Complete data of prostate examination

Prostate examination is mainly carried out by digital rectal ultrasound. Pay attention to the size, shape and hardness of the prostate, whether there are nodules, tenderness, fluctuations and central sulcus. This operation can also be used as a treatment.

Prostate is the largest accessory gonad in men, and its prostatic fluid is one of the main components of * * *. Normal prostatic fluid contains a lot of citric acid and phosphatase, which makes prostatic fluid weakly acidic. It also contains sodium, potassium, calcium, chlorine, zinc and other trace elements and amino acids, among which zinc plays an important role in maintaining the normal vitality of * *.

Chinese name: prostate examination mbth: Examination methods of prostate: digital rectal examination, B-ultrasound examination Note: Clinical significance of prostate, such as size, shape, hardness, how to diagnose, precautions, hazards, preparation of articles, observation contents, routine items, digital rectal examination, B-ultrasound, X-ray examination, tissue examination, urethrography, ultrasonic diagnosis, CT, MRI diagnosis, impact, clinical. It is characterized by uneven prostate contour and uneven density. The anterior wall of rectum and bladder wall can be infiltrated, and the seminal vesicle angle disappears. CT can also find lymph node metastasis and pelvic metastasis. CT is helpful to the staging of prostate cancer. On MRI, because prostatic hyperplasia mainly occurred in the central area, T2WI showed that the central area was enlarged. However, prostate cancer mostly occurs in the peripheral area, which leads to nodular shadows with limited or slightly lower signal in the peripheral area on T2WI. So MRI has more diagnostic value than CT. However, when the MRI manifestations of prostate cancer are atypical, the diagnosis is still difficult. How to diagnose 1 Patients often take knee-chest position or lithotomy position. If the patient is seriously ill or weak, he can also take lateral position. 2. The doctor wears gloves or finger covers, and the fingertips are coated with vaseline or liquid paraffin. 3. When taking knee-chest position, support the patient's left shoulder or hip with the left hand, and gently adjust the patient with the right hand to avoid sudden tension of sphincter. Then slowly insert your finger into * * *, and when the fingertip enters the front wall of the rectum about 5cm away from the * * * * door, you can touch the prostate. Pay attention to the shape and changes of prostate. 4.* * * During prostate surgery, slowly * * * move forward with your fingertips, about 4-5 times on each side, then move your hand to the upper part of the gland and squeeze it down along the median sulcus, so that the prostatic fluid can be discharged from the urethra, and you can take samples for inspection. Precautions 1. The indications of prostate should be clear, and it is generally used for chronic prostatitis. If tuberculosis, abscess or tumor is suspected, the use of * * is prohibited. 2.* * * strength should be even and appropriate. If it is too light, the prostatic fluid will not come out. If it is too heavy, it will cause pain. 3.* * * should be carried out in a certain direction and should not be * * *. Unreasonable methods often make the inspection fail. 4. A * * * failed or negative test, if there are clinical indications, needs to be repeated every 3-5 days. Damage 1. Weakening of male sexual ability: Prostatitis often leads to the excitement of male sexual activity nerves and nerve centers, but if it is excited for a long time, it will easily lead to the inhibition of male sexual excitement, thus inducing male sexual dysfunction. 2. Inducing gynecological diseases in women: Male prostatitis is induced by some bacterial infections, which can easily lead to these bacteria entering the female reproductive organs during sexual life, thus infecting women and inducing gynecological inflammation. 3, endocrine disorders: normal men's prostate can secrete a variety of active substances, but suffering from prostatitis is easy to cause secretions to be affected, which leads to endocrine disorders in men, which leads to dizziness, fatigue and other symptoms in men. 4. Life and work are affected: Men suffer from prostatitis, which leads to frequent urination, urgency and urinary incontinence, which makes patients often lose control of their emotions and fidget, thus affecting men's normal life and work. 5. Infection of other neighboring organs: Because prostatitis can't be cured for a long time, it is easy to lead to the spread of male inflammation, thus infecting neighboring organs and inducing inflammation. Abdominal examination was 3.0-5.0MHz, rectal examination was 5.0-8.0MHz and transurethral examination was 7.5MHz. Using electronic line array, sector scanning, electronic convex array and other probes, transurethral real-time high-speed radiation imager. Vaseline, liquid paraffin, latex sleeve. Observation content 1. Prostate size examination: abdominal wall examination measures the transverse diameter, longitudinal diameter or anteroposterior oblique diameter of prostate; Measure the front and rear diameters when cutting longitudinally. Transrectal and transurethral transection images can measure the transverse diameter and anteroposterior diameter. In the process of the probe moving from the inside to the outside or inserting from the outside to the inside, the distance from