Transrectal ultrasound (TRUS)

Panorama general

Transrectal ultrasound (TRUS) is an imaging test that involves placing a device into the rectum to make pictures of nearby organs. It's often used to make pictures of the prostate.

TRUS is a kind of ultrasound exam. Ultrasound is an imaging test that uses sound waves to make pictures.

Healthcare professionals use TRUS to check out prostate symptoms, such as trouble urinating, and get more information about prostate conditions, such as prostate cancer and enlarged prostate. TRUS images also can help guide prostate procedures and treatments.

TRUS can make pictures of any structure that is close to the rectum. Sometimes healthcare professionals use it to look at other organs, such as the rectum, seminal vesicles and uterus.

Por qué se hace

A transrectal ultrasound (TRUS) involves placing a device into the rectum to make pictures of nearby organs. It's often used to make pictures of the prostate and help with prostate procedures. Sometimes it's used to make pictures of other organs.

Prostate conditions

Healthcare professionals most often use TRUS to check out symptoms and get more information about prostate conditions. TRUS images of the prostate can show the size and shape of the gland. They also may show areas of prostate tissue that look different from the tissue around them.

• Enlarged prostate. Enlarged prostate, also called benign prostatic hyperplasia (BPH), happens when the prostate grows larger than usual. TRUS usually isn't used to diagnose BPH, but it can give the healthcare team more information about the condition. It may help the care team measure the size of the prostate.
• Prostate cancer. TRUS doesn't diagnose prostate cancer, but it can give the healthcare team information about the condition. TRUS helps the care team measure the size of the prostate, which helps with staging and treatment planning.
• Prostate cysts. Prostate cysts are pockets of fluid within the prostate tissue. TRUS can detect cysts.
• Prostatitis. Prostatitis is swelling and irritation of the prostate. If the condition doesn't respond to treatment, a healthcare professional might use TRUS to look closer at what's causing the symptoms.

Some people wonder whether TRUS or MRI is better for showing the prostate. Both tests have some benefits. MRI makes more-detailed pictures than TRUS does. Prostate MRI helps show the difference between healthy prostate tissue and prostate cancer better than TRUS. But MRI is more expensive and requires special equipment. TRUS is often done in a healthcare professional's office with equipment that is widely available. The cost is lower and the results are often available right away.

Prostate procedures

TRUS also might be used during prostate procedures. A healthcare professional might watch a TRUS image of the prostate on a monitor while guiding a biopsy needle or treatment tools to the right spot.

Procedures and treatments that can use TRUS guidance include:

• A procedure to place small metal markers in the prostate to help guide radiation therapy.
• Cryotherapy for prostate cancer, which treats cancer with extreme cold.
• Drainage procedures for prostate abscesses and cysts.
• High-intensity focused ultrasound (HIFU) for prostate cancer, which treats cancer with focused sound waves.
• Prostate biopsy, which removes tissue from the prostate for testing. TRUS is used during transrectal biopsy, transperineal biopsy and fusion biopsy.
• Prostate brachytherapy, which involves placing radiation in the prostate tissue to treat cancer.

Other conditions

TRUS can make pictures that show other organs near the rectum. Healthcare professionals might use TRUS to look for signs of:

• Male infertility. TRUS can look closely at the seminal vesicles and other parts of the male reproductive system for conditions that might cause male infertility.
• Tumors and cancers in the pelvis. TRUS can check out tumors, cancers and other growths in the pelvic area. This includes looking at the bladder, ovaries, rectum and uterus. TRUS also helps guide procedures to these organs.

TRUS can look at parts of the female reproductive system, so it's sometimes used in girls and women. But this isn't common. It might be used if something is hard to see on an ultrasound exam that involves placing a device in the vagina, called a transvaginal ultrasound. TRUS also might be an option if you aren't comfortable having a transvaginal ultrasound exam.

Riesgos

Transrectal ultrasound (TRUS) is a safe procedure. There are no known harmful effects from using sound waves to make the images. While other tests use radiation to make images, ultrasound doesn't use radiation.

During TRUS, a healthcare professional inserts a device into the rectum. For most people, this doesn't hurt but it can cause discomfort. Some people start to sweat or feel dizzy when the device is placed in the rectum. Tell the healthcare professional who does the procedure if you have these symptoms or feel a lot of discomfort.

