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Transrectal ultrasonography, or TRUS in short, is a method of creating an image of organs in the pelvis, most commonly used to perform an ultrasound-guided needle biopsy evaluation of the prostate gland in men with elevated prostate-specific antigen or prostatic nodules on digital rectal exam.
Prostate cancer screening is the screening process used to detect undiagnosed prostate cancer in men without signs or symptoms. [1] [2] When abnormal prostate tissue or cancer is found early, it may be easier to treat and cure, but it is unclear if early detection reduces mortality rates.
In a study of young adults in Greece (aged 21–50, mean age 40.9 years), the prevalence was found to be 7.35%. [4] While among urologic patients in South Korea (aged 29–89, mean age 61.9 years), the prevalence was 40.7%. [5] The prevalence is notably higher in patients with benign prostatic hyperplasia, ranging from 68.8% to 70%. [3]
Transrectal biopsy is a biopsy procedure in which a sample of tissue is removed from the prostate using a thin needle that is inserted through the rectum and into the prostate. [1] Transrectal ultrasound (TRUS) is usually used to guide the needle. [2] [3] The sample is examined under a microscope to see if it contains cancer.
Most men diagnosed have low-risk tumors confined to the prostate; 99% of them survive more than 10 years from their diagnoses. Tumors that have metastasized to distant body sites are most dangerous, with five-year survival rates of 30–40%. The risk of developing prostate cancer increases with age; the average age of diagnosis is 67.
The risk of postoperative urinary retention increases up to 2.11 fold for people older than 60 years. [6] Medications: Anticholinergics and medications with anticholinergic properties, alpha-adrenergic agonists, opiates, nonsteroidal anti-inflammatories (NSAIDs), calcium-channel blockers and beta-adrenergic agonists, may increase the risk. [2] [6]
A further transurethal method utilizes a robotically-controlled waterjet to remove prostate tissue. Visualization is provided by a combination of cystoscope and transrectal ultrasound methods. This procedure claims risk reduction advantages as a result of being heat free.
A urologist may perform additional tests such as a prostate-specific antigen (PSA) blood test or a bladder pressure testing. Imaging tests such as transrectal ultrasound and magnetic resonance imaging (MRI) might also be performed. Although prostatitis does not increase the risk of prostate cancer, a prostate biopsy may be performed. [20]