2013 ANATOMIC TRANSRECTAL ULTRASOUND EVALUATION OF THE EXTERNAL URETHRAL SPHINCTER IN MALE SUBJECTS

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology I1 Apr 20102013 ANATOMIC TRANSRECTAL ULTRASOUND EVALUATION OF THE EXTERNAL URETHRAL SPHINCTER IN MALE SUBJECTS Simone Crivellaro, Anna Palazzetti, Lorenzo Tosco, Ervin Kocjancic, Maria Abbinante, and Bruno Frea Simone CrivellaroSimone Crivellaro Udine, Italy More articles by this author , Anna PalazzettiAnna Palazzetti Udine, Italy More articles by this author , Lorenzo ToscoLorenzo Tosco Udine, Italy More articles by this author , Ervin KocjancicErvin Kocjancic Chicago, IL More articles by this author , Maria AbbinanteMaria Abbinante Udine, Italy More articles by this author , and Bruno FreaBruno Frea Udine, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2046AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES external urethral sphincter's anatomy and physiology have been matter of many papers without general consensus. Our purpose is to test out if transrectal ultrasonography (TRUS) is a reliable tool to assess rabdosphincter's morphology and, if it is, describe the anatomical and physiological informations we are able to obtain. METHODS 35 male subjects underwent TRUS, both longitudinal and transversal sections were acquired. Diameter, right and left lateral thickness and length of rabdosphincter were taken at rest, after coughing and after pelvic floor contraction. The ultrasonographic aspect of the external urethral sphincter has also been evaluated through a semi-quantitative scale dividing sphincters in anecogenic, moderately ecogenic and hyperecogenic. Contractility of the rabdosphincter has been measured through a new parameter: Sphincter Contraction Profile Index (SCPI) calculated as the ratio of the difference between sphincter's diameter after cough (Dc) and the diameter at rest (Dr) divided by the diameter at rest (Dc-Dr/Dr). We also calculated a pelvic floor CPI (PCPI) where we used the diameter of the sphincter after pelvic floor contraction. RESULTS external urethral sphincter has been easily assessable with TRUS in all subjects as an hypo-anecogenic ring shaped structure dorsal to membranous urethra which fades ventrally to it. Mean measured diameter was 12.09 mm, medium left lateral thickness was 2.4 mm, and medium right lateral thickness was 2.2 mm, medium length was 16.38 mm at rest. After coughing the same parameters were 12.26 mm, 2.4 mm, 2.3 mm, 15.1 mm and after pelvic floor contraction were 12.46 mm, 2.2 mm, 2.4 mm, 14.98 mm. Analysis of ultrasonographic aspect demonstrated that in young subjects tends to prevail an anecogenic rabdosphincter, and that ecogenicity varies with age of subjects in a way that makes hyperecogenicity more prevalent in older patients. SCPI and PCPI perfectly correlates with ultrasound visualized rabdosphincter contraction adding an objective assessment of its function CONCLUSIONS TRUS is an effective tool to assess the external urethral sphincter in male patients. We have been able to obtain additional information on it never reported before. Analysis of rabdosphincter contractility with SCPI and PCPI also permits a functional evaluation of this muscle which is the key structure in maintaining continence after radical prostatectomy. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e781 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Simone Crivellaro Udine, Italy More articles by this author Anna Palazzetti Udine, Italy More articles by this author Lorenzo Tosco Udine, Italy More articles by this author Ervin Kocjancic Chicago, IL More articles by this author Maria Abbinante Udine, Italy More articles by this author Bruno Frea Udine, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...