Ultrasound of the penis. Preparation for ultrasound of the penis. Ultrasound dopplerography of the vessels of the penis: indications, technique for performing ultrasound of the cavernous bodies

A full erection of the penis depends on the degree of blood filling of its cavernous bodies. Erectile dysfunction becomes the reason for the appointment and conduct of Doppler ultrasound.

With the help of this diagnostic technique, the circulatory system of the penis is examined, the condition of the superficial and deep arteries is assessed. Such an indicator as the intensity of blood circulation in these large arteries makes it possible to determine the causes of erectile dysfunction.

Indications for Doppler sonography

Ultrasound examination technique is widely used in medical diagnostics. It is absolutely safe, informative, it can be done an unlimited number of times. The ultrasound procedure is generally available at a price category.

Complaints that necessitate an ultrasound of the penis:

• erectile dysfunction;
• lack of potency;
• possible injuries;
• bulk neoplasms.

An ultrasound examination of the penis is prescribed for patients who refuse to undergo a diagnosis of sexual dysfunction using invasive techniques. Contraindications to dopplerography of the penis are elevated body temperature, inflammation in the tissues of the organ, specific infections.

Most often, ultrasound diagnostics allows you to determine:

• development of vascular thrombosis;
• the process of tumor formation;
• fibrosis of cavernous bodies;
• atherosclerotic lesions;
• stenosis of the arteries of the penis;
• Peyronie's disease;
• traumatic consequences.

Parameters examined by ultrasound

To carry out the procedure, a special sensor is used: the superposition of sound waves on each other forms a complete image of all the structures of the organ. On ultrasound of the penis, the following physiological and anatomical characteristics are assessed without fail:

1. The speed of blood flow in vessels and veins. This indicator indicates the state of the circulatory system of the penis.
2. Diameter and wall thickness of arteries. This becomes possible due to their superficial location.
3. Echogenicity of the structure of the cavernous bodies. This characteristic makes it possible to determine the localization of possible foci of inflammation, the development of fibrotic changes in the tissues of the organ, and pathological circulatory disorders.
4. The level of elasticity of the albuginea (membrane) of the penis and indicators of its thickness.
5. Indicators of blood flow in the veins. If at the moment of absolute excitation there is a venous outflow, then this may indicate erectile problems.

Ultrasound of the penis is often combined with vascular Doppler or duplex scanning techniques. If the indications of ultrasound scanning indicate a narrowing of the lumen of the arteries, and the movement of blood flow is insufficient, then potency disorders may be of a vascular nature. Most often, pathological vasoconstriction is a consequence of a chronic disease, perhaps atherosclerosis or diabetes mellitus.

Thickening of the penis membrane is a sign of Peyronie's disease, which is characterized by a curvature of the penis and the development of fibrous changes in the albuginea. The echogenicity index makes it possible to visualize the localization of the pathological process.

Doppler scanning technique

Doppler is based on the Doppler effect. It consists in the frequency changes of ultrasonic waves during the reflection of their moving substances. With a relative coincidence of a directed beam of a sound wave and a moving blood cell, a frequency change in the ultrasonic signal occurs. Using this data, the speed of the particles is calculated. These indicators are encoded, a graphical representation is made, and changes in the rate of blood circulation are presented visually.

During vascular diagnostics, peak systolic blood flow rates are examined. The dependence of the rate of increase in blood flow from zero to peak and over time is calculated. The criterion is above 100 m/s. indicates damage to the vessels of the examined organ.

Diastolic changes in blood flow are also recorded. In a state of full erection, the blood flow velocity should be equal to zero. Registration of blood flow in the veins of the penis in a rigid state indicates vascular pathologies.

Doppler ultrasound procedure

The quality of blood flow is studied in a state of rest and excitation of the penis. In the second case, pharmacodopplerography is used, where an injection of the drug into the cavernous bodies is used, causing a spontaneous erection.

In the case when the injection of the drug is impossible and threatens with the development of complications, Viagra is used to stimulate erectile function. The drug must be taken on an empty stomach half an hour before the start of the examination. Often the use of Viagra is combined with psychological factors that cause sexual arousal.

The procedure begins with an examination of the penis in an unexcited state. Then the scan is carried out in all phases of erectile excitation. Deciphering the results of the examination is done immediately, immediately after the procedure. UZDG lasts no more than 40 minutes. Since the onset of an erection, the intensity of blood flow is recorded every 5 minutes.