If you're having TRUS as part of another procedure, such as a prostate biopsy, other risks and side effects are possible. Talk about your procedure with your healthcare team. Ask what side effects you can expect.

Cómo prepararte

If your healthcare team gives you instructions to help you prepare for a transrectal ultrasound (TRUS), follow them carefully. Your care team may ask you to use an enema at home before your appointment. An enema flushes waste from the rectum with water or a solution.

Whether you need to do anything else before your TRUS may depend on the reason for the test. For example, if you're having a TRUS exam as part of a procedure, such as a biopsy, your care team might have different instructions.

Qué esperar

During a transrectal ultrasound (TRUS), a healthcare professional puts a device into the rectum to make pictures of the inside of the body. The test typically takes about 20 minutes. Your appointment might last longer if you're having TRUS as part of another procedure, such as a biopsy.

TRUS may be done by a trained ultrasound technician. It also can be done by other healthcare professionals, such as doctors who treat conditions that affect the urinary system, called urologists. If you're having TRUS as part of another procedure, such as a biopsy, the healthcare professional who does that procedure might do the TRUS.

Before TRUS

Before TRUS you will change into a gown. A member of your healthcare team may position you on an exam table for the procedure. You typically lie on your side with your knees bent.

You may have a digital rectal exam (DRE) before the TRUS begins. During a DRE, a healthcare professional inserts a gloved, lubricated finger into the rectum to examine the area. DRE can check for any problems in the rectum that might interfere with the TRUS. It also lets the health professional locate any bumps on the prostate so the TRUS can focus on those areas.

During TRUS

During TRUS a healthcare professional inserts a device shaped like a thin tube into your rectum. The device is called a transducer. It also is sometimes called a probe. The transducer gives off sound waves and records how the sound waves move through the body. You can't hear the sound waves during the exam. The transducer sends the data to a computer. The computer uses the data to make pictures that the health professional watches on a monitor.

The transducer goes a short way into the rectum. The transducer is similar in width to the size of a finger. During TRUS, the healthcare professional places a cover over the transducer and coats it with gel before putting it into your rectum.

TRUS typically doesn't hurt, but it may cause some discomfort. If there is a lot of discomfort, numbing medicine can be applied to help with this. Some people start to sweat and feel dizzy when the transducer goes into the rectum. Tell the healthcare professional if you start to feel these symptoms.

The healthcare professional who does the TRUS may move the transducer to make pictures from different angles. When the health professional has all the images needed for the exam, the transducer is removed.

After TRUS

You often can go about your day as usual after TRUS. But if you're having TRUS as part of another procedure, such as a biopsy, your healthcare team might give you other instructions. Follow any instructions you get from your care team.

Resultados

Results from a transrectal ultrasound (TRUS) may be given right away. If the exam is done in a healthcare professional's office, that person might explain your results to you.

Sometimes the images go to a doctor who specializes in using imaging tests to diagnose diseases, called a radiologist. The radiologist may look at the images and send the results to the healthcare professional who ordered the test. Ask your healthcare professional when you can expect to know your results.

What TRUS images look like

TRUS images are often black, white and gray. The different shades show the intensity of the sound waves coming from structures inside the body.

TRUS works using a device, called a transducer, that sends out sound waves. The sound waves hit the structures in the body and bounce back to the transducer as echoes.

The lighter areas on a TRUS image show places where the echo is stronger. Darker areas show weaker echoes.

Sometimes TRUS images have other colors. This might happen if your test includes Doppler ultrasound images. Doppler is a kind of ultrasound that detects blood flow. Tissue that has a lot of blood vessels, such as some cancers, may be a brighter color on Doppler ultrasound.

What TRUS results show

TRUS results often describe how the images look and note anything that was detected.

Some things found with TRUS aren't concerning. For example, calcifications, which are common, are clumps of debris that can be caused by infection and irritation in the prostate. Healthcare professionals consider calcifications to be typical and not a sign of disease.

The results also might describe the prostate zones. The prostate gland has four zones. The tissue in each zone looks a little different from the others on TRUS images. TRUS does a good job of showing the peripheral zone, which is the largest zone and the one where most prostate cancers happen.

TRUS results often include the prostate volume. This is an estimate of the size of the prostate. To get the volume, the healthcare professional who does the TRUS exam measures the prostate and uses a formula to calculate the volume.

Talk about your TRUS results with your healthcare professional. Your health professional can explain what the results mean and what the next steps might be.