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Office Ultrasound for the Urologist

  • Office Urology (N Shore, Section Editor)
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Abstract

Imaging of the genitourinary tract is essential in the workup of the majority of the conditions seen daily by urologists. The use of ultrasound in the office provides a safe, low cost, and efficient way for the clinician to evaluate the patient in real time. Ultrasound can allow for bedside diagnosis in many conditions and assist in treatment planning. This chapter covers the major applications of office ultrasound for the urologist as well as discusses future applications of ultrasound for the office setting.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Dussik K. Uber die Moglichkeit, hochfrequente mechanische Schwingungen als diagnostische Mittel zu verwerten. Z Ges Neurol Psych. 1941;174:153–68.

    Article  Google Scholar 

  2. Singer EA, et al. What's new in urologic ultrasound? Urol Clin North Am. 2006;33(3):279–86.

    Article  PubMed  Google Scholar 

  3. Fowlkes JB. American Institute of Ultrasound in Medicine consensus report on potential bioeffects of diagnostic ultrasound: executive summary. J Ultrasound Med. 2008;27(4):503–15.

    PubMed  Google Scholar 

  4. •• AIUM practice guideline for the performance of an ultrasound examination in the practice of urology. J Ultrasound Med. 2012;31(1):133–44. This is a review from the AIUM of the protocols and indications for ultrasound performed in the practice of urology.

  5. Schwerk WB, Schwerk WN, Rodeck G. Testicular tumors: prospective analysis of real-time US patterns and abdominal staging. Radiology. 1987;164(2):369–74.

    PubMed  CAS  Google Scholar 

  6. Woodward PJ, et al. From the archives of the AFIP: tumors and tumorlike lesions of the testis: radiologic-pathologic correlation. Radiographics. 2002;22(1):189–216.

    PubMed  Google Scholar 

  7. Shah A, et al. Re: New ultrasound techniques for imaging of the indeterminate testicular lesion may avoid surgery completely. Clin Radiol. 2010;65(6):496–7.

    Article  PubMed  CAS  Google Scholar 

  8. Cubillos J, et al. A conservative approach to testicular rupture in adolescent boys. J Urol. 2010;184(4 Suppl):1733–8.

    Article  PubMed  Google Scholar 

  9. Bhatt S, Dogra VS. Role of US in testicular and scrotal trauma. Radiographics. 2008;28(6):1617–29.

    Article  PubMed  Google Scholar 

  10. Buckley JC, McAninch JW. Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol. 2006;175(1):175–8.

    Article  PubMed  Google Scholar 

  11. Guichard G, et al. Accuracy of ultrasonography in diagnosis of testicular rupture after blunt scrotal trauma. Urology. 2008;71(1):52–6.

    Article  PubMed  Google Scholar 

  12. Chandra RV, et al. Rational approach to diagnosis and management of blunt scrotal trauma. Urology. 2007;70(2):230–4.

    Article  PubMed  Google Scholar 

  13. The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinics. World Health Organization. Fertil Steril. 1992;57(6):1289–93.

  14. Benoff S, Gilbert BR. Varicocele and male infertility: part I. Preface. Hum Reprod Update. 2001;7(1):47–54.

    Article  PubMed  CAS  Google Scholar 

  15. Sakamoto H, et al. Effects of varicocele repair in adults on ultrasonographically determined testicular volume and on semen profile. Urology. 2008;71(3):485–9.

    Article  PubMed  Google Scholar 

  16. Zucchi A, et al. Varicocele and fertility: relationship between testicular volume and seminal parameters before and after treatment. J Androl. 2006;27(4):548–51.

    Article  PubMed  Google Scholar 

  17. Tarhan S, et al. Long-term effect of microsurgical inguinal varicocelectomy on testicular blood flow. J Androl. 2011;32(1):33–9.

    Article  PubMed  Google Scholar 

  18. Honig SC, Lipshultz LI, Jarow J. Significant medical pathology uncovered by a comprehensive male infertility evaluation. Fertil Steril. 1994;62(5):1028–34.

    PubMed  CAS  Google Scholar 

  19. McCallum T, et al. Unilateral renal agenesis associated with congenital bilateral absence of the vas deferens: phenotypic findings and genetic considerations. Hum Reprod. 2001;16(2):282–8.

    Article  PubMed  CAS  Google Scholar 

  20. • Pinggera GM, et al. Assessment of the intratesticular resistive index by colour Doppler ultrasonography measurements as a predictor of spermatogenesis. BJU Int. 2008;101(6):722–6. This article establishes the threshold RI of 0.6 below which indicates of normal spermatogenesis.

    Article  PubMed  Google Scholar 

  21. Lefort C, et al. Ischemic orchiditis: review of 5 cases diagnosed by color Doppler ultrasonography. J Radiol. 2001;82(7):839–42.

    PubMed  CAS  Google Scholar 

  22. Jee WH, et al. Resistive index of the intrascrotal artery in scrotal inflammatory disease. Acta Radiol. 1997;38(6):1026–30.