the appearance to the disappearance of the probe is the vertical diameter of the prostate. Prostate examination detected early prostate lesions to observe the shape, contour regularity, internal echo shape, intensity and distribution, whether there is an echo mass inside, the size, shape and intensity of the echo mass, whether there is silent shadow, and the blood flow in the prostate and the mass. 2. Prostate hypertrophy and prostate cancer: the size of prostate is related to age, but generally its diameter is less than 5cm. Prostate hypertrophy is characterized by prostate protruding into the bottom of bladder. Smooth edge, uniform density, generally symmetrical on both sides, one side can be obviously enlarged. The coronal view shows more clearly. When prostate cancer grows in the capsule, CT is difficult to diagnose. Only when it invades the capsule and infiltrates the surrounding adipose tissue can it be diagnosed. It is characterized by uneven prostate contour and uneven density. The anterior wall of rectum and bladder wall can be infiltrated, and the seminal vesicle angle disappears. CT can also find lymph node metastasis and pelvic metastasis. CT is helpful to the staging of prostate cancer. On MRI, because prostatic hyperplasia mainly occurred in the central area, T2WI showed that the central area was enlarged. However, prostate cancer mostly occurs in the peripheral area, which leads to nodular shadows with limited or slightly lower signal in the peripheral area on T2WI. So MRI has more diagnostic value than CT. However, when the MRI manifestations of prostate cancer are atypical, the diagnosis is still difficult. Routine items: digital rectal examination of prostate generally involves digital rectal examination. By touching the prostate through the rectum, we can know the size, texture, induration and pain of the prostate, and we can also indirectly know the function of the urethral sphincter by feeling the tension of the sphincter. The possibility of prostate cancer should be considered when the surface of prostate touches induration. It is necessary to check the blood PSA (which will increase when suffering from prostate cancer) and make a definite diagnosis by prostate biopsy if necessary. 1. Patients usually take knee-chest position or lithotomy position. If the patient is seriously ill or weak, he can also take a lateral position. 2. The doctor wears gloves or finger covers, and the fingertips are coated with vaseline or liquid paraffin. 3. When taking knee-chest position, hold the patient's left shoulder or hip with his left hand, and gently * * * with his right hand on his mouth, so as to find prostate diseases as early as possible, adapt the patient and avoid sudden tension of sphincter. Then slowly insert your finger into * * *, and when the fingertip enters the front wall of the rectum about 5cm away from the * * * * door, you can touch the prostate. Pay attention to the shape and changes of prostate. 4.* * * During prostate surgery, slowly * * * move forward with your fingertips, about 4-5 times on each side, then move your hand to the upper part of the gland and squeeze it down along the median sulcus, so that the prostatic fluid can be discharged from the urethra, and you can take samples for inspection. B-ultrasound (1) Abdominal examination method: * * and prepare for bladder examination before examination. The probe was placed on the pubic symphysis, and the ultrasonic beam tilted downward to the foot side for transverse and longitudinal scanning. (2) Transrectal scan: Like bladder examination, the display range of prostate is large. (3) Transurethral examination: It is the same as bladder examination and has the same advantages as transrectal examination. (4) Transperineal examination; Stand on the bed in the left lateral position, lithotomy position, or upper body prone position, put the probe on the front edge of * * * with latex sleeve, and press forward and upward to scan the longitudinal section and oblique coronal section. Or placed on the back of scrotum for coronal section scanning. X-ray examination is of great value in the diagnosis of prostate diseases. For example, plain film can detect whether there is calcification or calculus shadow in prostate. Angiography can help to check whether there is prostate hyperplasia or prostate cancer. CT examination is more important for differential diagnosis of prostate diseases. Histological examination is very useful for clarifying the nature of prostate tumors, and it is very helpful for clarifying the histological classification and cytological characteristics of prostate tumors. Transrectal needle aspiration biopsy or perineal needle aspiration biopsy is painful and traumatic, but it is necessary. In addition, urodynamic examination of lower urinary tract is very helpful for the diagnosis of benign prostatic hyperplasia. Cystoscope can directly observe the hyperplasia of posterior urethra, seminal vesicle and middle and lateral lobe of prostate, and it is also very important for the diagnosis of prostate diseases. Prostate fluid was treated by prostate method. Normal prostatic fluid is a thin milky liquid. Microscopically, there are many lecithin bodies, and the number of white blood cells in each high-power field is below 10, occasionally * * *. In prostatitis, the number of white blood cells or pus cells per high magnification is below 10, and some of them are piled up, and lecithin bodies are reduced, with