Ch. 43 & 44- Urethra & Prostate Gland Flashcards
Ddx for this rad finding?
Paraprostatic cysts and abscesses
What’s your dx? Ddx?
The mucosal margin of the prostatic urethra is markedly irregular
and filled incompletely, and there is attenuation of the lumen diameter of
the proximal membranous urethra.
Neoplasia or inflammatory
The intraabdominal portion of the urethra is longest in the:
cat
Ultrasonographic findings and most likely dx
myltiple hypoechoic structures within the prostate
Such cavities may represent small cysts or abscesses, but
they are also seen with neoplasia. Such a finding warrants obtaining an
ultrasound-guided transurethral prostatic wash cytology
What is the anatomic position of a normal prostate gland?
The normal prostate gland surrounds the most proximal aspect
of the urethra and lies ventral to the rectum and caudal to the
urinary bladder, typically within the pelvic canal.
Normal or abnormal finding?
The small filling defect in the dorsal wall of the prostatic urethra is a normal structure, the colliculus seminalis. It should not be mistaken for a lesion caused by prostatic or urethral disease.
Intraprostatic
gas can be evidence of:
gas-forming bacterial prostatitis.
In addition to routine lateral and ventrodorsal views, which additional view should be made in male dogs when there is a suspicion of urethral calculi?
Lateral view with the pelvic legs pulled cranially (butt shot)
What is your radiographic findings and ddx?
There is a well defined spherical soft tissue opacity located in close proximity of the pelvic inlet. There is another well defined soft tissue opacity just cranial to the previously described soft tissue opacity. There is dorsal deviation of the colon. One may say that the first described soft tissue opacity is displacing the urinary bladder ventrally and cranially but the only way to be 100% sure is by doing an contrast cystogram. Suspect prostatic enlargement. Ddx: BPH if the dog is not neutered, prostatitis, neoplasia, cyst, abscess
Prostatic size that exceeds 90% of the distance from the
pubis to the sacral promontory is suggestive of a mass lesion
(cyst, abscess, or neoplasm).
In male dogs, calculi commonly
occur where?
at regions of luminal narrowing or restriction: the ischial
arch and base of the os penis.
Ultrasound examination of the urethra
requires general anesthesia.
generally cannot visualize the entire pelvic urethra.
can usually differentiate neoplastic from inflammatory diseases of the urethra.
can reveal urethral wall layers consistently.
All of the above
generally cannot visualize the entire pelvic urethra.
CT findings:
Pre and post contrast images are included.
There is asymmetric enlargement of the prostate gland.
Irregular contrast enhancement of the prostate gland
is present. (The heterogeneity reflects the presence of nonperfused regions
because of cyst formation or necrosis.)
The urethra cannot be seen.
Note the dorsal displacement and compression of the rectum
Ddx: abscess, neoplasia
What’s your radiographic findings? ddx?
Asymmetric
positioning of the urethra within the prostate indicates an
asymmetric disease process within the prostate gland such as
a tumor or abscess with abscess being more common.
Definite pooling of the contrast medium within the
prostate gland is abnormal, however.
A change in the opacity of the prostate gland from its
normal soft tissue opacity indicates:
severe or chronic disease.
Areas of calcification within the gland are a sign either of
longstanding prostatitis or of neoplasia
Retrograde urethrography is a special radiographic technique
to examine the urethra using positive-contrast medium. Describe in your own words how it is performed in males and females.
Males and females: insertion ballon tipped foley in uretha. Inflaion of catheter. Administration of contrast (water-soluble, iodinated contrast medium). Inject constrast and acquire rads when there is about 1-2mLs left.
Vaginocystourethrography is an alternate technique
for evaluation of the female urethra and may be performed
in dogs and cats. Often need GA.
Ultrasonographic findings and ddx
The scattered focal hyperechoic regions that
create shadowing represent mineralizations within the gland. These mineralizations,
which are highly suggestive of prostatic neoplasia.
What is your radiographic findings?
A large region of contrast
medium extravasation is seen proximal to the os penis and
extends through a cutaneous wound cranially, consistent with rupture of
the penile urethra following puncture.
Rupture of the urethra is most commonly the result of pelvic
trauma and is diagnosed by urethrography with extraluminal
extension of contrast medium
What’s your dx?
An
irregularly margined focal filling defect distends the lumen of the membranous
urethra proximal to the ischial arch, consistent with a
urethrolith.
Air bubbles introduced into the
urethra during contrast-medium injection can generally be
distinguished from calculi by their smoothly rounded shape,
which does not distend the urethra, and inconsistent presence
with subsequent injections of contrast medium
What’s your dx?
A faint, cone-shaped mineral opacity is
seen in the region of the penile urethra, consistent with urethral obstruction by sandy mineral calculi.
MRI findings:
There is marked enlargement
of the prostate gland with irregular hyperintense cystic cavities
Ddx: cystic BPH
What’s your ultrasonographic findings?
The urethra is markedly
thickened and heteroechoic with extension of disease into the neck of the
urinary bladder.
Ddx: neoplasia, inflammatory
