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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.
A further study, the NHS Comparison Arm for ProtecT (CAP), as part of the Prostate testing for cancer and Treatment (ProtecT) study, randomized GP practices with 460,000 men aged 50–69 at centers in 9 cities in Britain from 2001–2005 to usual care or prostate cancer screening with PSA (biopsy if PSA ≥ 3). [65]
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.
During the transrectal procedure, an ultrasound probe is inserted into the rectum to assist in guiding the biopsy needles. Following this, a local anesthetic, such as lidocaine, is administered into the tissue surrounding the prostate. Subsequently, a spring-loaded biopsy needle is inserted into the prostate, resulting in a clicking sound. When ...
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.
Incidentally, cysts, tumours, and stones may be found on ultrasound. Post-void residual volume of more than 100 ml may indicate significant obstruction. [52] Prostate size of 30 cc or more indicates enlargement of the prostate. [53] Prostatic calcification can be detected through transrectal ultrasound
Physical examination including a digital rectal examination and routine blood tests are carried out. At least six transrectal ultrasound guided biopsies taken from different zones of the prostate are usually obtained. Other considerations include bowel preparation the day before surgery and taking antibiotics.
Transrectal biopsies, the more common type, involve inserting a needle through the rectum to obtain tissue samples. However, they may not accurately sample the entire prostate, increasing the risk of missed diagnoses, and have a higher risk of infection due to the insertion through the rectum.