even. Roughness usually speaks of inflammation and swelling of the capsule.

Fibrosis and calcifications look like areas of increased echogenicity (white) on ultrasound, this is a consequence of the replacement of healthy tissues that died during inflammation of the prostate. In principle, fibrosis is dangerous only with a progressive dysfunction of the prostate (decreased libido and fertility), but large stones can move and cause pain. A 0.6 mm cyst is not dangerous, but can grow and suppurate. Since only a conclusion is given, and not a description of the picture of the prostate, it is impossible to differentiate the origin and nature of hyper- and hypoechoic areas, they are called fibrosis, calcifications and cysts, although another specialist may interpret the data differently.

Recommendations for the short term, based on prostate ultrasound data: prevent exacerbation of prostatitis (do not overcool, regularly engage in safe sex, minimize bad habits and dietary errors, increase fluid intake), take a PSA test and repeat it twice a year ( allows you to diagnose prostate cancer in time, since cancer does not have typical signs on ultrasound), discuss with the doctor the prospects for adenoma therapy (transurethral resection, laser vaporization or enucleation). There is no urgent situation, questions of further examination and treatment should be discussed with the doctor in a planned manner.

All about deciphering the ultrasound of the prostate: the norm or pathology of the organ

Different diagnostic methods are used to detect pathologies of the prostate gland. ultrasound examination of this organ is considered the most accurate, informative and accessible among all. What can be revealed, and how is prostate ultrasound decoding performed correctly?

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Briefly about ultrasound of the prostate

In the vast majority of cases, ultrasound examination of the prostate is performed transrectally, that is, through the rectum. This is due to the fact that in this way it is easiest to get close to the organ, because when the probe is inserted into the anus, only a thin mucous membrane separates the prostate from the ultrasound machine, which is not at all an obstacle to diagnosis. This study is called TRUS of the prostate.

In rare cases, when the patient has contraindications to rectal ultrasound, abdominal ultrasound is also used. It is carried out on the patient's abdomen. Such a study is considered less informative, since the skin and layers of fat of the patient in this place make it difficult to correctly assess the size, contours and other characteristics of the organ, which means that the detection of pathology will also not be so successful. In obese patients with a significant fat layer, abdominal ultrasound is not performed at all.

The positive aspects of ultrasound examination of the prostate include the fact that the patient receives the results almost immediately, in his hands. In addition to the diagnosis, the specialist can also provide images of the prostate gland, which will help the urologist to correctly assess the extent of the problem in the future.

Decoding ultrasound of the prostate: main characteristics

These include those indicators that must be present in the study protocol. This is a necessary minimum, without which it is simply impossible to correctly assess the work and structure of an organ.So what are these characteristics:

What diseases can be detected by the results of ultrasound of the prostate?

Identification of diseases in this case is just a suspicion of them, and not a final diagnosis. So, what can be revealed by the results of ultrasound:

Ultrasound results: normal

Normally, the uzist will give a conclusion in which the following phrase will be indicated - "ECHO signs of the disease were not detected." This does not mean the complete absence of the disease, but that even in the presence of pathology, the functioning of the organ is not yet dangerous. If the rest of the tests are also normal, then it can be stated that his prostate is completely healthy. If the results of other tests are not so rosy, then it makes sense for the patient to undergo other diagnostic methods.

Can an uzist indicate diagnoses in the conclusion?

No, the ultrasound protocol is just one of the diagnostic methods, and diagnoses are not made on it. In addition, the uzist does not have any authority to do so, because only the attending physician, the urologist, has the right to make a final diagnosis, for which he will be guided not only by ultrasound of the prostate gland, but also by the results of other studies, including blood tests, urine tests, uroflowmetry, prostate culture etc.

According to the results of ultrasound, a specialist can only suspect the presence of a pathology. The more diagnostic methods the patient undergoes, the more accurate and explicit his diagnosis will be, which means that the treatment will most likely be correct.

What else is it necessary to perform ultrasound of the prostate?

