If the contours of the prostate gland are fuzzy

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.

Heterogeneous echostructure of the prostate is one of the signs of prostatitis

The prostate gland is a vulnerable place in the body of a man, especially in adulthood. Her condition depends on many external factors, lifestyle. Adverse changes in the prostate can be caused by infection, tumor processes, hypothermia. Even the regularity of sexual activity affects the gland - prolonged abstinence can lead to stagnation of blood in the small pelvis.

To establish the condition of the prostate, palpation, ultrasound, biopsy, or other diagnostic measures may be required. Ultrasound is considered the most common and very reliable diagnostic method.

Indications for the procedure

The reasons for an Ultrasound examination are any signs of pathology.

• difficulty urinating;
• pain and discomfort in the perineum or sacrum area;
• feeling of incomplete emptying of the bladder after going to the toilet;
• erectile dysfunction;
• difficulty conceiving a child.

The above symptoms may indicate a variety of prostate pathologies. If they are detected, an ultrasound scan is mandatory.

In cases where there are reasons to sign up for an ultrasound examination, you should first make a visit to a urologist. After listening to complaints, a qualified doctor will be able to make assumptions about the nature of the disease, conduct an examination, and issue a referral for an ultrasound scan, if necessary. After the study, it would be advisable to visit this doctor again, and based on the results, receive prescriptions for treatment.

For men over 40 years old, it will be useful to undergo an annual ultrasound of the prostate, even without observing any health problems. If for some reason you do not want to undergo a study, an alternative may be a periodic blood test for PSA.Prostate-specific antigen is a prostate tumor marker that allows you to determine the presence of a malignant neoplasm at the earliest stages.

Research, norms

Using ultrasound, it is possible to determine not only the size, shape and structure, but also the features of the relative position of the pelvic organs. To visualize the prostate, it is enough to conduct an ultrasound by a non-invasive method - through the anterior abdominal wall, with a filled bladder. This method allows you to set the shape and size. A more detailed study (parameters of structure and blood flow) involves conducting a study with dopplerography.

The prostate without pathologies in the frontal plane looks like a rounded, symmetrical formation. In the vertical plane, the organ should be oval and have even, clear contours. Good differentiation of the glandular capsule is a favorable sign. Due to the capsule, the prostate gland is separated from the paraprostatic tissue, which has a high echogenicity.

In the normal state, the tissue is characterized by homogeneity and low echo density, and the gland is not found in the lumen of the bladder. Seminal vesicles should be located on the sides of the prostate, and have a diameter of no more than 1 centimeter.

Variants of deviations from the norm

Among the main pathologies detected by ultrasound, the following disorders are most common:

In 87% of cases, inflammation of the prostate gland (prostatitis) is the cause of the heterogeneity of the echostructure. This is a rather serious disease, the treatment of which requires the intervention of a qualified doctor.

Treatment nuances, risk factors

Classification of prostatitis implies the division of the disease into several categories:

• bacterial (acute and chronic);
• abacterial;
• asymptomatic;

The standard treatment for inflammation of the prostate gland of bacterial origin includes anti-inflammatory and pain medications, as well as antibiotics.

When choosing methods to combat abacterial prostatitis, doctors usually start from the symptoms that bother patients. The asymptomatic type is often discovered by chance, during a long examination of the whole body. As a rule, it does not require special therapy.

The likelihood of inflammation of the prostate may be increased due to:

• urethral or bladder infections;
• Installing a urethral catheter;
• lack of timely emptying of the bladder, and performing heavy physical work with an overflowing bladder;
• regular cycling or horseback riding

If left untreated, prostatitis can cause severe urinary problems or even cause bacteremia. Therefore, if during an ultrasound scan a heterogeneity of the prostate echostructure is diagnosed, the attending urologist must certainly examine all the data obtained.

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.