| Popis: |
Clinical assessment and urodynamic studies (UDS) remain the gold standard for the diagnosis of lower urinary tract dysfunction (LUTD) but it is important to recognize the potential and emerging role of noninvasive diagnostic, prognostic, and predictive biomarkers in this field. In particular, imaging provides direct information about the morphological and functional anatomy of the lower urinary tract (LUT), allowing a better understanding of the pathophysiology of LUTD. Ultrasound (US) is the first-choice imaging modality in the diagnostic workup of men and women with lower urinary tract symptoms due to its cost-effectiveness, lack of radiation exposure, noninvasiveness, and wide availability. Different ultrasound approaches are available such as transabdominal (TAUS), transperineal (TPUS), transvaginal (TVUS), and transrectal (TRUS) ultrasound. Due to the differences in the anatomy of LUT in males and females, resulting in different pathological disorders and clinical presentations, and to the different ultrasound approaches available in the two genders, the diagnostic US assessment of LUTD in men and women will be discussed separately. TAUS represents the first-line approach in both sexes and it provides a primary assessment of post-void residual urine (PVR) and bladder wall thickness (BWT). TPUS is the recommended approach in women for an optimal evaluation of urethral status (mobility and funneling) and pelvic organ prolapse. In men, TAUS and TRUS are used to assess prostate size and morphology and biomarkers that evaluate both these parameters are preferred, such as presumed circle area ratio (PCAR), intravesical prostatic protrusion (IPP) and prostatic urethral angle (PUA). The aim of this chapter is to provide practical information on the use of imaging, primarily US, in the diagnosis of LUTD. |
