The Prostate and Ultrasound The Prostate and Ultrasound

The embryologic development of the prostate is highly dependent on androgenic hormones. The organ begins to form at about the eleventh week of gestation (7:33-34). Stimulated by testosterone, multiple solid outgrowths emerge from the urethral epithelium about the entrance of the mesonephric ducts. These outgrowths eventually form the prostate's glandular elements. While the mesenchyme into which they grow contributes to the prostatic capsule, the Wolffian duct forms the stroma and epithelium of the intraprostatic vas deferens and ejaculatory ducts (6:8-9).

Upon gross examination, the prostate resembles an inverted cone measuring about 4.1 cm wide, 3.3 cm long, and 2.4 cm deep. Normally, it weighs approximately 20 grams. The organ is bordered posteriorly by the rectum, anteriorly by the pubis symphysis, and laterally by the levator ani and obturator internus muscles. Moreover, it lies posterior to the urogenital diaphragm and inferior to the bladder. It is positioned s

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pe under the bladder base (2:42-43)." Around the prostatic urethra, this half-moon outline has a well-defined capsule. At the base of the prostate itself, however, sonograms may vary from oval to triangular in shape. Examinations usually proceed from transverse (axial) sections to an oblique coronal plane and then to a sagittal (longitudinal) plane. The prostate is perhaps most easily identified using transverse ultrasonography (4:50-51). In this sonogram, the left and right prostatic lobes appear on the left and right side of the picture, respectively. In contrast, in sagittal sections, the apex of the prostate points toward the right margin of the image (i.e., in the caudal direction), while the bladder neck and seminal vesicals occupy the left margin (cephalic side). Prostatic sonograms typically show the prostatic capsule as a dense echo band; whereas, the surrounding muscles usually reflect few echoes. The prostatic tissue itself generally yields a "lamellar, homogenous, dense echo pattern (4:50-51)." One pathologic condition that can be evaluated using ultrasound techniques is benign prostatic hyperplasia. This disease often originates within the organ's transition zone. In general, benign prostatic hyperplasia
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