Also, duplex scanning allows you to find out the causes and etiology of blood disorders in the pelvic organs. The procedure is widely used in urology and andrology. The results of dopplerography of the vessels of the penis facilitate the diagnosis and enable the appointment of effective therapy.

The detection of a weakening of the arterial blood flow through the vessels indicates the development of arteriogenic erectile dysfunction. A symptom of this pathology is a prolonged and defective erection. Violations of venous blood flow contribute to the rapid, but short-term occurrence of an erection. Ultrasound of the penis is performed to diagnose developmental disorders, neoplasms, possible injuries in men, as well as to identify the causes and pathologies that cause erectile dysfunction, during a general examination before plastic surgery.

The method of ultrasonic research is a display of the internal state of the human body in real time using high-frequency sound waves.

Ultrasound diagnoses problems with internal organs, blood vessels, soft tissue structures in the body. And although this method is usually associated with examination during pregnancy, ultrasound is used to diagnose many other parts of the body, including the gallbladder, kidneys, liver, pancreas, stomach, bladder, and many other internal structures.

Ultrasound of the penis is the most informative method for diagnosing the male genitourinary system. Ultrasound is widely available, has no contraindications and harmful effects on human health, as it uses sound waves rather than radiation.

What are the indications for this study?

This type of research is also one of the most highly informative and safe and plays an important role in establishing the causes of impotence. Erectile dysfunction in more than half of cases is caused by impaired blood flow of blood vessels. Doppler ultrasound (USDG) makes it possible to see the state of the vessels of the penis, arterial inflow and the viability of the mechanisms of venous occlusion, on which the quality of erection directly depends.

In addition to the study of erectile dysfunction, ultrasound is also used in the anatomical and functional assessment of many other ailments, in particular in trauma and neoplasms, infectious diseases, curvature of the penis, priapism, stones, foreign bodies, strictures and diverticula of the urethra.

An ultrasound of the penis may be ordered by surgeons during a procedure such as a biopsy. They play an important role in the planning of certain types of therapy and surgery, as well as in the postoperative period, to determine whether the patient's body is responding to treatment. Ultrasound can be used to find cysts, blockages, or infections in the body.

Thus, ultrasound is performed in such cases as:

• Injuries, closed injuries, fractures of the penis
• Open injuries caused by an animal bite, careless handling of piercing or cutting objects
• Pathology of the vessels of the penis
• Peyronie's disease
• Swelling and pain during urination or intercourse caused by an infection
• Erectile dysfunction in men
• Congenital anomalies in the development of the penis

What preparation is required before the procedure?

Dopplerography of the penis does not require special preparation, so the fullness of the bladder and diet do not matter. For one or two days before the examination, doctors do not recommend taking drugs for the treatment of erectile dysfunction, and you may also be asked to refrain from masturbation and sexual intercourse on the day of the examination in order to achieve the most accurate results during the examination.

How is an ultrasound scan (doppler ultrasound) of the penis performed?

The procedure takes on average about 30 minutes. It is non-invasive and relatively easy to perform, but requires the participation of a qualified and well-trained specialist. The ultrasound machine should be equipped with color and pulse Doppler, modern high-frequency sensors.

For an ultrasound scan, the penis must be in an excited state. For this, the patient is offered special medications that can cause an erection. If a pharmacologically satisfactory erection is not achieved, the patient may be asked to retire for self-stimulation. Erection by the end of the study, as a rule, passes safely.

However, there is a possibility that it will be painful and excessively long, which is fraught with serious complications and may require the administration of an antagonist drug. In this situation, patients with diabetes are at particularly high risk. Therefore, if you are in this group of patients, you should warn your doctor about your illness in advance.

Side effects such as pain and hematoma at the injection site, slight dizziness are also possible. In some clinics, in order to exclude complications, patients are asked to take a pill of an erection-promoting drug in advance of the study and are provided with visual stimulation.

Carrying out the research procedure

At the discretion of the doctor during the study, the patient lies on his back with legs straightened or divorced and half-bent at the knees and hip joints, while the genital organ is placed on the stomach or on a towel folded between the thighs. At the first stage, a survey study is performed - gray-scale echography. To do this, the doctor applies a special acoustic gel to the penis and, moving the sensor directly over the skin, evaluates the anatomical structures and the initial, in a state of “rest”, blood flow.

