When your doctor tells you to have a transrectal ultrasound, you may feel a little scared and uncomfortable just hearing the name. That's normal. But it's actually a very common, safe, and relatively painless test. So today, let's find answers to all your questions about it.
Simply put, what is transrectal ultrasound (TRUS)?
Ultrasound is a method of using sound waves to look at the organs inside our bodies. It's like a ship's sonar system. It doesn't emit any radiation.
The word transrectal means "through the anus." So in this test, the doctor inserts a small, finger-sized instrument (probe) through your rectum. The high-frequency sound waves emitted by this probe hit the organs inside your body and bounce back. The reflected waves are converted into clear images on a computer screen.
This test is mainly used to examine the prostate gland in men. It is also sometimes used to examine the pelvic cavity and reproductive organs in women.
Who is recommended to take this test?
Your doctor may recommend this test in the following cases:
| Reason | A simple explanation |
|---|---|
| Abnormalities in a DRE exam | If the doctor feels an unusual lump or change in the prostate gland during a digital rectal exam (DRE). |
| Rising PSA levels | If the level of a protein called PSA (Prostate-Specific Antigen) in the blood is higher than normal. |
| Prostate symptoms | If you are showing symptoms of prostate cancer, such as difficulty urinating or a frequent need to urinate. |
| Treating an existing medical condition | As a guide in the treatment of cancerous or non-cancerous conditions of the prostate. |
| Infertility | To diagnose problems with the reproductive system in women and men. |
| Other cancer detection | To diagnose conditions such as rectal cancer or anal cancer. |
How does the TRUS test actually work?
Knowing about this process will help ease your fears. Let's take a step-by-step look at it.
What should you do before the test?
Your doctor will give you some special instructions.
- Tell your doctor about any allergies , heart disease, lung disease, and any medications you are taking.
- You may be asked to stop taking aspirin and NSAIDs (e.g., ibuprofen, naproxen) painkillers and blood thinners for a few days.
- You will be asked to use an enema a few hours before the test to cleanse your rectum and lower colon. This will help to obtain clearer images.
- You may also be asked to urinate and empty your bladder before the test.
What happens during the test?
This is a process that usually takes less than 30 minutes.
1. You will be made to lie on a bed, turned to one side, with your knees pulled up to your chest .
2. The doctor will slowly insert a lubricated, finger-sized probe into your anus. At this point, you will feel a pressure similar to what you feel when you have to have a bowel movement.
3. After positioning the probe in the correct position, the doctor will observe the images of your organs on the computer screen.
What if a biopsy is taken?
Often, during this TRUS test, a small piece of tissue (biopsy) is taken from the prostate gland to check for cancer cells.
Don't be afraid! The area will definitely be numbed before a biopsy is taken.
- The doctor first injects an anesthetic into the prostate gland to numb the area.
- Then, a thin, hollow needle is inserted parallel to the probe and several tissue samples are taken from the prostate gland.
What happens after the test?
You can go home the same day after the test. Your doctor may prescribe antibiotics to prevent infection. The biopsy sample will be sent to the lab and it may take a few days or a week for the report to arrive. Once the report is received, your doctor will call you to explain it.
What are the benefits and risks of this?
Advantages:
- There is no exposure to radiation.
- It can obtain clearer images of soft tissues than an X-ray.
- You can view images in real time while the test is being performed.
Risks:
There are no known risks associated with a TRUS scan. However, the following temporary complications may occur if a biopsy is performed . These usually resolve completely within a few days or weeks.
- Blood in the semen (Hematospermia)
- Blood in the urine (Hematuria)
- Slight rectal bleeding
- Pain when urinating (Dysuria)
- Pain and soreness in the area being examined
- Infections - Antibiotics are given to prevent this.
- Erectile Dysfunction (ED) - This is a very rare, often temporary condition.
Recovery and when to see a doctor
If you have only had a TRUS without a biopsy, you can return to your normal activities immediately. If you have had a biopsy, it is best to rest for two to three days. If you are in pain , a warm bath may help. Drink 6-8 glasses of water a day for a few days.
Call your doctor immediately if you experience the following symptoms:
- Fever
- Blood clots in the urine
- Bleeding in the urine that does not stop for several days
- Inability or severe difficulty urinating
- Severe pain that is not controlled even with medication
If you experience any of these symptoms, don't hesitate to go to the Emergency Department (ETU) of the nearest hospital.
Take-Home Message
- Transrectal ultrasound (TRUS) is a safe, non-invasive test that uses sound waves.
- This is mainly used to diagnose and treat prostate problems in men.
- Follow your doctor's instructions carefully before and after the test.
- The only risks associated with the test are if a biopsy is done, and even that is often temporary.
- If you still have questions about this, don't be afraid to talk to your doctor and resolve them.
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