Modern examination and the subsequent high-quality treatment of patients suffering from diseases of the urogenital tract largely depend on information which the doctor has about the changes in the structure and anatomy of the affected organ. Recently, a great help in identifying such changes renders the application of ultrasonic methods of research, especially research transrectal investigation (TRUS) of prostate gland, seminal vesicles, bladder, etc.
TRUS method requires special high rectal probes (5 to 10 MHz). Currently, there are sensors with linear scanning surface, pie sensors biplanned (linear and Convex), as well as sensors with the possibility of using pulsed and color Doppler. Acquisition costs of these sensors are fully justified, since diagnosis of diseases of the pelvic organs in males (especially – the prostate gland) at the present level is impossible only during the transabdominal (conventional) sonography.
The resarch is usually carried out in the position of the patient on his left side with legs bent and drawn to belly down. The gel is applied on the scanning surface of the sensor, the rubber cap is put on top of it. The cap is smeared with vaseline. Probe is inserted into the rectum is usually to a depth of 5-6 cm – for the study of prostate cancer, deeper – to study the bladder and seminal vesicles. Depending on the type of device for scanning the sensor surface obtained by the longitudinal (with a linear sensor), the transverse and slanting- oblique (with sector or Convex probe) sections. If during the transabdominal study the distance from the sensor to the prostate gland range from 7-15 cm or more, then during TRUS bladder, prostate gland, seminal vesicles, virtually separated from the scanning surface of only a wall of the rectum, fascia and a thin layer of tissue adrectal. Typically, this distance does not exceed 7-8 mm.
It is naturally that during TRUS visualization of the smallest elements of the structure of these bodies, completely inaccessible during the transabdominal study is possible. In carrying out TRUS by the linear transducer it is obtained longitudinal sections of the bladder and prostate gland, similar longitudinal sections with transabdominal sonography. In the study by the sector and Convex probe obtained by cross-sections and slanting- oblique cut of the bladder and prostate cancer, similar to the transverse and oblique cut at transabdominal ultrasound.
The pathology of bladder neck best revealed by TRUS with a linear transducer, particularly during voiding cystic samples diagnosed as bladder neck contracture, and the disclosure of the bladder neck, amid anechoic strips of the fluid polyps, strictures, stones, etc. visualized in the projection of urethral.
Miction pharmatests are used for the diagnosis of detrusor-sphincter dissenergy. Contraindication to transrectal exam is the presence of deep cracks in anus rectum, inflamed hemorrhoids.
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