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A prostate or rectal ultrasound

Is an imaging test that uses sound waves to look at your prostate or your rectum. The healthcare provider uses a device called a transducer to make the images of your prostate or rectum. The transducer sends out sound waves that bounce off your organs and other structures.

A transrectal ultrasound of the prostate gland is performed to:

  • detect disorders within the prostate.
  • determine whether the prostate is enlarged, also known as benign prostatic hyperplasia (BPH), with measurements acquired as needed for any treatment planning.
  • detect an abnormal growth within the prostate.
  • help diagnose the cause of a man's infertility.

A transrectal ultrasound of the prostate gland is typically used to help diagnose symptoms such as:

  • a nodule felt by a physician during a routine physical exam or prostate cancer screening exam.
  • an elevated blood test result.
  • difficulty urinating.
  • Guidance for biopsy in the presence of an abnormal digital rectal examination or elevated PSA or a suspicious prostatic lesion detected on magnetic resonance imaging (MRI). This includes use of transrectal ultrasound (TRUS) biopsy as part of the TRUS/MRI fusion technique.
  • Assessment of prostate volume before medical, surgical, or radiation therapy and to calculate PSA density.
  • Real-time guidance for the placement of brachytherapy seeds.
  • Assessment of lower urinary tract symptoms.
  • Assessment of congenital anomalies.
  • Infertility.
  • Hematospermia.
  • Evaluation for suspected recurrence in the prostatectomy bed in patients who have undergone prostatectomy.

How should I prepare?

You should wear comfortable, loose-fitting clothing for your ultrasound exam. You may need to remove all clothing and jewelry in the area to be examined.

You may be asked to wear a gown during the procedure.

You may be instructed to avoid taking blood thinners, such as aspirin, for seven to 10 days prior to the procedure if a biopsy is planned. An enema may be taken two to four hours before the ultrasound to clean out the bowel.

How is the procedure performed?

In men, the prostate gland is located directly in front of the rectum, so the ultrasound exam is performed transrectally in order to position the imaging probe as close to the prostate gland as possible.

For a transrectal ultrasound, you will be asked to lie on your side with your knees bent. A disposable protective cover is placed over the transducer, it is lubricated, inserted through the anus and placed into the rectum.

The images are obtained from different angles to get the best view of the prostate gland.

If a suspicious lesion is identified with ultrasound or with a rectal examination, an ultrasound-guided biopsy can be performed. This procedure involves advancing a needle into the prostate gland while the radiologist watches the needle placement with ultrasound. A small amount of tissue is taken for microscopic examination. Shown is an example of a transrectal transducer (probe).

A prostate-specific antigen (PSA) test, which measures the amount of PSA in the blood, may be administered to determine if a patient is at high risk for cancer. In this case, a biopsy is performed and an ultrasound probe is used to guide the biopsy to specific regions of the prostate gland.

When the examination is complete, you may be asked to dress and wait while the ultrasound images are reviewed.

This ultrasound examination is usually completed in less than 20 minutes.

  • Benign hyperplasia
  • Adenoma of the prostate that manifests with the nodes
  • Stones of the prostate gland, which are small and located in its ducts.
  • Inflammatory diseases.
  • Cysts of the prostate that look like small bubbles filled with liquid.
  • Malignant neoplasms of the prostate, spread them on nearby organs.

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