Then a pharmacological erection is performed. The drug is injected with a thin needle directly into one of the corpora cavernosa under ultrasound control, the injection itself is not painful and lasts only a few seconds. Preference is given to prostaglandin E1 preparations due to the slower and longer action with less risk of provoking priapism. A complete assessment of vascular blood flow is available using color duplex mapping, in the phase of turgidity (or swelling) and rigidity (i.e. directly during erection). The arteries are assessed, while the veins are visualized in the phase of detumescence (erection decline).

What does the doctor see during the examination?

The penis consists of a pair of cavernous bodies and a spongy body located to the bottom and between them. Cavernous, they are also cavernous, bodies on the screen of an ultrasound machine appear as homogeneous hypoechoic (gray) rounded structures surrounded by thin light, i.e. hyperechoic layer, the so-called tunica albuginea. The spongy, or spongy, body is also round in shape and in the normal state has a homogeneous structure, often of relatively greater echogenicity, the urethra passes through it, having the form of a line.

The doctor documents the results by taking three images at the base and in the middle of the penis, and at the level of the head in such a way that the right cavernous body is on the left, and the left, on the contrary, on the right side of the image. Depending on which surface of the penis was scanned, the upper or lower (dorsal or ventral, as the doctor is more likely to designate them) spongy body with the urethra passing through it, respectively, will be below or above the cavernous bodies.

How is the patient's condition assessed?

If the doctor does not detect abnormalities in the echogenicity of the structures, he will describe it as “normal” or “usual” in the protocol. Increased echogenicity of the corpora cavernosa may be due to the presence of fibrous changes, and a decrease in echogenicity may be due to edema during their inflammation. The protein membrane is normally of uniform thickness, no more than 0.2 cm at rest and about 0.05 cm during erection. In the case of Peyronie's disease, the shell unevenly, more often along the dorsal (upper) side, thickens in the form of hyperechoic plaques, in the structure of which calcium is often deposited, which on ultrasound gives an intense echo with a "track", the so-called acoustic shadow.

The results of the ultrasound of the penis. The arrows indicate the places of rupture of the albuginea as a result of trauma.

At rest, the diameter of the cavernous arteries is estimated (normally 0.3-0.5 cm), the limiting systolic blood flow velocity is usually 15-25 cm / s, the diastolic current is minimal or absent. After the injection, measurements are taken every five minutes and changes in the blood flow of the vessels corresponding to the phases of erection are noted.

At the beginning of an erection, the maximum systolic velocity normally reaches 35 cm/s and above, and a diastolic current is recorded with a speed of 8 cm/s. In young patients with normal erections, these values ​​can reach 100 and 20 cm/s, respectively. The diameter of the cavernous arteries increases to 0.6-1.0 cm, the pressure in them increases, the diastolic current decreases and levels out in the rigidity phase and becomes reversed. If during the study it was not possible to obtain a peak systolic velocity of 25 cm / s, this indicates an arterial origin of dysfunction.

Border values ​​are considered to be 25-30 cm / s. Other important markers are an increase in the cavernous arteries by less than 60%, the difference between the peak systolic velocities on the left and on the right is more than 10 cm/s, the time of increase in the velocity to the peak is 100 m/s or more in atherosclerotic lesions. If a diastolic current of 5 cm/s or more is recorded during the rigidity phase, we can speak of venous insufficiency.

Since one of the mechanisms for maintaining an erection is the compression of the veins by the cavernous bodies filled with blood, it will not be possible to reliably assess the venous flow in case of arterial dysfunction.

Can there be side effects after the procedure?

In general, the procedure is safe and painless. However, the patient may experience pain and discomfort if he is diagnosed with damage or infection of the penis.

After the ultrasound, the erection quickly disappears. But in 1-2% of cases, a persistent incessant erection is possible - priapism. This is potentially dangerous as the penis will not be able to access the required amount of oxygen or be unable to get rid of the accumulated urine during this time. If the patient is still experiencing an erection three hours after the injection, it is necessary to contact the attending urologist.

What other procedures can a doctor prescribe?

In addition to an ultrasound of the penis, an ultrasound of the scrotum with vascular Doppler may be prescribed. It will help to assess the condition of the patient's scrotum, the quality of blood flow in it, as well as to identify possible deviations from the norm. Examination of the scrotum organs also does not require special preparation. The procedure is non-invasive and painless.

When will the test results be ready?

