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Transrectal Ultrasound

What is a transrectal ultrasound?

A transrectal ultrasound allows the doctor to view a patient’s internal organs — including the prostate or rectum in men, and the ovaries in women, much like an x-ray. This type of imaging equipment has been used since the 1970’s with great success. Instead of relying on radiation, which is how an x-ray functions, the TRUS technology uses sound to create a digital image, which is then projected onto a screen for the doctor to view in real time. 

This imaging tool emits high-frequency sound waves that echo off of the surrounding organs, forming pictures of the area. These images will either show areas with normal tissue (isoechoic areas), areas that may show signs of cancer (hypoechoic areas), or areas that may be affected by stones in the prostate (hyperechoic areas.)

The transrectal ultrasound can help a doctor both to view any abnormalities in the organs and glands, as well as to guide the needle in order to collect affected tissue during a prostate biopsy. 

How does transrectal ultrasound help with cancer detection?

In regards to detecting prostate cancer early on so that it can be treated before spreading to other organs, the best method is to come in for an annual digital rectal exam and any necessary prostate-specific antigen (PSA) blood testing. 

But if one of these tests come back abnormal — indicating the potential presence of cancer in the prostate gland — your doctor will likely order a prostate biopsy, which will be accompanied by a transrectal ultrasound, or TRUS. Sometimes, a transrectal ultrasound is performed on its own, without a biopsy needed.

Women may also need this procedure if they show signs of cancer or cysts, are having ongoing fertility issues, or are unable to undergo a  transvaginal ultrasound procedure.

What Should I Expect During a Transrectal Ultrasound?

The TRUS procedure on its own can take anywhere from 5 to 20 minutes. If it is being used as a supplementing tool for another procedure, like a biopsy, it could take longer. We perform this type of ultrasound in our office, so there is no need for hospitalization or inpatient care. 

Prior to the ultrasound, the doctor may ask you to use an enema. You may also be asked to discontinue certain types of medications for several days prior, and possibly given antibiotics to prevent infection if needed. You will not need to fast unless you require general anesthesia for an accompanying procedure.

You will be asked to empty your bladder prior to the TRUS procedure. In order to access the ultrasound area, you will lie down on your side, and the doctor will insert a lubricated probe, which will cause some pressure but will not be painful. 

Once in the rectum, the probe will begin to release sound waves, which will echo off of the other organs. These echoes, translated into images, will provide information about the normal or abnormal state of the rectum and surrounding areas.

You may want someone to accompany you to the appointment to drive you home afterward if you are also receiving a biopsy, and we require this if sedatives are used.

What Is the Recovery Time?

There is very little recovery needed after the transrectal ultrasound procedure as this is not a surgery. Some patients might feel some soreness in the area, especially during bowel movements, which should subside within a day or two. Some feel as if they need to urinate or pass a bowel right after the procedure, which is normal.

Typically, patients are able to return to normal activity immediately after a transrectal ultrasound. Again, this could vary if additional procedures were performed or tissue samples were taken. If there is a simultaneous prostate biopsy along with the TRUS, there will likely be additional side effects and recovery may take a few days. 

Side effects of a biopsy might include:

  • Soreness in the rectum
  • Urges to urinate or have a bowel movement
  • Light bleeding, or traces of blood in the stool, urine, or semen for days or weeks

If you experience side effects like fever, foul-smelling urine, pelvic or abdominal pain, burning sensations during urination, or heavy bleeding, call your doctor right away.

While a transrectal ultrasound is not necessarily able to tell the doctor everything, it can indicate important details that may point to the need for further testing, like an infected, inflamed, or enlarged prostate gland or the presence and size of a cyst or tumor. 

If you are presenting urological symptoms or have been diagnosed with a condition that could indicate cancer, cysts, or related issues, your doctor may order a transrectal ultrasound to get a better snapshot of the internal glands and effectively diagnose and treat the issue. As always, for men over 45, continuing to make yearly appointments for digital rectal exams is the best method for early detection and swift treatment of urological cancers.