Radiology3- Urethra and Prostate

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What are the segments of the male urethra?
- Prostatic: caudal bladder to caudal prostate (within the prostate)
- Membranous: caudal prostate to caudal pelvis
- Penile: caudal pelvis to distal penis
The penile urethra is _________ to the __________.

ventral; os penis
How do you radiograph the penile urethra (the "butt shot")?
- pull the back legs cranially to avoid superimposition with the penile urethra
- make sure to include the most caudal aspect of the perineal region
What are indications for contrast urethrography? (3)
- abnormal urination
- hematuria
- pelvic fractures
What is the technique for contrast urethrography in a male?
- inject diluted iodinated contrast through a foley catheter in the distal urethra
- take images during the injection of the last 2-3mL
- lateral, right and left VD obliques
What are causes of intra-luminal filling defects on a urethrogram? (2)
- calculi
- air bubbles
What are causes of intra-mural filling defects on urethrogram? (3)
- neoplasia
- granuloma
- inflammation
What is a cause of extra-mural extra-luminal filling defects on urethrogram?

adjacent mass compressing urethra (also enlarged prostate)
What are urethrographic signs of disease? (2)
- filling defects
- extravasation of contrast medium outside of urethra
What are radiographic signs of urethral neoplasia?

enlarged urethra with poorly defined filling defects and mucosal irregularity
What are radiographic signs of prostatomegaly? (3)
- soft tissue mass caudal to bladder (prostate not usually seen in cats or neutered dogs)
- cranial displacement of bladder
- dorsal displacement of the bladder
What are differentials for prostatomegaly? (5)
- neoplasia
- abscess
- cyst
- prostatitis
- BPH
- [if >90% pelvic height, probably a mass]
How does prostatitis and prostatic neoplasia appear radiographically? (3)
- irregular cranioventral margin
- mild regional loss of serosal detail in caudal abdomen
- mineralization (usually neoplasia, sometimes with chronic prostatitis)
Describe the incidence of prostate conditions in neutered male dogs.

Neutered dogs rarely get prostatitis and never get BPH, so enlarged prostate is almost always neoplasia
How does BPH appear radiographically? (3)
- round soft tissue opacity caudal to bladder
- smoothly margined
- *intact dog or recently neutered
- also consider neoplasia
How does prostatic neoplasia appear radiographically? (4)
- rounded soft tissue opacity caudal to the bladder
- smooth or irregular margins
- +/- mineralization
- look for sublumbar lymphadenopathy and vertebral body metastasis
What are radiographic characteristics of paraprostatic cysts?
- well-defined with smooth margins
- +/- thin rim of minrealization
- [can be bigger than bladder...do a cystogram]
Describe the prostatic urethra on urethrogram.
- diameter varies with distention
- extravasation of contrast into the prostate may be seen normally
What are signs of prostatic disease on urethrography? (4)
- displacement
- narrowing/ stricture
- filling defects
- ulceration of mucosa
Describe positioning of the U/S probe for prostatic U/S.

just cranial to the pubis, may need to angle caudally
How should the prostate appear on U/S?
- homogenous
- echogenicity similar to adjacent fat (more hypoechoic when neutered)
How does BPH appear on U/S? (3)
- hyperechoic
- smoothly margined
- may be cystic
How does prostatitis appear on U/S? (3)
- echogenicity varies
- symmetrically enlarged unless concurrent abscess (then asymmetric)
- +/- hyperechoic adjacent fat
Describe the U/S appearance of prostatic cysts and abscesses. (2)
- thin-walled anechoic to hypoechoic
- abscesses more echogenic and septated
Describe the U/S appearance of prostatic neoplasia. (3)
- asymmetrical enlargement
- heterogeneous echogenicity
- +/- mineralization

Author

Mawad

330123

Card Set

Radiology3- Urethra and Prostate

Description

vetmed radiology3

Updated

2017-04-24T17:15:27Z