Transrectal ultrasound

Transrectal ultrasound (TRUS) is a diagnostic imaging technique used primarily in the field of urology to visualize the prostate gland and surrounding tissues. This procedure involves the use of an ultrasound probe inserted into the rectum, providing detailed images that can help in diagnosing and managing conditions such as prostate cancer, benign prostatic hyperplasia (BPH), and prostatitis. TRUS is also employed in guiding needle biopsies of the prostate, a critical step in the diagnosis of prostate cancer.

Procedure

During a TRUS procedure, the patient is usually positioned on their side with knees bent. A protective cover is placed over the ultrasound probe, which is then lubricated and gently inserted into the rectum. The probe emits sound waves that bounce off the prostate and surrounding tissues, creating echoes that are captured and transformed into real-time images displayed on a monitor. The procedure typically lasts 20 to 30 minutes and is generally well-tolerated, though some discomfort or pressure may be felt.

Applications

• Prostate Cancer Diagnosis: TRUS is instrumental in detecting abnormalities in the prostate that may indicate cancer. It is often used to guide biopsies, where small tissue samples are taken for further analysis.
• Evaluation of Benign Prostatic Hyperplasia (BPH): TRUS helps in assessing the size and shape of the prostate, which is crucial in diagnosing BPH and planning its management.
• Detection of Prostatitis: The technique can identify signs of inflammation or infection in the prostate.
• Guidance for Prostate Treatments: TRUS is used in various therapeutic procedures, including brachytherapy (radioactive seed implantation) for prostate cancer, by guiding the placement of radioactive seeds directly into the prostate gland.

Advantages

TRUS offers several benefits, including:

• High-resolution images of the prostate and surrounding areas.
• Minimally invasive nature, with no incisions required.
• Ability to guide precise biopsy needle placement.
• Useful in planning and guiding certain treatments for prostate conditions.

Risks and Complications

While TRUS is generally safe, there are potential risks and complications, including:

• Discomfort or pain during the procedure.
• Risk of infection, particularly urinary tract infections (UTIs) or prostatitis.
• Minor bleeding, especially after a biopsy.
• Allergic reaction to the lubricant or local anesthesia, if used.

Preparation

Patients may be advised to:

• Follow specific dietary restrictions or bowel preparation procedures.
• Use an enema to clear the rectum before the procedure.
• Inform the healthcare provider of any allergies, medications, or existing health conditions.

Aftercare

Post-procedure, patients should monitor for signs of infection, such as fever, chills, or increased pain, and report any concerns to their healthcare provider. Normal activities can usually be resumed shortly after the procedure, barring any specific instructions from the healthcare provider.