Study On The Changes Of Elasticity Of Tissues Around The Urethra During Real-time Urination In Males By TRUS Elastography

men’s real-time dynamic urination,which would provide a basis for the study of the anatomical mechanism of the urination process and the clinical diagnosis and treatment of urination disorders.Objective Transrectal ultrasound(TRUS)elastography was used to study the elastic changes of the tissues around the urethra during the process ofMaterials and methods1.General information: Selected those who underwent transrectal ultrasound elastography in the Ultrasound Department of the First Affiliated Hospital of Dalian Medical University from October 2018 to December 2019.Finally,67 eligible cases were collected,aged 17-70 years old,and 67 subjects were divided into normal group and hyperplasia group,there were 30 cases with normal prostate weight and37 cases with enlarged prostate weight.The prostate weight of subjects in the normal group ranged from 11.56-19.75 g with an average weight of(16.92±2.42)g;the prostate weight of subjects in the hyperplasia group ranged from 21.24-109.63 g with an average weight of(37.21±17.56)g.2.Apparatus and method: the C10-3v intracavity probe of PHILIPS EPIQ7 was selected for TRUS elastic imaging,the probe frequency was3-10 MHz.Before the TRUS elastography examination,the subject needed drink plenty of water to fully fill the bladder.During the examination,the subject was in the left decubitus position,with his hands on his knees to fully expose the anal area,then slowly insert the transrectal probe into the rectal cavity through the anus.When the prostate was displayed,adjusted the probe,and observed the longitudinal image of the prostate through longitudinal scan.Properly adjusted the probe so that the entire urethra through the prostate and surrounding tissues were clearly displayed.After finding the inner orifice and outer orifice of the urethra,selected the double-frame contrast elastography mode,and performed transrectal ultrasound elastography.After the elastography was stable for 3-5 seconds,the dynamic images of resting state(not uriating)were taken.Then the subjects were asked to urinate,the elastic changed of tissues around urethra during urination were observed and the corresponding dynamic images were taken.Took the image of the resting state before urination and the image of the process of urination when the urethra was maximally opening,the strain rate ratio of the internal and external sphincter of urethra,the soft tissue area of anterior venous plexus,anterior urethral gland,posterior gland and the bladder wall during the two states were measured.Compared the strain rate ratio of the tissues around the urethra from the resting state before urination to the process of urination in the normal group and the hyperplasia group;the strain rate ratio of the tissue around the urethra in the normal group and the hyperplasia group in the resting state before urination were compared;the strain rate ratio of the tissue around the urethra in the normal group and the hyperplasia group during urination were compared.result1.In the normal group and the hyperplasia group,the strain rate ratio of the internal urethral sphincter,external sphincter,anterior urethral gland,and soft tissue area decreased from the resting state to the process of urination(P<0.05),and the strain rate ratio of the posterior urethral gland and the bladder wall increased,and the difference was statistically significant(P<0.05).2.The strain rate ratio of the tissue around the urethra in the normal group and the hyperplasia group changed the same at the resting state(P>0.05);the strain rate ratio of the tissue around the urethra in the normal group and the hyperplasia group changed the same during the process of urination,and there was no significant difference(P>0.05).conclusion1.From the resting state to the process of urination,the internal urethral sphincter,external sphincter,anterior gland,and soft tissue areas of men gradually became harder,and the posterior urethral gland and bladder wall gradually became softer.2.There was no difference in the hardness of the tissues around the urethra in the normal group and the hyperplasia group under the same state.