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Transrectal Ultrasound

A transrectal ultrasound is a diagnostic imaging procedure used to check the health and diagnose any conditions related to the prostate.

The prostate is a small, walnut-sized gland located just below the bladder in men. This gland helps contribute fluid to the semen, which helps sperm travel through the urethra and toward an unfertilized egg.

Ultrasounds are minimally invasive procedures that provide a wide range of health information to health care providers. Unlike X-Rays or CT scans, ultrasound scans can show images moving in real-time, giving doctors a firsthand look into the movement of organs and tissue in the body.

Transrectal ultrasound machines use transducers that send out high-frequency sound waves into the body. Once these sound waves have bounced off soft tissue and organs in the body, they are converted into ultrasound images on a computer. After these images are recorded by the technologist (also known as a sonographer), a radiologist examines the results and forwards a report of the results to a primary care provider for diagnosis and treatment.

Transrectal ultrasounds are diagnostic imaging tests that help doctors check the health of the prostate. Specifically, these tests help doctors:

  • Detect any abnormalities and growths in a man’s prostate
  • Detect disorders of the prostate (such as benign prostate hyperplasia - an enlargement of the prostate gland)
  • Detect and diagnose the cause of infertility in men
  • Guide the doctor through the rectum to retrieve a biopsy sample from the prostate

All men are at risk of prostate problems. If you have a family history of prostate conditions, you may be at a greater risk of developing one yourself. Some common conditions that affect the prostate include:

- Benign prostate hyperplasia (BPH): BPH is an enlargement of the prostate. A man’s risk of developing BPH increases with age. BPH only causes symptoms in about half of diagnosed cases and does not lead to prostate cancer.

- Prostate cancer: One of the most common forms of cancer diagnosed in men, the risk of prostate cancer increases with age. Nearly 1 in 6 men are diagnosed with prostate cancer in their lifetime. Although this form of cancer is rarely fatal, and generally treatable, it must be diagnosed early in its development.

- Prostatitis: An infection of the prostate, prostatitis occurs when bacteria in urine leaks into the prostate. This can cause pain, flu symptoms, and difficulty with urination.

Common symptoms of a prostate condition include:

  • Difficulty with urination
  • Pain in the groin or lower abdomen
  • Flu-like symptoms
  • Incontinence
  • Blood in the urine
  • Cloudy urine

It is important to note that even though ultrasounds can help doctors detect suspicious masses or growths in the prostate, an ultrasound is rarely used to definitively diagnose cancer. For this, your doctor will require a biopsy (a tissue sample) from the prostate to screen it for cancer cells. To retrieve a sample of the prostate, your doctor will use a transrectal ultrasound as a guide through the rectum and to the prostate.

Unlike other forms of diagnostic imaging - most of which require you to fast for several hours - transrectal ultrasounds do not require fasting. Your doctor will give you specific preparation instructions based on the purpose of your ultrasound.

Transrectal ultrasounds may require an enema 2-4 hours before the exam to empty the bowels. Additionally, if the ultrasound is being used to assist a biopsy procedure, your doctor may order you to stop taking any blood thinner medication - like aspirin - for a week or so before the test.

No other preparation is required. You will be asked to remove all metallic items from your person such as jewelry, piercings, eyeglasses, and dentures. Because of this, it is usually recommended that you leave most of these items (specifically jewelry and piercings) at home on the day of your appointment.

After changing into your hospital gown, you will be guided to an examining table. In most cases, a transrectal ultrasound requires you to lie on your side with your knees bent.

Your doctor will use a hand-held device known as a transducer, which directs high-frequency sound waves into the tissue being studied. After the area is gelled (gel helps conduct the ultrasound waves), the transducer is inserted into the anus. The device will be covered in gel and a plastic or latex sheathe to ease this passage. You may experience some mild discomfort as the transducer is inserted into the anus, but this should pass after a few moments.

As the sound waves echo off the tissue of the prostate and surrounding organs, the transducer sends data to a computer that records the feedback and creates images. You may be asked to hold your breath for several seconds as images are being taken.

Your doctor may manipulate the transducer when it is positioned near the prostate to get images from several angles. In some cases, if a lesion or mass is found on the prostate, your doctor may elect to perform a biopsy immediately. This can help diagnose prostate cancer, which is more easily treatable the earlier it is detected.

The entire procedure of a transrectal ultrasound takes about 20-30 minutes, depending on whether or not a biopsy is performed.

After your appointment, a radiologist will review the images produced by the exam. They will then present their findings to your health care provider, who will pass on the results to you. This may take 1-3 business days, depending on the clinic.

If suspicious lesions or masses are found on the prostate, your doctor may order a follow-up appointment to perform a biopsy (if one wasn’t performed during the first appointment). Before this appointment, talk to your doctor about specific preparation for a biopsy.

Yes. Ultrasounds are non-invasive exams that provide real-time imaging of blood flow and organs in the body. Unlike X-rays, ultrasound does not use ionizing radiation. Instead, ultrasounds use sound waves (too high-pitched for humans to hear) to give doctors real-time images of organs and tissues. The transducer used by the sonographer might be a little cold, and you may experience some discomfort as the transducer is inserted into the anus, but these sensations often pass quickly.

Ultrasounds are generally less expensive than other forms of imaging. They do not require injections, nor is sedation needed for the procedure. These are quick and painless exams that usually take under an hour. After your appointment, you will likely be cleared to leave and go about your daily activities.

If you have any questions about different types of imaging, talk to your health care provider about the method that is right for you.

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