The result of the survey is available almost immediately. After the procedure, the doctor will show you the finished images and explain their meaning.

During the ultrasound of the penis, specialists can also examine the blood flow, arteries and the intensity of the venous outflow. Almost always, the study is carried out in conjunction with dopplerography. The advantage of the procedure is that it is absolutely painless. During the scan, the patient does not feel any discomfort. In addition, you do not need to prepare for the examination. You can go through it at any time convenient for a man.

The survey allows you to identify diseases at an early stage of development. Therefore, doctors recommend that some men regularly undergo ultrasound as a preventive measure. The information obtained during the study helps doctors to create an effective treatment program. Ultrasound scanning is also prescribed for patients before penile surgery. In this case, the method helps to correctly plan the course of the surgical intervention.

Price for ultrasound of the vessels of the penis

The cost of research in Moscow varies greatly. The reason for this is that each institution independently sets the price for ultrasound. At the same time, they take into account the prestige of the clinic, the training of specialists, the quality and modernity of the equipment used. But if you want to undergo an ultrasound of the vessels of the penis quickly and at a pleasant cost, then just sign up for diagnostics at the Open Clinic.

Examination in Moscow

Ultrasound of the penis in the capital is carried out in specialized diagnostic centers. But you can get the examination quickly and without queues at the Open Clinic. The procedure takes on average no more than 20 minutes. The examination is carried out in our institution on modern devices of the new generation. We guarantee that you will receive high service, medical care from the best doctors of the capital and an individual approach.

What kind of erection a man will have is influenced by the filling of the penis, or rather its cavernous bodies with blood. In case of violation of this function, an ultrasound examination by the Doppler method can be prescribed. This safe diagnosis will help determine the condition of the vessels, the general blood supply. The state of the deep arteries is also assessed, which cannot be examined by another method. It is the determination of the cause of the failure in erectile function that is the main task of ultrasound. The method is safe and will not harm the male reproductive system and erection in any way.

Basics of the technique

The method of studying the vessels of the penis is based on the well-known Doppler effect. It consists in the fact that ultrasound waves tend to be reflected from moving blood cells. Depending on the speed of their movement, the frequency of the return sound wave will be different. The sent and received signals are analyzed and the results are displayed on the monitor in the plot's villa.

In the course of diagnostics, peak systolic indices of blood flow velocity are measured. In the course of this, the blood flow velocity is calculated from zero to peak values ​​per unit of time. If the criterion exceeds 100 m/s, this indicates damage to the vessel.

In addition, the distolic index is fixed. In a state of erection, this indicator should be equal to zero. If blood flow is fixed in this state, this indicates a pathological state of the vessels.

Ultrasonography often has to be combined with other methods of vascular examination. For example, duplex scanning. In this case, it is possible to determine not only the narrowing of the arteries, but also the place of this narrowing. If this is observed, then the decrease in erectile function occurs due to vascular damage. This can occur due to chronic diseases such as diabetes or atherosclerosis.

When is it appointed?

In order for the doctor to prescribe a detailed examination of the vessels of the penis, a preliminary examination is necessary. If abnormalities and certain complaints are detected, the man is sent for the procedure of ultrasonic dopplerometry. Indications for the implementation of metol are:

1. Erection problems.
2. Lack of potency.
3. Injury to the penis.
4. innovation on it.
5. It is prescribed in case of refusal to check the state of erectile function by invasive techniques.
6. Before plastic surgery on the genitals.

This method has a number of contraindications, among them:

• Inflammation on the penis.
• Elevated temperature.
• Sexually transmitted infections and other specific infections.

What can be determined by the procedure?

In the course of the study, it is possible to detect the cause of deterioration in blood supply, and hence the causes of erectile dysfunction.

In addition, the following pathologies can be detected:

1. Vascular thrombosis at different stages of development.
2. Tumor, malignant and benign.
3. Fibrosis of the cavernous bodies.
4. Plaques on vessels.
5. Stenosis of the arteries is a narrowing of their lumen, which prevents normal blood circulation.
6. Peyronie's disease.
7. Consequences of trauma.

What parameters are being investigated?

