Male pelvic ultrasound (technique)

The male pelvic ultrasound is a noninvasive, painless and effective diagnostic imaging technique used for evaluating and examining the pelvic region, specifically the lower abdomen, bladder and prostate gland in males.

Indications

Some common indications for male pelvic ultrasound are ^1,2:

• urinary symptoms such as urgency, frequency or retention

• prostate volume estimation

• hematuria

Preparation

For optimal image quality, patients should follow these preparation steps before undergoing a male pelvic ultrasound:

• consume water prior to the examination in order to achieve a full bladder, since possessing a urine-filled bladder is ideal for the transabdominal approach during the evaluation of pelvic contents ¹

• transrectal ultrasound: patients must undergo a bowel preparation for transrectal ultrasounds, usually involving an enema or suppository to ensure clear imaging ³

Techniques

There are three main techniques in male pelvic ultrasound: transabdominal, transrectal, and transperineal ^4-6.

Normal findings

Normal findings on male pelvic ultrasound include ^7,8:

• prostate gland: homogeneous echotexture without calcifications or nodules; size varies with age but usually measures approximately 4 x 3 x 2 cm

• urinary bladder: symmetrical appearance with no wall thickening, mass or diverticula; anechoic urine

• seminal vesicles: elongated tubular structures with anechoic appearance in the normal state, measuring around 2-2.5 cm in length and 1-1.5 cm in diameter

• surrounding tissues: absent positive findings, e.g. lymphadenopathy, mass, free fluid

Related pathology

Male pelvic ultrasound can aid in diagnosing a range of pathologies, such as:

• prostate cancer: hypoechoic lesions or irregularity in the shape of the prostate gland ⁹

• benign prostatic hyperplasia (BPH): enlarged, heterogeneous echotexture in the transition zone of the prostate ¹⁰

• prostatitis: heterogeneous echotexture with increased vascularity ¹¹

• seminal vesicle cysts or obstruction: dilatation or cystic changes in seminal vesicles ¹²

• bladder pathology: increased bladder wall thickness, presence of masses or stones ¹³