Ultrasound examination via the rectum: Guidelines, process, expenses, and additional details
A transrectal ultrasound (TRUS) is a procedure used to help diagnose issues affecting the prostate. This non-invasive, cost-effective imaging technique plays a crucial role in prostate cancer detection and evaluation of prostate abnormalities.
Procedure and Preparation
Before the procedure, you may need to stop taking blood-thinning medications, as advised by your doctor. You might also be asked to take prophylactic antibiotics to reduce infection risk and have an enema or laxative to clear the rectum for better imaging and comfort. Inform your physician of any allergies or current medications.
During the procedure, you'll lie on your side with knees pulled up towards your chest, or sometimes on your stomach or back with feet in stirrups. The rectal area is cleaned with an antiseptic, and a local anesthetic gel or injection is applied to numb the rectal area and prostate region, minimizing discomfort during probing and biopsy.
A lubricated ultrasound probe is gently inserted into the rectum. The probe emits sound waves to create real-time images of the prostate on a monitor, allowing precise visualization of the gland and any suspicious areas. This imaging guides the biopsy needle to exact locations. A thin, spring-loaded needle is quickly inserted through the rectal wall into various regions of the prostate, typically taking 10 to 12 cores (small tissue samples) systematically from different prostate zones.
The entire process generally lasts 10–20 minutes, and after the procedure, you can usually go home the same day.
Possible Outcomes and Results
The histopathology of biopsy cores determines if cancer cells are present, their grade, and extent. TRUS-guided biopsy can detect prostate cancer, inflammation, or benign prostatic hyperplasia. Minor side effects include rectal bleeding, blood in urine or semen, discomfort, or infection. Serious complications are rare but may include infection or urinary difficulties.
Recent improvements include combining TRUS with MRI for targeted biopsy, improving cancer detection accuracy. The transrectal approach is standard, but alternative transperineal biopsy is emerging due to lower infection risk and better anterior prostate access.
This method remains a cornerstone in prostate cancer diagnosis, especially when combined with MRI imaging for precise targeting and improved diagnostic yield. A TRUS does not use ionizing radiation and does not typically cause health issues. If a doctor suspects a person has an enlarged prostate, they may recommend medication or surgery.
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