The mystery of the periprostatic vessels:

Whilst doing a TRUS (Transrectal Ultrasound scan) for the prostate, seminal vesicles, etc., I have often come across these large, anechoic, tubular structures (V) on either side of the lateral lobes of the prostate. After reading extensively on the topic, I have found few answers. In this transverse section, the tubes (V) are seen well.
Note the inhomogenous echotexture of the prostate, with some hyperechoic area in the left side of the inner gland s/o chronic prostatitis. The patient was a young man with history of chronic dysuria and lower abdominal pain.























On sagittal section, the structures can be traced anteriorly and inferiorly.. definitely not the ureters.









Oblique transverse sections show the vessels communicating with their counterpart from the other side. Obviously these are vessels, most likely to be the periprostatic venous plexus.

The periprostatic veins communicating freely anterior to the prostate.

Diagnosis: prostatitis with dilatated periprostatic veins.