At an appointment with a urologist, a man sometimes receives a referral for TRUS . The question is natural – what is TRUS of the prostate gland, how is it done, what should be the preparation, whether the method has features and contraindications.

The answer can be obtained from the attending physician, but many are embarrassed to ask. Therefore, we will talk in detail about this method of research, its functionality and how to properly prepare for it.

Transrectal ultrasound

The analysis allows you to evaluate the prostate using ultrasound. If the device is equipped with a function for studying blood flow, which is called Dopplerography, then the doctor receives additional important data.

Transrectal imaging is effective due to the structural features of the male genital organs at the level of the small pelvis. The prostate is located directly below the bladder, the urethra passes through the central lobe. Behind the prostate is the rectum.

With transabdominal scanning, physiological limitations may occur due to intestinal motility, overcrowding of the bladder. The difference is in the methodology. Transrectal ultrasound eliminates these problems.

Which doctor prescribes TRUS ?

1. A urologist can refer you for prostate examination after a consultation. If, according to the results of laboratory diagnostics, he assumes damage to the organ, then transrectal ultrasound will answer his questions.
2. The second option is a proctologist when a pathological compaction is detected at the level of the rectal wall.
3. Anyone can sign up for an ultrasound, because the method has no radiation exposure, it is harmless. Upon reaching a certain age, it becomes mandatory for the early detection of oncology, even if the man feels healthy.

Reasons for appointment

Ultrasound of the prostate is necessary in the following cases:

• detection of pathological changes in the organ;
• measurement of the parameters of the gland, which will become fundamental for making a diagnosis and prescribing treatment;
• under the control of ultrasound, an invasive manipulation is carried out – a biopsy, the essence of which is the collection of tissue fragments for histological analysis (targeted examination of cells for oncology);
• determination of the cause of male infertility.

If to describe schematically, the prostate consists of the central, peripheral and fibromuscular zones. It narrows at the bottom and widens at the top. Behind are paired groups of seminal vesicles. Between the right and left lobes of the central zone lies the urethra.

TransUS of the prostate is necessarily required for pathological subjective sensations of the patient and objective data from laboratory tests:

PSA (prostate specific antigen) is a marker, its increase may indicate oncology. The normal value is up to 4 ng / ml, if the indicator exceeds the limit of 10, then it is more likely to speak of a tumor process. Almost any laboratory ( Invitro ) can do this analysis.

List of detected diseases

Transrectal ultrasound shows the following diseases:

• prostate cancer (localization, size, involvement of the organ capsule);
• benign hyperplasia (the number of adenomatous nodes);
• acute or chronic inflammation (prostatitis);
• changes in seminal vesicles (physiological age-related decrease, inflammation, cysts);
• anomalies in the development of the genital organs;
• the reaction of adjacent lymph nodes (their increase may indicate inflammation, tumor lesions).

As an alternative to TRUS, an MRI of the pelvic organs is indicated. If ultrasound diagnostics or magnetic resonance imaging reveals signs of oncology, then a biopsy is necessary for confirmation.

Features of preparation for TRUS

To obtain the most accurate and reliable information on TRUS of the prostate, preliminary preparation for the study is required.

It consists of three stages – nutrition, cleansing, mental attitude. The correct three-step approach minimizes discomfort during the procedure.
From the diet it is necessary to exclude products that enhance physiological fermentation:

• legumes;
• fermented milk;
• sweet pastries;
• pasta;
• fresh vegetables, fruits;
• carbonated drinks (lemonade, beer);
• any alcohol.

The diet should be made up of lean foods prepared by boiling, stewing, baking in the oven in foil. It is advisable to adhere to such a diet for 2-3 days before the study.

1. On the eve of the procedure, the last meal – no later than 6 pm. An hour later, you need to take an activated angle at the rate of 1 tablet per 10 kg of weight. An alternative is the Polysorb adsorbent .
2. The next important point of preparation is the cleanliness of the intestines. For this, therapeutic enemas are made, for example, ” Esmarch ‘s mug “. It can be difficult to clean it yourself, so the enema is replaced with a drug – Fortrans . Before a TRUS , it is recommended that you ask your doctor about the need to bring a special medical condom with you. At the pharmacy, when buying, you should inform that you need it for transrectal ultrasound.
3. Fear breeds anxiety, which intensifies the discomfort. Therefore, in a few days, doctors advise preparing and drinking mild sedative herbal medicines – Novopassit , Persen . They differ in different components, but have similar sedative effects.

Steps for performing a transrectal prostate evaluation

TRUS procedure consists of the following steps:

1. The patient takes off his trousers, underwear, and lies down on the couch in the fetal position. The legs must be bent at the knees, pulled to the stomach.
2. The study is carried out using a special cavity endorectal sensor. An ultrasound doctor puts on a condom on him, applies a gel and inserts it through the anus into the rectum.
3. To assess the prostate, the depth of insertion is about 6 cm, for seminal vesicles and the level of the internal opening of the urethra – up to 10 cm.
4. Live images are displayed on the screen of the machine. If necessary, areas with pathological changes are printed in sonogram format .
5. When finished, the doctor removes the transducer.

After TRUS, the patient receives a protocol with a decoding of the parameters of the prostate, seminal vesicles, ejaculatory ducts, and the volume of residual urine.

It is difficult for the patient to understand it, with the results it is necessary to make an appointment with the attending physician.

When can’t you pass?

The method has a list of limitations, contraindications, in which the study is prohibited:

• fistulous communication between the intestinal lumen and adjacent adipose tissue;
• phase of exacerbation of prostatitis;
• defecation disorders in the form of diarrhea;
• profuse bleeding from the intestine;
• abscess formation of the prostate;
• mental illness;
• acute form of paraproctitis (inflammation of the surrounding fatty tissue).

If the diseases are available for correction, then TRUS is tolerated until the acute condition is relieved. Otherwise, the doctor considers an alternative option.

For example, magnetic resonance imaging or transabdominal ultrasound in the case of an asthenic physique of the patient.

Reviews about the procedure

Urologists give positive feedback about transrectal ultrasound of the prostate. The reasons for this attitude are the lack of radiation exposure, surgical intervention to obtain information. The ability to combine with puncture increases the prevalence and popularity.

Doctors advise not to be afraid and not to worry, the patient will feel only a slight tension in the rectal area. If you correctly follow the preparation for TRUS of the prostate, then there will be no pain.

Conclusion

TRUS is not a new, but very informative way to obtain diagnostically accurate data on the anatomy of the disease, variants of the development of the male gland.

The examination will reveal early signs of inflammation, oncology. Accordingly, treatment will be started on time and the likelihood of recovery without consequences will increase.