occasional trichomonas. Prostate fluid can also be used for bacterial culture. Urography cystourethrography is a method of developing bladder by inserting catheter into bladder and injecting 100 ~ 200ml of 3% ~ 6% sodium iodide solution. It is mainly used to diagnose diseases such as bladder tumor, bladder diverticulum's disease and external compression, such as prostatic hypertrophy. Bladder and urethral gas examination has a good effect on displaying bladder tumor and prostatic hypertrophy. Iodine and gas can also be used at the same time to form a double contrast. Inserting a catheter into the anterior urethra, or holding a syringe directly against the urethral orifice, and injecting 12.5% sodium iodide or 15% ~ 25% meglumine diatrizoate can show male urethral lesions. At the end of voiding urography, voiding urography can also be performed, which is voiding urography. For patients with urethral stricture, it is even more necessary for the catheter not to pass through. The main clinical manifestations of prostatic hypertrophy (BPH) are dysuria, incomplete urination and increased urination. Cystography shows that there is an arc impression on the bottom of the bladder, or the tumor shadow protrudes upward, and its edge is often smooth and tidy, or it can be slightly leaflike. The posterior urethra is compressed and deformed, showing elongation, stenosis and increased normal curvature. In addition, we can see the bladder changes caused by chronic obstruction, such as conical bladder and irregular edge. Ultrasonic diagnostic ultrasound images are acoustic images of human organs and tissue structures, which are closely related to anatomical structures and pathological changes and have certain regularity. However, the current ultrasound images can not reflect the histological and cytopathological features. Therefore, in the diagnosis work, we must combine the ultrasonic image with the knowledge of anatomy, pathology and clinic to make analysis and judgment, so as to make a correct conclusion. CT and MRI diagnosis Both CT and MRI are suitable for the diagnosis of bladder and prostate diseases. MRI is superior to CT in showing the invasion of adipose tissue of adjacent organs, showing the internal structure of prostate, showing the central area, surrounding area and transitional area. CT examination of bladder needs proper inflation to distinguish bladder wall from lumen. Drinking more water, normal saline, and inflating the bladder without urinating are simple, but not accurate enough. Low concentration iodine, air or CO2 gas is injected into bladder through urethral intubation, which is easy to show lesions. Conventional cross-sectional scanning, from pubic symphysis up to pelvic upper edge, with a thickness of 65438±0cm. The tumor or prostate cancer at the top or bottom of the bladder invades the bottom of the bladder, and it is best to use coronal reconstruction. Enhanced scanning can make ureter develop, which is helpful to distinguish swollen lymph nodes. However, scanning the bladder should be carried out at the early stage when the bladder is filled with contrast agent, because it is too late and the contrast agent in the bladder is too concentrated, which is prone to artifacts. In addition to the transverse section, MRI also needs sagittal or (and) coronal scanning, especially in the triangular area of bladder. Multiple echo scanning is helpful to judge the characteristics of diseased tissue and its infiltration to the surrounding area. Bladder is located in the front of pelvic cavity, and its size and shape vary with the surplus degree and plane height. On CT, bladder shows soft tissue density and uniform thickness. Prostate can be seen on the obturator plane, which is round and has uniform soft tissue density. The small round low density area in the middle is the urethra. There is an external sphincter behind the prostate, which is the density of soft tissue. The boundary with the prostate is unclear, and the rectum can be seen at the upper level, and the boundary with the prostate is clear. On the dorsal side of the bottom of the bladder, the seminal vesicle connected with the prostate is a protrusion protruding symmetrically on both sides. The gap between the seminal vesicle and the posterior wall of the bladder is the seminal vesicle angle. Anal digital examination of normal prostate showed low signal on T 1WI, which was relatively uniform. T2WI can display the central area, transition area and surrounding areas. The signal in the central area is slightly lower, and the signal in the surrounding area is stronger because of the high water content of glands, and the signal in the transition area is very narrow and low. Affect the proteolytic enzymes contained in the prostate, which can make * * * liquefy rapidly after being injected out of the body. 5a- reductase can transform testosterone into dihydrotestosterone with stronger physiological activity, and promote the spermatogenic function of testis. When suffering from prostatitis, not only will there be serious sexual dysfunction, such as impotence and premature ejaculation, but also the quality of * * * will be seriously reduced. Acute prostatitis can change the composition and physical and chemical properties of * *. If bacterial prostatitis occurs, it will make * * * contain bacteria and toxins, inhibit the vitality of * * *, cause * * * poisoning, agglutination and death, thus greatly reducing male fertility. Record carefully.