Thickened Bladder Wall. Axial US of a neurogenic bladder (B) demonstrates marked thickening (arrows) of the bladder wall with trabeculation. The patient had an indwelling Foley catheter, the tip of which is evident (open arrow).

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Ectopic Ureterocele. US images in left sagittal (A) and transverse (B) planes demonstrate an ectopic ureterocele (u) of the left upper pole ureter (lu) protruding into the lumen of the bladder base. The upper pole collecting system was hydronephrotic, but the lower pole collecting system was normal. The wall of the ureterocele (arrows) is clearly seen. A ureterocele changes in size with peristalsis of the ureter. B, bladder.

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Bladder Diverticulum. Axial-plane image shows a urine-filled diverticulum (D) projecting through a defect (arrow) in the bladder wall. B, bladder.

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Enlarged Prostate. Midline sagittal US image shows an enlarged prostate (P) protruding into and elevating the base of the bladder (B). The urethral orifice (long arrow) forms a V-shaped depression in the prostate. The seminal vesicles (open arrow) are also seen. The bladder wall is mildly thickened (between short arrows).

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Prostate Abscess. Transverse transrectal US reveals an abscess (arrows) in the right side of the prostate gland in a patient with fever, pelvic pain, and pyuria. The abscess contained purulent debris, which was seen on US as floating particulate matter.

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Benign Prostatic Hypertrophy. Transrectal axial US view through the midprostate demonstrates excellent differentiation of a normal peripheral zone (pz, solid arrows). The inner gland (IG) demonstrates mild enlargement and heterogeneity that is characteristic of benign prostatic hypertrophy. A small prostatic cyst is evident (open arrow). The hypoechoic fibromuscular zone (FM) is anterior. A, anterior; P, posterior.

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Prostate Cancer. Right sagittal transrectal US image shows a distinct hypoechoic nodule (arrows) in the peripheral zone. US-guided transrectal needle biopsy confirmed prostate carcinoma. sv, seminal vesicle.

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Normal Seminal Vesicles. Transrectal US image shows the normal hypoechoic convoluted tubular appearance of the seminal vesicle (arrow). B, bladder.

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Prostate Anatomy. Transrectal US images of the prostate are routinely viewed inverted. The transducer is at the bottom rather than the top of the image. This sagittal image shows the normal peripheral zone (arrow) to be slightly echogenic compared to the hypoechoic, more heterogeneous central gland (G).

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Chronic Epididymitis. The epididymis (arrows) is grossly enlarged and has a large central echogenic area, representing fibrosis and chronic inflammation. The testis (T) is diffusely hypoechoic because of diffuse orchitis.

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Spermatocele. US image displays a complex, septated extratesticular cyst (arrows) at the superior pole of the testicle (T). Debris within the spermatocele produces floating particles within the fluid.

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Varicocele. Sagittal view of the scrotum demonstrates a network of curving tubular structures (between arrows) at the superior pole of the testis (T). Color Doppler US confirmed slow venous flow within these dilated vessels.

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Large Hydrocele. An US image through the long axis of the testis (T) demonstrates its homogeneous midlevel echogenicity. The head of the epididymis is seen as a small nodular structure (curved arrow) at the superior aspect of the testis. The tunica albuginea (straight arrow) is the tough fibrous capsule that covers the testis. The hydrocele (H) surrounds all portions of the testis except its posterior portion, where the testis is attached to the scrotal wall.

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Fractured Testis. The testis (T) is heterogeneous and its normal shape is disrupted. Multiple areas of hemorrhage (arrowheads) are evident. This man had been injured in a motorcycle accident.

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Dilated Rete Testis. A complex-appearing mass is made up of numerous tiny cystic tubular structures and is located in the mediastinum of the testis.

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Testicular Cyst. A benign testicular cyst is viewed as a well-defined, spherical, uniformly anechoic mass (arrow) within the testis. Care must be taken to differentiate simple testicular cysts from cystic necrosis within testicular tumors.

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Testicular Microlithiasis. Innumerable tiny echogenic spots (arrows) are evident throughout the testicular parenchyma. This benign condition is associated with a significant risk of testicular carcinoma.

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Malignant Melanoma Metastasis. Long-axis view of the testis reveals complete replacement of parenchyma by an inhomogeneous, predominantly hypoechoic tumor (between arrows). No recognizable normal parenchyma remains.

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Choriocarcinoma. An US view of a testis in long axis demonstrates a large tumor (between open arrows) replacing the testicular parenchyma. Note the marked inhomogeneity of the tumor with large areas of necrosis (n). The residual testicular parenchyma is indicated by the black arrows.

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Seminoma. Longitudinal US demonstrates near-complete replacement of the testes (betweenwide arrows) by a homogeneous hypoechoic mass (S) that proved to be seminoma. Only a thin rim of normal testicular parenchyma remains (between thin arrows).

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