What is the role of imaging in the workup of prostatitis?

Updated: Dec 06, 2018
  • Author: Paul J Turek, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

Transabdominal ultrasonography or a bladder scan is used to assess for volume of retained urine in cases of prostatitis associated with significant voiding dysfunction. [2]

On transrectal ultrasonography, characteristic features of prostatitis are capsular thickening and prostatic calculi. A hypoechoic halo in the periurethral region, a heterogeneous echo pattern, and enlargement and thickening of the septa of the seminal vesicles may be seen. [20]

Interpretation of transrectal ultrasound is highly subjective and therefore not very reliable for the diagnosis of prostatitis. This study is not routinely indicated in prostatitis patients, except when prostatic abscess is suspected.

Computed tomography (CT) studies of the pelvis may also be useful in the evaluation of prostatic abscess or suspected neoplasm. Cystoscopy is useful in refractory cases with significant voiding dysfunction symptoms to rule out neoplasm of the bladder or interstitial cystitis. Voiding cystourethrography (VCUG) or retrograde urethrography (RUG) may be appropriate for evaluation of the bladder neck anatomy and penile and anterior urethra in cases of suspected bladder neck dyssynergia or urethral stricture.


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