[Echodynamics of the cervical ureter junction]

Transrectal dynamic ultrasonography is a 3 dimensional study that identifies accurately bladder neck (B.N.) diseases during micturition, providing precise noninvasive images of the B.N. orifice and the posterior urethra. This technique requires a 7-10 Mhz high frequency linear transducer. Benign Prostaic Hyperplasia (BPH) may restrict the urethral lumen and deviate its intra prostate tract. The images obtained allow a detailed and precise analysis of the B.N. and intravesical development of the median lobe. The urethra classically has a stretched and elongated appearance. This technique is useful in the diagnosis and in the follow up of neuropathic bladder. It is also useful in morphological and dynamic study of the B.N. after TURP. Diagnosis of B.N. hypertrophy or sclerosis is easy if a posterior beak at internal meatus level and positive stop test are present. After radical prostatectomy or radical cystectomy with orthotopic neobladder, this technique is useful to evaluate the internal urethral meatus and voluntary skeletal sphincter providing to a continence mechanism. We believe dynamic transrectal echography should become a procedure to be included as a part of the routine pre-surgical investigation of the B.N. diseases, for its non invasive nature, easiness to perform, and highly useful information.