Prostate ultrasound: transrectal and transabdominal diagnostics

Medically reviewed: 18, February 2024

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What is transrectal and transabdominal prostate ultrasound?

Ultrasound examination in andrology is carried out for the diagnosis of diseases of the genito-urinary organs (penis, scrotum, prostate organs), monitoring of tumor formations, determining the causes of infertility in men. Prostate ultrasound is performed in a transabdominal or transrectal way.

US-Dopplerography – a method of visualization and measurement of blood flow in the vessels allows to detect violations of the blood supply to the prostate, scrotum and penis. The conduct of ultrasound in andrology is preferably at the first stage of diagnosis, and also as a screening for early and asymptomatic prostate cancer.

Transrectal prostate ultrasound (TRUS)

TRUS prostate is a modern highly informative method of ultrasound diagnosis, used to study the condition of the prostate and adjacent organs. It is used in the process of diagnosis and treatment of adenomas, cysts and malignant tumors of the prostate, prostatitis, sclerosis and microabscesses of the prostate and some other diseases.

The prostatic TRUS is performed using a sensor inserted into the rectum. Allows you to assess the size and structure of the prostate gland, determine the localization, number and diameter of pathological foci, as well as identify pathological changes in seminal vesicles. It is carried out both in outpatient and in inpatient settings. Requires minimal preparation.

TRUSI prostate is one of the most informative noninvasive prostate gland used in andrology. Unlike conventional abdominal ultrasound, in which scanning is performed through the anterior abdominal wall, the prostate TRUS is guided through the rectum into which a special sensor is inserted. Even in the absence of obesity, the distance from the skin of the abdominal wall to the prostate gland is about 10 cm. With obesity, this figure can significantly increase.

Passing through fatty tissue, ultrasonic radiation weakens, which negatively affects the quality of abdominal examination. The introduction of the sensor into the rectum, located in the immediate vicinity of the prostate, minimizes the distance between the sensor and the organ being studied. When carrying out a prostate TRUS, a doctor can use higher frequencies.

As a result, the clarity and informative nature of the image is increased, the accuracy of the diagnostic technique is increased in assessing the state of the prostate gland and revealing the pathological changes of this organ.

Indications for transrectal prostate ultrasound

At present, the TRUSI prostate is increasingly replacing the traditional abdominal ultrasound of the prostate. The method has a wide range of indications, including male infertility, potency disorders, ejaculation disorders, soreness during intercourse and hematospermia. In addition, TRUZI prostate appoint with increased, difficulty or pain during urination, signs of kidney failure, pain in the lower abdomen, perineum, suprapubic and lumbar region.

Contraindications for the transrectal ultrasound of the prostate

An absolute contraindication for performing a prostate transrectal ultrasound (TRUS) is when the rectum has been surgically removed. The list of relative contraindications includes urinary incontinence, hemorrhoids with signs of inflammation, severe anal fissures and recent surgical procedures on the rectum. In the presence of relative contraindications, the decision on the need for prostate TRUS is taken individually, taking into account the severity of the pathology of the prostate and all possible risks.

Preparation for transrectal ultrasound

This diagnostic procedure requires minimal preparation. On the eve of the TRUSI prostate should clean the intestines with an enema or laxatives.

In some cases, a complete bladder must be presented for the procedure. If the doctor has advised that the patient should spend 1-2 hours in a full bladder before starting a transrectal ultrasound of the prostate, then it is important to follow this instruction carefully, it is necessary to drink about liter of a liquid. With you, you need to take the results of tests and other diagnostic procedures, extracts from the case histories, the conclusions of the consultant doctors and referral to the ultrasound procedure.

How is transrectal prostate ultrasound performed?

The procedure is carried out in prone position. The sensor is inserted into the patient’s anus and the insertion depth is about 5 cm. Anesthesia is not required, the ultrasound of the prostate is associated with minimal discomfort, which does not exceed the discomfort of the digital rectal examination. The procedure typically takes approximately 30 minutes to complete.

If necessary during the procedure, material is taken for histological or cytological examination. Before biopsy, a local anesthetic is injected into the tissue sampling area.

After completion of the transrectal ultrasound procedure, the doctor deciphers the results of the study, draws up an appropriate conclusion and gives it to the patient’s hands or passes it to the attending physician. Preparation of the conclusion usually takes no more than half an hour, less often (with a high workload of a specialist), the study protocol is issued the next day.

Transrectal prostate ultrasound: Interpretation of results

In the process of research, the doctor studies the condition of the capsule and vessels of the prostate gland, assesses the size and structure of the organ, identifies the altered areas, determines their number, diameter, structure, presence or absence of a clear boundary with the surrounding unchanged tissues, etc.

The prostatic ultrasound is effective at malignant tumors of the prostate – neoplasia sprouts the capsule of the organ and is often easily detected during the procedure.

In addition, this diagnostic procedure allows you to determine the size, boundaries and features of the structure of the adenoma, identify cystic formations and areas of calcification. In all these cases, the transrectal ultrasound provides an opportunity not only to diagnose the existing pathology, but also to choose treatment tactics (conservative therapy, surgical intervention).

Along with the prostate gland, the seminal ducts are visualized during the study. During the examination of the ducts, cysts, areas of blockage, inflammation, and other abnormalities that lead to infertility can be identified.

When carrying out a procedure, the doctor can also examine the bladder and veins of the prostatic plexus. In the process of investigation, bladder stones, neoplasms of the bladder and the ureteral anus, varicose veins of the small pelvis can be detected. The wide possibilities of transrectal diagnostics, high accuracy and reliability in the recognition of pathological processes have allowed this study to become one of the main methods of diagnosis of diseases of the prostate.

The cost of transrectal prostate ultrasound in the US

Transrectal ultrasound is a widely used technique used in the diagnosis of a variety of diseases of the prostate. The procedure is carried out in many diagnostic and medical-diagnostic medical institutions of the capital, has a democratic value.

Price of the transrectal ultrasound of the prostate in the US depends on the form of ownership of the clinic and the order of the scan (scheduled or without a queue). When carrying out additional manipulations (collection of material for a histological or cytological study), the cost of transrectal ultrasound of the prostate increases.

Transabdominal prostate ultrasound

Transabdominal ultrasound of the prostate is a method of ultrasound echolocation of the prostate gland performed through the anterior abdominal wall. In comparison with transrectal ultrasound, this method has a large error and does not provide such a clear visualization of the structure of the gland.

Ultrasound of the prostate is prescribed for complaints of frequent urination, a weak urine stream, difficulty or incomplete emptying of the bladder, a violation of potency, as well as the detection of enlargement or compaction of the prostate in palpation. The condition for transabdominal prostate ultrasound is a well-filled bladder; At the end of the study, after the discharge of the bladder, the residual urine is determined.

Prostate ultrasonic dopplerography

Ultrasonic dopplerography of the prostate is a technique of objective qualitative and quantitative assessment of the state of hemodynamics in the prostate gland with the help of ultrasound. USDG is performed transrectally and is used for early diagnosis of adenoma and prostate cancer, prostatic syndrome (pain, urination disorders and sexual dysfunction), infertility and other conditions.

Dopplerography of the prostate is performed for the purpose of planning transurethral resection of the prostate or adenomectomy, as well as evaluating and reducing the risk of intraoperative bleeding. With USDG, echocontrast agents can be used to better visualize the organ vessels.

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