Norm of Prostate Ultrasonography (Prostate Echogram, Prostate Ultrasound)
The prostate gland is round and about 3 cm in diameter. Prostatic tissue is homogeneous and causes only a slight bladder wall indentation.
Usage of Prostate Ultrasonography (Prostate Echogram, Prostate Ultrasound)
Adjunct to digital examination of the prostate, diagnosis and staging of and screening for prostate cancer, evaluation of the size and shape of the prostate gland, monitoring response to treatment in prostate disease, and providing guidance for transrectal biopsy of the prostate gland or for positioning of clients for radiation of the prostate gland.
Description of Prostate Ultrasonography (Prostate Echogram, Prostate Ultrasound)
Evaluation of the prostate gland by the creation of an oscilloscopic picture from the echoes of high-frequency sound waves passing through the anterior rectal wall or through the urethra over the pelvic area (acoustic imaging, endosonography). The time required for the ultrasonic beam to be reflected back to the transducer from differing densities of tissue is converted by a computer to an electrical impulse displayed on an oscilloscopic screen to create a three-dimensional picture of the pelvic contents. Because of the risk of sepsis and trauma from transurethral ultrasonography, the transrectal route is preferred. For staging prostate cancer, transrectal ultrasonography costs less than magnetic resonance imaging, with comparable or superior accuracy. This technique may help detect prostate lesions before they become large enough to palpate. Ultrasound techniques are still inferior to prostate biopsy in sensitivity for diagnosing prostate cancer.
Professional Considerations of Prostate Ultrasonography (Prostate Echogram, Prostate Ultrasound)
Consent form IS required.
Transurethral route: Sepsis and trauma.
Transrectal route: Hematuria, infection, urinary retention. Note: Complications are more frequent in clients who receive a preprocedural enema.
Transurethral route: Bleeding disorders, thrombocytopenia.
- This test should be performed before intestinal barium tests, or after the barium is cleared from the system.
- Obtain ultrasonic gel or paste.
- For transrectal ultrasonography, a hypertonic enema of sodium phosphate or a bisacodyl suppository may be prescribed.
- The client must disrobe below the waist or wear a gown.
- See Client and Family Teaching.
- Just before beginning the procedure, take a “time out” to verify the correct client, procedure, and site.
- An injection of lidocaine or inhalation of a nitrous oxide/air mixture may be used to manage procedure-associated pain.
- The client is positioned supine, and a short transabdominal ultrasonogram may be performed to evaluate for kidney distention.
- A suprapubic examination of the prostate is performed, and the rectum is examined digitally for obstruction.
- The client is assisted to a knee-elbow, lateral decubitus, or rising position.
- The probe is covered with an air-free, sterile, transparent cover or condom. The condom is then coated with sterile lubricant, and the probe is slowly inserted into the rectum.
- After the probe is inserted into the rectum, the condom may be inflated with 20–60 mL of deaerated water, depending on the practitioner's preference.
- The probe is angled anteriorly, and ultrasonography of the prostate is performed.
- Photographs of the oscilloscopic display are taken. Doppler ultrasonography may be used to further define abnormalities in vascular supply and differentiate vascular differences in the prostate tissue.
- A biopsy of the prostate lesions may be performed during ultrasonography.
- Remove the gel from the skin.
- Sterilize the endosonography probes by soaking them in glutaraldehyde solution for 10 minutes.
Client and Family Teaching
- An enema may be prescribed before the procedure.
- Drink normal amounts of fluids for 24 hours before the procedure.
- Clients under age 60 experience more discomfort than older men during the procedure. Both local and topical anesthesia may be used to reduce discomfort.
Factors That Affect Results
- Dehydration interferes with adequate contrast between organs and body fluids.
- Lower intestinal barium obscures results by preventing proper transmission and deflection of the high-frequency sound waves.
- Allow at least 6 weeks between procedures if biopsies are taken.