For diagnostics, a special sensor is used, which is applied to the penis on both sides - this helps to examine all the structures of the organ. During the ultrasound, the following important parameters of the organ are examined:

• Velocity of venous and vascular blood flow. This indicator will tell a lot about the blood supply to the organ and its speed.
• Diameter and wall thickness of arteries. This can be done due to their surface location.
• Echostructure of the cavernous bodies. This will help determine possible inflammatory processes and their location. A detailed examination will make it possible to see the development of fibrous pathologies in the tissues. Pathological disorder of blood flow.
• The elasticity of the protein membrane, the parameters of its thickness. If its thickening is observed, this indicates Peyronie's disease. It leads to a curvature of the penis, fibrous changes occur in its albuginea. When checking echogenicity, you can find the place of development of the pathological process.
• The parameter of blood flow in the veins. Venous outflow during the period of excitation should not be, if it exists - this indicates erectile dysfunction.

How is the research done?

First of all, the blood flow is studied in a calm state. After a detailed study, a special drug is injected into the penis, which provokes an instant erection. In this state, all necessary parameters are also checked.

If for any reason it is impossible to make medical stimulation or puncture, Viagra is used. This is often known before the procedure, so the patient needs to take a pill 30 minutes before the study on an empty stomach.

In a state of erection, each phase of its development is examined, blood flow is measured every 5 minutes. The duration of the study does not exceed 40 minutes, upon completion, a protocol is issued.

Some features of the procedure

Many men are not afraid of the diagnostic process itself, but the need to inject a drug into the penis by injection. This can likely lead to pain at the puncture site. This can become a psychological barrier.

This condition is fraught not only with fears, but also affects the quality of the study. This is because stressful situations are accompanied by an increase in the tone of the nervous system. This leads to spasms of the cavernous arteries, so the erection may not be complete or not occur at all. And this does not give the opportunity to get complete information.

In such cases, not only Viagra, but also manual and audio-video visualization can be used.

Another difficulty in using injection stimulation is the long-term maintenance of an erection. In this case, self-stimulation is needed. If this does not help, and the erection lasts more than 4 hours, you should contact a urologist.

Conclusion. Ultrasound of the penis is a procedure that will help determine the cause of erectile dysfunction. The procedure cannot be called completely painless, since injections are used, but there is an alternative for them.

Ultrasound of the penis- this is one of the most common studies of the genital organs in men, with its various pathologies.
This modern diagnostic method has a number of advantages: it is informative, safe, widely available, and absolutely does not cause any unpleasant or painful sensations.
Besides, Ultrasound of the penis can be carried out repeatedly, and in some cases this research method is uncontested.

How is an ultrasound of the penis performed in men

Depending on the task of the study, the doctors of our clinic conduct:

- Ultrasound of cavernous tissues. This type of diagnosis is most often used for Peyronie's disease, which is a curvature of the penis due to the formation of a fibrous plaque or fractures of the penis.

- Ultrasound of the cavernous tissue with high accuracy is able to determine the location of plaques in Peyronie's disease, as well as the presence of calcifications in them. In the case of a penis fracture, this type of ultrasound helps to determine the location of the rupture of the albuginea, its condition, the presence of hematomas, as well as their size.

- Ultrasound of the vessels of the penis. This type of study is considered highly informative for the detection of erectile dysfunction or impotence associated with vascular pathologies.

At the time of the study, the doctors of our clinic evaluate arterial inflow, venous outflow, identify the stage of vascular blood flow disorders, and also monitor the dynamics and effectiveness of the treatment.

Ultrasound of the penis in men does not require any prior preparation. It can be carried out both in a hospital, in a clinic and even at home. The main conditions for successful diagnosis:

A urologist who owns the methods of ultrasound diagnostics, conducting research more than once from time to time, but regularly;

Modern ultrasonic equipment of an expert class.

In addition, it should be understood that penis ultrasound- despite the availability and safety, it is considered a difficult procedure for a doctor who conducts diagnostics.

Indications for an ultrasound of the penis

Closed injuries resulting from a bruise, blow or bending of an erect organ;

Open injuries resulting from a fracture, animal bite, impact using piercing or cutting objects;

Tumors of the penis;

Infectious diseases accompanied by edema, hyperemia of the penis, pain at the time of urination, during intercourse, the appearance of a rash, discharge or ulcers;

Peyronie's disease;

Vascular pathologies of the male genital organ.

If you need to go through Ultrasound of the penis or get advice on this issue, then the doctors of our medical institution are ready to help with this.

We offer each client a huge range of services that help diagnose and then cope with the identified disease.

To do this, our clinic has everything you need: highly qualified specialists, as well as modern and high-tech equipment.