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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.
The catheter is inserted into the vessel under ultrasound or fluoroscopic guidance and tunneled through the skin. Tunneled catheters have multiple channels called lumens which lay exposed on the surface of the skin. These lumens are the access points when the catheter is used. Tunneled catheters can be single, double, or triple lumened.
A port catheter is passed through the tunnel where one end is attached to the chemport and another end is left hanging out near the IJV insertion site. The length of the hanging port catheter should be about 16 to 17 cm (or can be measured from the IJV insertion site until 2 cm below the sternal angle where the right atrium should begin).
Examples include Hickman catheters, peripherally inserted central cathethers (or PICCs), tunneled small bore central venous catheters, and mediports. These lines differ in where they are inserted but are all placed under imaging guidance and adjusted so the end of the catheter sits in the vena cava adjacent to the heart.
Groshongs may be left in place for extended periods and are used when long-term intravenous therapy is needed, such as for chemotherapy.Similar to the Hickman line, the tip of the catheter is in the superior vena cava, and the catheter is tunneled under the skin to an incision on the chest wall, where the distal end of the catheter exits the body.
An implanted central venous catheter, also called a port a "cath" or "port-a-cath", is similar to a tunneled catheter, but is left entirely under the skin and is accessible via a port. Medicines are injected through the skin into the catheter. Some implanted ports contain a small reservoir that can be refilled in the same way.
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If medical treatment does not reduce a patient's urinary symptoms, a TURP may be considered following a careful examination of the prostate or bladder through a cystoscope. If TURP is contraindicated, a urologist may consider a simple prostatectomy, in and out catheters, or a supra-pubic catheter to help a patient void urine effectively. [3]
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