Name of the Procedure:

Ultrasound, transrectal (also known as Transrectal Ultrasound or TRUS)

Summary

A transrectal ultrasound (TRUS) is an imaging test where a small probe is inserted into the rectum to obtain detailed images of the prostate gland and surrounding tissues using sound waves.

Purpose

TRUS is primarily used to:

• Detect abnormalities in the prostate, including tumors, cysts, and inflammation.
• Guide needle biopsies of the prostate for diagnosing prostate cancer.
• Assist in evaluating prostate health and conditions like benign prostatic hyperplasia (BPH).

Indications

• Elevated prostate-specific antigen (PSA) levels.
• Abnormal findings from a digital rectal exam (DRE).
• Symptoms of urinary problems that could be related to prostate conditions.
• Monitoring of diagnosed prostate conditions.

Preparation

• Patients may be asked to use an enema a few hours before the procedure to clear the rectum.
• A light meal is usually permitted, but fasting may be required.
• Patients should inform their doctor about any medications they are taking, especially blood thinners, as these may need to be adjusted.

Procedure Description

1. The patient changes into a gown and lies on their side with knees bent.
2. A lubricated TRUS probe, slightly larger than a finger, is gently inserted into the rectum.
3. The probe emits sound waves that create images of the prostate gland on a monitor.
4. The procedure may include a biopsy, where small tissue samples are taken for analysis.
5. Images are reviewed by a radiologist or urologist to diagnose or assess the health of the prostate.

Tools: TRUS probe, ultrasound machine, biopsy needle (if applicable). Anesthesia: Typically, no general anesthesia is required, but a local anesthetic may be applied if a biopsy is performed.

Duration

The procedure usually takes about 15-30 minutes.

Setting

TRUS is typically performed in an outpatient clinic, hospital radiology department, or a urologist's office.

Personnel

• Radiologist or Urologist
• Ultrasound Technician
• Nurse or Medical Assistant

Risks and Complications

Common:

• Mild discomfort or pressure during the procedure.
• Light rectal bleeding or blood in the stool, urine, or semen. Rare:
• Infection.
• Significant bleeding.
• Allergic reaction to local anesthetic (if used).

Benefits

• Non-invasive and relatively quick.
• Provides detailed images for accurate diagnosis.
• Helps in early detection and treatment of prostate conditions.

Recovery

• Most patients can resume regular activities immediately.
• If a biopsy is performed, avoid strenuous activities for 24-48 hours.
• Follow-up appointments may be necessary to discuss results and next steps.

Alternatives

• Digital Rectal Exam (DRE): Less detailed than TRUS.
• Magnetic Resonance Imaging (MRI): More comprehensive but more expensive and not always necessary.
• PSA Blood Test: Indicates potential issues but not specific for diagnosis, often combined with TRUS.

Patient Experience

During the procedure:

• Patients may feel slight pressure or discomfort due to the insertion of the probe.
• If a biopsy is performed, brief, sharp pains from the needle may be felt despite local anesthesia.

After the procedure:

• Mild rectal discomfort or slight bleeding may occur.
• Pain management is usually not necessary, but over-the-counter pain relievers can be used if needed.

Comfort measures include communicating with the physician about any pain or discomfort, and the use of local anesthetics if a biopsy is needed.