The use of transrectal ultrasonography in the diagnosis of urethroprostatic reflux

Abstract

Fig. 1. A cystourethrogram showing UPR into both lobes of the prostate, with dilated intraprostatic ducts.iiCase report A 34-year-old man with a neuropathic bladder secondary to spina bifida presented to the fertility clinic with hypofertility and urinary symptoms of urgency, enuresis and a sensation of incomplete bladder emptying. He had had repeated episodes of cystitis and pyelonephritis over the previous few years. His only relevant previous medical history was surgery to his bladder neck at the age of 6 years.Ultrasonography and an isotope renogram revealed a non-functioning hydronephrotic right kidney and a normal left kidney. A cystometrogram showed a poorly compliant bladder with an end-filling pressure of 35 cm H 2O. There was no evidence of detrusor instability. Cystoscopy showed a thick-walled trabeculated bladder with a wide-open bladder neck; the ureteric orifices and prostate appeared normal. A micturating cystogram confirmed the neuropathic bladder. Vesico-ureteric reflux was not demonstrated, but contrast medium was seen to reflux into the prostatic ducts during the filling phase (Fig. 1). Transrectal ultrasonography (TRUS) performed immediately after cystography confirmed bilateral grossly dilated fluid-filled prostatic ducts arising from a single main duct (Fig. 2). The anatomy of the proximal duct system was better demonstrated with TRUS than with cystography.

Kronik Prostatit/Kronik Pelvik Ağrı Sendromunda Etyoloji ve Tanı

“…Yine belli kan gruplarında mikroorganizmaların ya da spesifik bakteri suşlarının prostat afinitesinin olabileceği ileri sürülmüştür (40). Klinik çalışmalarda KPAS'lı olguların ürodinamik incelemelerinde mesane çıkım obstrüksiyonu, detrusor aşırı aktivitesi, hiperestezi, detrusor sfinkter disinerjisi gibi suprasakral patolojilerde de görülebilecek bulgulara sahip oldukları bildirilmiştir (41,42). Bir çalışmada detrusor sfinkter dissinerjisinin %18.6 civarında görüldüğü bildirilmiştir (43).…”