Ultrasound has evolved to become the mainstay of urology imaging diagnosis, allowing a thorough evaluation of the kidneys, dilated ureters, bladder, seminal vesicles, prostate gland and the testes.

	Dilated pelvicaliceal system in a female patient with acute onset of flank pain radiating to the genitalia.
	A small stone, impacted near the vesicoureteral junction proved to be the cause of the clinical complaint.
	Ureteral jet from the ipsilateral ureteral orifice proves the ureter is still patent and the kidney is functional. Note edema of the ureteral orifice.
	Concurrent bladder tumours (1,2) in a patient presenting with hematuria.
	Testicular tumour (seminoma)

In everyday praxis it has practically replaced more invasive procedures using ionizing radiation and intravenous contrast media like iv urography in the initial assessment of obstructive symptoms of the urinary tract.

Ultrasound can diagnose a great variety of congenital, inflammatory, traumatic and tumoral lesions.

	Orcheoepididymitis (Inflammation of the testis and the epididymis). Markedly increased vascularity of the inflamed structures evident upon examination by Power Doppler.
	Testicular Microlithiasis a predisposing condition for development of testicular neoplasm - Sagittal section of a testis and transverse section through both testes reveal innumerable microcalcifications of the testicular parenchyma. This condition requires meticulous follow up by ultrasonography.

Ultrasound contributes greatly to the evaluation of patients with a fertility problem.

	Varicocele with reflux during a Valsalva maneuver.
	Varicocele with intense reflux during a Valsalva maneuver.

Color Doppler is also used in evaluation of male erectile dysfunction allowing us to test the vascular response of the penile vessels during a pharmaceutically provoked erection.

	Venous insufficiency of the corpora cavernosa in a patient with erectile dysfunction. Despite a satisfactory arterial response, there is continuous venous flow during the erection in the deep dorsal vein of the penis.
	Continuous venous flow in the deep dorsal vein, during a pharmaceutically provoked erection. Demonstration of flow with pathologically high velocity in the deep dorsal vein of the penis.

Transrectal Ultrasound (TRUS) has assumed a central role in the diagnosis of the prostate gland. It allows demonstration of the internal prostate gland anatomy and of pathology that cannot be detected transabdominally. Furthermore, it can be used to guide our biopsy needle to obtain biopsy samples from suspicious areas of the prostate gland during TRUS-Guided Biopsy of the prostate gland, allowing us to diagnose and locally stage malignancy of the prostate gland, a common clinical problem.

	Biopsy of the prostate gland guided by Ultrasound - In the case of this 55 year-old patient with steadily rising PSA and a negative prior biopsy, adenocarcinoma of the prostate gland was diagnosed by TRUS-guided biopsy.
	Large bladder tumour with feeding vessel demonstrated by Power Doppler. Note also calcification on the frond-like surface of the tumour.