L'IMAGERIE ECHOGRAPHIQUE DE LA PROSTATE

Progress in prostatic ultrasonography has been dramatic during the last decade, due to constant improvements in ultrasound equipment. Several ultrasonic approaches (suprapubic, perineal, transrectal or trans-urethral) are now available. The author reports its own examination technique which combines several approaches and equipments. The normal anatomy of the prostate and seminal vesicles is described, and the benefits of this new imaging method in prostatic pathology are reviewed. The size of the prostate can be accurately measured by ultrasound. The ultrasonographic patterns of benign prostatic hypertrophy, cancer, prostatitis and lithiases are described and diagnostic ambiguities are mentioned. The lack of specificity of the method is obviated by new techniques of ultrasound guided transperineal biopsy. Transrectal ultrasonography has proved effective in the assessment of local cancer invasion. The urodynamic repercussions of prostatic disease can also be evaluated by ultrasound. Finally, this safe and harmless method should be used to evaluate the response of prostatic carcinomas to conservative treatments.