Transrectal ultrasound of the prostate, or TRUS for short, is an imaging examination procedure. It is used to diagnose prostate diseases and is hardly stressful for the patient. During TRUS, the examining doctor guides an endorectal ultrasound probe through the rectum directly to the prostate. This enables high-resolution images of the prostate and its surroundings.
Here you will find further information as well as selected TRUS specialists and centers.
Ultrasound examination (sonography) is a widely used imaging examination procedure. It allows the doctor to assess the examined organ in real time.
Sonography works with harmless ultrasound waves. During the examination, the ultrasound probe emits ultrasound waves into the tissue. The different tissue structures reflect the sound waves in different ways. The ultrasound device records the reflected sound waves and uses them to create an image in real time.
Ultrasound can provide the best image of an organ if the sound waves do not have to pass through other layers of tissue first. This is where endoprobes come into play. The examiner brings an ultrasound probe through a hollow organ with a natural opening to the site of the desired examination.
In the case of the prostate, which lies directly against the anterior wall of the rectum, the rectum is suitable . During a TRUS, a transrectal ultrasound examination, the doctor guides the ultrasound probe via the rectum up to the prostate. The ultrasound waves then only have to penetrate the front wall of the rectum, which is just a few millimetres thick. This allows them to image the prostate with high resolution.
Transrectal ultrasound (TRUS) © bilderzwerg / Fotolia
Only with transrectal ultrasound of the prostate can the prostate be imaged with high resolution. Better resolution means greater accuracy, for example to detect tissue abnormalities such as prostate cancer.
TRUS is the only way to reliably measure the prostate in order to determine its volume. In addition, only TRUS allows the different anatomical zones of the prostate to be differentiated.
This is important for prostate biopsy in order to differentiate between the peripheral zone and the transitional zone of the prostate. Carcinomas occur primarily in the peripheral zone.
As a rule, carcinomas are hypoechogenic (darker than the surrounding prostate tissue). TRUS is essential for taking a sample (prostate biopsy).
Other methods are used as part of the TRUS to better visualize prostate cancer, such as
Elastography visualizes the harder cancerous tissue. Special ultrasound devices use a contrast agent to visualize atypical vessels of the carcinoma.
The TRUS examination is usually performed in the left lateral position. To protect the ultrasound probe and for reasons of hygiene, the doctor puts a latex condom over the endorectal probe. He applies a lubricant before inserting the probe via the anus into the rectum.
The examination is less stressful and safe for the patient .
Figure 1: TRUS image of the prostate
Figure 1: TRUS image of the prostate on the left in transverse (transversal) and on the right in longitudinal view (sagittal plane). It is easy to distinguish between the peripheral and transitional zones in the left image. The black area above the prostate corresponds to the urinary bladder filled with urine (anechoic). Note how close the prostate is to the anterior wall of the rectum!
Figure 2: TRUS image of the prostate after performing a TURP
Figure 2: TRUS image of the prostate on the left in transverse (transverse) and on the right in longitudinal (sagittal) view after transurethral ablation of the prostate (TURP). The prostatic urethra hollowed out by the operation is clearly visible in transverse and sagittal views.
Figure 3: TRUS image of the prostate after performing an extensive TURP
Figure 3: TRUS image of the prostate on the left in transverse (transverse) and on the right in longitudinal (sagittal) view after extensive transurethral ablation of the prostate TURP. The prostatic urethra has become very wide and is filled with anechoic (black) urine. After the operation, there is a wide transition from the bladder to the prostatic urethra, which is completely anechoic (black). Hardly any residual prostate tissue is visible after the operation.
The Leading Medicine Guide's quality assurance is ensured by the following acceptance prerequisites.