This study is carried out not only to detect pathology, but also in the process of treating prostate pathology. Deciphering the ultrasound will help control the condition of the organ. Thus, a decrease in the size of the prostate will indicate the correctness of the treatment and the speedy recovery of the patient. A stable pathological condition indicates the possible futility of the therapy and the need to replace drugs. If the situation worsens as a result of the ultrasound, then the doctor must take urgent measures, including performing an operation on the patient.

In other words, the correct interpretation of prostate ultrasound will allow timely and competently monitoring the clinical picture and identifying changes that are not felt by the patient.

In addition, the ability to take a photo of the organ during ultrasound of the prostate is of great importance. How can she help a urologist? So, in the presence of cysts or calcifications (stones) in this organ, it is impossible to reliably determine their location “by touch”. If the patient is scheduled to undergo surgery in the near future, then this data will help the surgeon to correctly assess their actions in advance.

Finally, if the results of the biopsy have confirmed that dark formations with low echogenicity are cancer cells, then the ultrasound photograph of the prostate of this area will indicate their exact location. This information is simply necessary when conducting radiation therapy, because, if possible, only pathogenic metastasizing cells should be irradiated, and not healthy tissues.

Ultrasound examination of the prostate how to decipher the results yourself

Ultrasound diagnosis of the male prostate is a popular and affordable method for many patients to examine the prostate gland and the presence of problems in it. The results of the ultrasound of the male prostate gland, the decoding of which is not always clear and understandable to a simple patient, force each patient to seek medical advice. But you can try to decipher and figure out some points on your own.

Structure of the prostate

First, a little theory. The prostate gland is shaped like an ordinary chestnut, divided into two halves and is located in the small pelvis, just below the bladder. In the prostate itself, there are up to 50 glands with ducts, which, as a result of fusion, form the outlet of the urethra. Another part of the prostate connects to the diaphragm.

Doctors divide the gland into several zones, which are responsible for their own characteristics. Three parts of the prostate gland are usually called: inferolateral, superior and inferior. Behind the prostate there is a seminal tubercle where male sperm is formed. Also, the gland consists of fibromuscular tissue. All these parts today can be examined using ultrasound and pinpoint the location of inflammation or other disease.

When to perform an ultrasound

Diagnostics of the prostate for a man is prescribed by a doctor in case of complaints of a violation in the work of the urinary system, intimate life. Also, the study can be carried out after passing the tests, where they diagnosed a violation in the work of the gland or after examining the patient.

Pain in the groin

Among the main symptoms, after which they give a referral for ultrasound, they note:

• pelvic pain.
• Pain when going to the toilet, weak urine stream, or frequent urination.
• lack of erection.
• Pain in the region of the kidneys.
• complaints about the reproductive or urinary system and other organs by men over the age of 40.

Types of ultrasound for the study of the gland

Most often, the prostate gland is examined using the following methods:

Organ study

• Transabdominal ultrasound examination (the most accessible and common option. The procedure is painless and simple, has no contraindications for use. The ultrasound results are quite clear and understandable. The analysis itself is carried out in the lower abdomen).
• Transperineal ultrasound (similar to the previous type of ultrasound, but the sensor takes a picture in the area of the perineal surface. Thus, the apex of the prostate is carefully studied, but in worse quality).
• Transurethral ultrasound (a rather traumatic method for which you need to properly prepare. But as a result of the study, you can get a very clear picture of the prostate. After such an ultrasound, the patient may experience complications, for example, urinary retention, so it is used very rarely.< /li>
• Transrectal ultrasound (a universal option for conducting a study that shows a complete high-quality picture of the entire prostate gland. But to conduct such an ultrasound, the device’s sensor must be inserted into the anus, which causes discomfort in men. This type of analysis cannot be used for those who have problems with the rectum.