    PubMed  CAS  Google Scholar 

  23. Patel U, et al. Colour flow and spectral Doppler imaging after papaverine-induced penile erection in 220 impotent men: study of temporal patterns and the importance of repeated sampling, velocity asymmetry and vascular anomalies. Clin Radiol. 1993;48(1):18–24.

    Article  PubMed  CAS  Google Scholar 

  24. Broderick GA, and Lue TF. The penile blood flow study: Evaluation of vasculogenic impotence, in Erectile Dysfunction. In: Jonas U, Thon WF, and Stief CG, editors. Springer-Verlag: Berlin; 1991.

  25. Shabsigh R, et al. Comparison of penile duplex ultrasonography with nocturnal penile tumescence monitoring for the evaluation of erectile impotence. J Urol. 1990;143(5):924–7.

    PubMed  CAS  Google Scholar 

  26. Benson CB, Vickers MA. Sexual impotence caused by vascular disease: diagnosis with duplex sonography. AJR Am J Roentgenol. 1989;153(6):1149–53.

    PubMed  CAS  Google Scholar 

  27. Lue TF, et al. Vasculogenic impotence evaluated by high-resolution ultrasonography and pulsed Doppler spectrum analysis. Radiology. 1985;155(3):777–81.

    PubMed  CAS  Google Scholar 

  28. Mueller SC, Lue TF. Evaluation of vasculogenic impotence. Urol Clin North Am. 1988;15(1):65–76.

    PubMed  CAS  Google Scholar 

  29. Pescatori ES, et al. A positive intracavernous injection test implies normal veno-occlusive but not necessarily normal arterial function: a hemodynamic study. J Urol. 1994;151(5):1209–16.

    PubMed  CAS  Google Scholar 

  30. Bassiouny HSM, Levine LA. Penile duplex sonography in the diagnosis of venogenic impotence. J Vasc Surg. 1991;13(1):75–82. discussion 82–3.

    Article  PubMed  CAS  Google Scholar 

  31. Quam JP, et al. Duplex and color Doppler sonographic evaluation of vasculogenic impotence. AJR Am J Roentgenol. 1989;153(6):1141–7.

    PubMed  CAS  Google Scholar 

  32. Naroda T, et al. Clinical studies for venogenic impotence with color Doppler ultrasonography–evaluation of resistance index of the cavernous artery. Nippon Hinyokika Gakkai Zasshi. 1996;87(11):1231–5.

    PubMed  CAS  Google Scholar 

  33. Cormio L, et al. Resistance index as a prognostic factor for prolonged erection after penile dynamic colour Doppler ultrasonography. Eur Urol. 1998;33(1):94–7.

    Article  PubMed  CAS  Google Scholar 

  34. Feldman HA, et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med. 2000;30(4):328–38.

    Article  PubMed  CAS  Google Scholar 

  35. Blumentals WA, et al. Should erectile dysfunction be considered as a marker for acute myocardial infarction? Results from a retrospective cohort study. Int J Impot Res. 2004;16(4):350–3.

    Article  PubMed  CAS  Google Scholar 

  36. O'Kane PD, Jackson G. Erectile dysfunction: is there silent obstructive coronary artery disease? Int J Clin Pract. 2001;55(3):219–20.

    PubMed  Google Scholar 

  37. • Mulhall J, Teloken P, and Barnas J. Vasculogenic erectile dysfunction is a predictor of abnormal stress echocardiography. J Sex Med. 2009;6(3):820–5. Description of why patients with vasculogenic erectile dysfunction should be sent for a cardiology referral.

    Article  PubMed  Google Scholar 

  38. Brock G, et al. The anatomy of the tunica albuginea in the normal penis and Peyronie's disease. J Urol. 1997;157(1):276–81.

    Article  PubMed  CAS  Google Scholar 

  39. Chou YH, et al. High-resolution real-time ultrasound in Peyronie's disease. J Ultrasound Med. 1987;6(2):67–70.

    PubMed  CAS  Google Scholar 

  40. Kang BC, et al. Post-traumatic arterial priapism: colour Doppler examination and superselective arterial embolization. Clin Radiol. 1998;53(11):830–4.

    Article  PubMed  CAS  Google Scholar 

  41. Gallentine ML, Morey AF. Imaging of the male urethra for stricture disease. Urol Clin North Am. 2002;29(2):361–72.

    Article  PubMed  Google Scholar 

  42. Morey AF, McAninch JW. Role of preoperative sonourethrography in bulbar urethral reconstruction. J Urol. 1997;158(4):1376–9.

    Article  PubMed  CAS  Google Scholar 

  43. Choudhary S, et al. A comparison of sonourethrography and retrograde urethrography in evaluation of anterior urethral strictures. Clin Radiol. 2004;59(8):736–42.

    Article  PubMed  CAS  Google Scholar 

  44. Morey AF, McAninch JW. Sonographic staging of anterior urethral strictures. J Urol. 2000;163(4):1070–5.

    Article  PubMed  CAS  Google Scholar 

  45. Quaia E, Bertolotto M. Renal parenchymal diseases: is characterization feasible with ultrasound? Eur Radiol. 2002;12(8):2006–20.

