A Transrectal Ultrasound (TRUS) is a diagnostic imaging procedure that allows healthcare providers to examine the prostate gland and surrounding tissues. This method uses sound waves to create images of internal body structures. Healthcare professionals often use a TRUS to gain a clearer view of the prostate than what might be possible with other examination techniques. The procedure assists in evaluating the size, shape, and overall health of the prostate.
Understanding the Sensations
For most individuals, a transrectal ultrasound is generally not described as painful, but rather as causing pressure, fullness, or mild discomfort. Patients typically report a sensation similar to needing a bowel movement due to the presence of the ultrasound probe within the rectum. This feeling arises as the probe applies gentle pressure to the rectal wall, which is in close proximity to the prostate gland. The experience can vary among individuals, influenced by factors such as a person’s anxiety levels or the specific characteristics of their prostate.
Sharp or severe pain during the procedure is uncommon and should be immediately communicated to the medical professional performing the examination. While some individuals might experience a brief, mild ache, this usually subsides quickly once the probe is adjusted or removed.
The Examination Process
Patients are typically advised to perform a cleansing enema at home a few hours before the appointment to clear the rectum, which helps improve image quality. Additionally, an empty bladder is usually preferred for the procedure, so individuals may be asked to urinate just before the examination begins.
During the procedure, the patient will typically lie on their side, often with their knees drawn towards their chest, a position that facilitates access to the rectum. A digital rectal exam (DRE) often precedes the ultrasound, where the healthcare provider inserts a gloved, lubricated finger into the rectum to manually feel the prostate. This initial step helps the provider assess the prostate’s general characteristics and can help guide the subsequent ultrasound. Following the DRE, a special lubricating gel is applied to the ultrasound probe.
The ultrasound probe, which is thin and lubricated, is then gently inserted a few inches into the rectum. Once the probe is in place, the healthcare professional will slowly move it to capture images of the prostate from various angles. The probe emits high-frequency sound waves that bounce off the prostate and surrounding tissues, creating real-time images on a monitor. After all the necessary images are captured, the probe is carefully removed.
Minimizing Discomfort
Open communication with the healthcare professional performing the transrectal ultrasound can significantly help manage any discomfort. Patients are encouraged to express any sensations they are experiencing during the procedure, allowing the technician or doctor to make necessary adjustments. Practicing relaxation techniques, such as slow, deep breathing, can also help alleviate tension and reduce perceived discomfort.
If at any point the discomfort becomes too much, patients can request a brief pause. Discussing any pre-existing concerns or anxieties with the healthcare provider before the procedure begins can also be beneficial, as they can offer reassurance and specific advice. In some cases, a local anesthetic gel may be applied to further reduce sensation, though this is not always necessary.
Following the procedure, individuals might experience minor soreness or a lingering sensation of fullness in the rectal area. These post-procedure sensations are typically mild and should subside quickly, often within a few hours. Patients can usually resume their normal activities immediately after a TRUS. Any persistent or worsening discomfort should be reported to the healthcare provider.
Common Reasons for a TRUS
One common reason is to investigate an elevated Prostate-Specific Antigen (PSA) level found during a blood test, which can indicate potential prostate issues. Similarly, an abnormal finding during a digital rectal exam (DRE), such as a firm or enlarged area, often prompts a TRUS for further evaluation.
The TRUS is frequently used to guide a prostate biopsy, a procedure where small tissue samples are taken from the prostate for microscopic examination to diagnose prostate cancer. The real-time imaging from the ultrasound allows the healthcare provider to accurately direct the biopsy needle to specific areas of concern. Beyond cancer detection, a TRUS can also be utilized to assess other prostate conditions, such as benign prostatic hyperplasia (BPH), which is an enlargement of the prostate, or prostatitis, an inflammation of the prostate gland. The procedure can also aid in investigating cases of male infertility by evaluating the seminal vesicles and ejaculatory ducts.