How to prepare for a prostate ultrasound

If a patient has been prescribed a transabdominal ultrasound, then no special preparation is required for its implementation. To conduct an ultrasound, you need to have a little urine in the bladder - for this, it is enough to drink a liter of water an hour before the ultrasound. First of all, a transabdominal ultrasound is always performed on the patient, and if after it the problem needs to be treated or studied further more deeply, then other types of analysis are performed.

If the patient is going to have a transrectal examination, then he needs to clean the intestines with an enema before visiting a specialist. If the patient has suspicions of diseases or damage to the rectum, then before the ultrasound, he should undergo sigmoidoscopy or sigmoidoscopy - the study of the mucous membrane of the rectum.

How is ultrasound of the prostate performed

With transabdominal ultrasound, the patient lies down on a couch or urological chair, and the doctor examines the gland using a special sensor from the pubis upwards. The gland is analyzed along and across, changing the movement of the sensor to obtain the most accurate image.

For a transrectal examination, the patient is laid on the left side and the legs are drawn up to the stomach. A condom is put on the ultrasound sensor and, with the help of a lubricant, it is inserted into the anus by 6-7 centimeters. Sometimes the condom is filled with water to get the clearest image and to study all parts of the prostate.

What is measured on ultrasound of the prostate

During the study, a specialist usually determines the size of the male prostate, studies the clarity of its contours and the uniformity of tissues. As a result of ultrasound, the following parameters should be indicated: the width, length and thickness of the prostate gland, the volume of the gland (calculated by a special formula for multiplying all sizes by 0.52) and other details indicated by the doctor in the direction for the examination.

Deciphering ultrasound of the prostate

In order to correctly decipher the results of an ultrasound scan, you need to know what indicators the specialist studied during the study. Most often, this is the size, homogeneity, echogenicity, the presence or absence of stones, cysts, seals, as well as the condition of the ducts through which the sperm passes.

Prostate Size - The male prostate can vary in size depending on the age of the man. In a 25-year-old man, the gland acquires a constant size and under normal conditions it no longer increases. If a man had pathologies or serious diseases, then the structure and size of the prostate gland may change. Thus, the functioning of the genitourinary system may be disrupted and even a malignant tumor or an inflammatory process may develop, which will spread to other organs.

During a prostate check, the transcript may include several items. Normally, the volume of the prostate should be from 18 to 26 cubic centimeters, and the length is from 2.5 to 4 centimeters, the width is 3-4.5 centimeters, and the thickness is one and a half to two centimeters. The contours in a healthy gland are clear and even. The echogenicity of the gland should be medium, and the structure should be fine-grained. The shape of the prostate should be semicircular or triangular. The exact ratio of the size of the prostate and the age of a man is determined by the Gromov formula - the volume of the prostate is 0.13 times the patient's age plus 16.4.

How to decipher ultrasound in prostate diseases

Decoding ultrasound of the prostate for diseases of the patient is also simple. Most often, the analysis is deciphered by a doctor.For example, as a result of the study, the main sign of the presence of prostate adenoma will be an impressive change in the size of the gland and the presence of seals, cysts in the structure, as well as increased echogenicity up to 7 millimeters. A diffuse prostate will be characterized by a heterogeneous structure.

If the patient's echogenicity has increased, then this means that the disease is chronic, and if it has decreased, the presence of an inflammatory process. The development of an abscess will be characterized by anechoic or hypoechoic formation, cysts. Rough and indistinct contours of the gland and the absence of echogenicity may indicate a malignant tumor. Also in this case, there may be seals of various echogenicity and an increase in lymph nodes by two or more centimeters in the inguinal region. If there are such indicators, then the patient is sent for additional tests.

It is worth noting that small formations up to 5 millimeters can also be present in the body of a healthy man.

A separate decryption requires the presence of stones. These are small formations that are characterized by very high echogenicity. The sizes of stones can be different and there can be one or several stones in the gland.

In conclusion, we can say that almost all diseases of the male prostate can be diagnosed using ultrasound. The reliability of this type of survey is also quite high and accurate, more than 80%. In almost all cases of diseases, the doctor first of all appoints a man to undergo tests and an ultrasound examination