    PubMed  Google Scholar 

  46. Moghazi S, et al. Correlation of renal histopathology with sonographic findings. Kidney Int. 2005;67(4):1515–20.

    Article  PubMed  Google Scholar 

  47. Torres-Macho J, et al. Initial accuracy of bedside ultrasound performed by emergency physicians for multiple indications after a short training period. Am J Emerg Med. 2012.

  48. • Manger JP, et al. Use of renal ultrasound to detect hydronephrosis after ureteroscopy. J Endourol. 2009;23(9):1399–402. This article illustrates the importance of office ultrasound, in this case detecting asymptomatic hydronephrosis after ureteroscopy.

    Article  PubMed  Google Scholar 

  49. Tublin ME, Bude RO, Platt JF. Review. The resistive index in renal Doppler sonography: where do we stand? AJR Am J Roentgenol. 2003;180(4):885–92.

    PubMed  Google Scholar 

  50. Ray AA, et al. Limitations to ultrasound in the detection and measurement of urinary tract calculi. Urology. 2010;76(2):295–300.

    Article  PubMed  Google Scholar 

  51. Ekici S, and Sinanoglu O. Comparison of conventional radiography combined with ultrasonography versus nonenhanced helical computed tomography in evaluation of patients with renal colic. Urol Res. 2012.

  52. Dhar M, Denstedt JD. Imaging in diagnosis, treatment, and follow-up of stone patients. Adv Chronic Kidney Dis. 2009;16(1):39–47.

    Article  PubMed  Google Scholar 

  53. Katz SI, et al. Radiation dose associated with unenhanced CT for suspected renal colic: impact of repetitive studies. AJR Am J Roentgenol. 2006;186(4):1120–4.

    Article  PubMed  Google Scholar 

  54. Park BK, et al. Assessment of cystic renal masses based on Bosniak classification: comparison of CT and contrast-enhanced US. Eur J Radiol. 2007;61(2):310–4.

    Article  PubMed  Google Scholar 

  55. Nicolau C, Bunesch L, Sebastia C. Renal complex cysts in adults: contrast-enhanced ultrasound. Abdom Imaging. 2011;36(6):742–52.

    Article  PubMed  Google Scholar 

  56. Kang SK, Kim D, Chandarana H. Contemporary imaging of the renal mass. Curr Urol Rep. 2011;12(1):11–7.

    Article  PubMed  Google Scholar 

  57. Park JS, et al. Bladder wall thickness is associated with responsiveness of storage symptoms to alpha-blockers in men with lower urinary tract symptoms. Korean J Urol. 2012;53(7):487–91.

    Article  PubMed  Google Scholar 

  58. Jarow JP. Transrectal ultrasonography in the diagnosis and management of ejaculatory duct obstruction. J Androl. 1996;17(5):467–72.

    PubMed  CAS  Google Scholar 

  59. Turkbey B, et al. Imaging localized prostate cancer: current approaches and new developments. AJR Am J Roentgenol. 2009;192(6):1471–80.

    Article  PubMed  Google Scholar 

  60. Pinto F, et al. Imaging in prostate cancer staging: present role and future perspectives. Urol Int. 2012;88(2):125–36.

    Article  PubMed  Google Scholar 

  61. • Harvey CJ, et al. Applications of transrectal ultrasound in prostate cancer. Br J Radiol, 2012. Detailed review of transrectal ultrasound and future imaging technologies in prostate cancer.

  62. Smeenge M, et al. Novel contrast-enhanced ultrasound imaging in prostate cancer. World J Urol. 2011;29(5):581–7.

    Article  PubMed  Google Scholar 

  63. Teng J, et al. Transrectal sonoelastography in the detection of prostate cancers: a meta-analysis. BJU Int. 2012.

  64. Simmons LA, et al. Detection, localisation and characterisation of prostate cancer by Prostate HistoScanning(). BJU Int. 2012;110(1):28–35.

    Article  PubMed  Google Scholar 

  65. Xu S, et al. Real-time MRI-TRUS fusion for guidance of targeted prostate biopsies. Comput Aided Surg. 2008;13(5):255–64.

    Article  PubMed  Google Scholar 

  66. Ukimura O, et al. 3-Dimensional elastic registration system of prostate biopsy location by real-time 3-dimensional transrectal ultrasound guidance with magnetic resonance/transrectal ultrasound image fusion. J Urol. 2012;187(3):1080–6.

    Article  PubMed  Google Scholar 

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Disclosure

E. Goldenberg has reported no potential conflicts of interest relevant to this article; BR Gilbert has received royalties from Gulf Coast Ultrasound and payment for developing educational presentations for the American Urologic Association.

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Correspondence to Etai Goldenberg.

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Goldenberg, E., Gilbert, B.R. Office Ultrasound for the Urologist. Curr Urol Rep 13, 460–466 (2012). https://doi.org/10.1007/s11934-012-0280-y

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