Penile Ultrasound

Penile Ultrasound

 The dorsal side of the penis so in the anatomic position the penis pointing you know in the normal position the dorsal is the aspect you see so the dorsal aspect of the penis.

Began there proximal so that's towards the mons pubis or towards the body and you can see here the two corpus cavernosum and the corpus spongiosum.

 Labeled it dorsal penis transverse proximal take a couple pictures right you can use either the 15 or an 18 megahertz probe and then put the color doppler this exam was to rule out a penile fracture so you want to call a doppler to make sure there are no abnormal collections all right so then we go to uh dorsal penis transverse mid again you  can see the corpus cavernosum on either side this is the right side

this is the left side and then the corpus one josem and as you may know or may not know the cove the fibrous covering of the corpora cavernosum is the tunica albuginea so you want to make sure that that's intact all right so a mid couple of pictures made now that  look at this kind of looks like a praying mantis all right so corpus cavernosum with colored doppler again corpus spongiosum this is a dorsal aspect of the penis the ventral aspect of the penis so this is just pretty much the normal lay of the penis the testicles would be down here all right then distal is towards the glans or the penis head again corpus cavernosum again and corpus spongiosum you can start seeing some of the more egogenics glands come into play, uh this patient was uncircumcised so you can see these echogenic dots here that's air under the foreskin all right so dorsal penis transverse distal put color doppler again you want to make sure that the corpus cavernosum are intact that there's no abnormal collections or hypoechoic areas that may suggest a penile fracture and then the glands here you can see the beginning or where the urethra is which would become the meatus all right glands for color doppler again you can see these echogenic dots all around the glands of the penis that's air under the foreskin that's normal.

Once you're done with the transverse evaluation you want to do sagittal of each corpus cavernosum.  Begin with the right so dorsal penis sag right corpus cavernosum this is a proximal section and this distal would be this way so here you can see the corpus cavernosum perfectly you can see the tunic apple genie is intact there are no defects to suggest a penile fracture so take a couple images from proximal to distal it tapers down distally as it as the corpuscle connects to the glands and then you see here is the beginning of the glans right there and this is a corpus cavernosum and then finally the glands right there you can see the end of it right here there's still foreskin over it.

Color Doppler and then did a panoramic view from proximal to distal so there you see how the corpus cavernosum of the penis dips into the body because the corpus cavernous goes deeper than just the surface of the skin and you can see the tunic albuginea very intact and then this is the glands right here and then do the same thing with the left proximal-distal corpus cavernosum you can pretty much see the whole corpus cavernosum here there's no defect there are no irregularities in the corpus cavernosum to suggest a penile fracture color doppler again oftentimes you'll see the cavernosa artery within the center of the corpus cavernosum and in a flaccid penis you may pick up doppler there or you may have a hard time picking up doppler there because the in the flaccid penis the penis is not really active so that artery is not engaged it's not uh you know pumping blood into the corpus cavernosum so you may have a hard time picking up blood flow there obviously.

We when you do penile exams for erectile dysfunction they inject them with pepevirin and in those cases, you will see the cavernosa artery with color doppler and you would also add Spectro adopter to measure the velocities and given the exam.

An example is just for penile fracture so again corpus camera knows you can see the tunica albuginea is intact here's the glands color doppler and then another panoramic showing from proximal to distal so against proximal, you can see the corpuscle dipping into the body now the corpus cavernosum dips into the body and goes further into the body and attaches bilaterally to the ischial pubic rami now we're not going to be able to see that the extent of that with the ultrasound and you're not going gonna have a penile fracture there so you can just see where it's dipping into the body so here's a so again tunica albuginea intact and here are the glands so once we're done with that you can put the penis towards the body and then start uh examining the corpus spongiosum from the ventral side of the penis so typed the ventral penis.

Transverse proximal so here's the ventral side of the penis and this is the corpus sponge osm and in the center of the corporate sponge osm is where the urethra goes through so it's also good to see so now you have the corpus spongiosum proximo and the two corpus cavernosum posterior so the same thing a proximal couple pictures  labeled there cc and cs all right proximal here you can actually see the two cover and also arteries right there even with the colored doppler you see it's not really filling but that's typical you're gonna have to that will be more apparent in an erect penis which this example is not

for all right so than mid ventral penis transverse mid and it also tapers down as it goes towards the glands just like the corpus cavernous  made a couple pictures color doppler and then distal the distal is right before it reaches the glands so corpus spongiosum here corpus cavernosum on either side and

then finally distally all the way to the glands you can see again the urethra right here you know the urethra terminates in the meatus and that's pretty much what you're seeing there again the echogenic dots representing air.