A Transrectal Ultrasound (TRUS) of the prostate is a commonly used medical imaging technique. This procedure uses sound waves to create detailed images of the prostate gland. It serves as a tool for assessing prostate health.
What is Transrectal Ultrasound of the Prostate
TRUS is a diagnostic imaging procedure that utilizes high-frequency sound waves to produce real-time images of the prostate gland and surrounding tissues. A small, lubricated probe is gently inserted into the rectum, which is positioned close to the prostate gland. This probe emits sound waves that travel through the rectal wall and bounce off the prostate.
The echoes of these sound waves are then received by the same probe and sent to a computer. The computer translates these echoes into a visual image on a screen, allowing healthcare providers to evaluate the prostate’s size, shape, and internal structure.
Reasons for a TRUS Prostate
A TRUS prostate procedure is often recommended when there are abnormal findings from other initial tests. For instance, an elevated or rapidly increasing Prostate-Specific Antigen (PSA) level can be a trigger for further investigation. PSA is a protein produced by the prostate gland, and abnormal levels might indicate a prostate issue.
Another common reason for a TRUS is a palpable abnormality detected during a digital rectal examination (DRE). During a DRE, a doctor manually checks the prostate for any unusual size, shape, or texture. If such an abnormality is found, a TRUS can provide a more detailed view of the prostate to assess its condition and any potential concerns. The procedure helps to further investigate these findings and distinguish between conditions like benign prostatic hyperplasia (BPH) and prostate cancer.
The TRUS Prostate Procedure
During a TRUS prostate procedure, the patient typically lies on their left side with their knees pulled up towards their chest. After a digital rectal exam to ensure there are no obstructions, a small, lubricated ultrasound probe, roughly the width of a finger, is gently inserted into the rectum. This insertion may cause a feeling of fullness or pressure.
The procedure usually takes between 10 to 30 minutes. The probe emits sound waves to create images of the prostate from various angles, allowing the physician to assess the gland’s size, shape, and any suspicious areas. If a biopsy is needed, a thin, hollow needle is inserted through the rectal wall and guided by the ultrasound images directly into specific areas of the prostate to collect tissue samples. Local anesthesia is often administered to minimize discomfort during the biopsy.
Preparing for and Recovering from TRUS
Before a TRUS procedure, patients receive instructions. This often includes bowel preparation, such as using an enema or laxative, to clear the rectum. Patients may also need to adjust certain medications, especially blood thinners, to reduce the risk of bleeding. If a biopsy is anticipated, antibiotic prophylaxis is commonly prescribed to prevent infection.
Following a TRUS, especially if a biopsy was performed, patients may experience mild discomfort in the rectal area or light bleeding. Patients are advised to avoid strenuous activities briefly. Patients should also be vigilant for signs of infection, such as fever, chills, or persistent pain, and report them to their doctor promptly. Recovery is quick.
Understanding TRUS Results
The images obtained from a TRUS can reveal details about the prostate gland, including its size, shape, and any abnormalities. The ultrasound can help identify areas that appear different from normal prostate tissue, often showing hypoechoic areas that may indicate the presence of cancer. However, TRUS alone cannot definitively distinguish between benign (non-cancerous) and malignant (cancerous) tissue.
Therefore, when suspicious areas are identified, the primary purpose of TRUS is to guide a biopsy, which involves obtaining tissue samples for analysis. A pathologist then analyzes these samples under a microscope to determine if cancer cells are present or if other conditions are causing the abnormalities. The results of the TRUS and any accompanying biopsy are then communicated by the healthcare provider, who will discuss potential next steps, which could range from continued monitoring to specific treatment options based on the findings.