1.13 Imaging techniques of examination the bladder, the prostate and the male genitals

Question 1

examination of the bladder?
Ultrasound
what can you see
what can’t you see

Answer 1

• Bladder should be full. To see if there is any residual volume in the bladder after urination
• can see:
  1. Bladder stones
  2. Congenital disorders (diverticulum, ureterocele)
  3. Foreign bodies
  4. Filling defects
• Can’t see:
  1. cystitis
  2. small tumors can be missed

Question 2

examination of the bladder?
what is x-ray cystography

Answer 2

• Fill bladder with contrast material using a urinary catheter

Question 3

indication of x-ray cystography?

Answer 3

• Hematuria
• dysuria
• reflux
• incontinence
• trauma
• strictures
• recurrent UTIs
• bladder tumors
• VUR
• bladder stones
• foreign bodies
• polyps
• diverticulum

Question 4

contra-indication of x-ray cystography?

Answer 4

• pregnancy
• active UTI
• recent bladder surgery
• urethral strictures

Question 5

examination of the bladder?
x-ray Urethrography

Answer 5

Fill urethra with contrast material to detect strictures

Question 6

examination of the bladder?
Cystourethroscopy
what is it good for

Answer 6

• Either rigid or flexible instrument
• For biopsy, visualizing tumor and stone etc.

Question 7

examination of the prostate?

Answer 7

US:
- Supravesical or transrectal
- Volume measurement, normal: 20-25ml
- Enlarged: Commonly protruding into the bladder
- Transrectal ultrasound for biopsy (TRUS)

MRI:
- good to visualize the prostate.

Question 8

Seminal vesicles examination?

Answer 8

Ultrasound:
- Only visible transrectally, obstructed in case of tumor

Question 9

examination of the testes?

Answer 9

Ultrasound:
- Small tumor, epididymitis, torsion, infarct, cyst, intrascrotal hernia
- Hydrocele, varicocele, hematocele

CT scan