What to Expect From a Transrectal Ultrasound

A transrectal ultrasound (TRUS) is used as a diagnostic or screening tool as a way to take images and assess organs and tissues inside the body. The procedure may also be referred to as a prostate sonogram (when used on men) or an endorectal ultrasound.

Although TRUS is most often used with male patients, one study in the journal, Ultrasound in Obstetrics and Gynecology, reported that this ultrasound method could be used in females with comparable results to transvaginal ultrasounds and better results than transabdominal ultrasounds when imaging the pelvis.

When it comes to imaging equipment, you may be most familiar with X-rays, which utilize radiation technology to produce pictures of internal structures in your body. But transrectal ultrasounds are unique in that they use high-energy sounds waves emitted from a probe that’s inserted into the rectum, as opposed to radiation.

The sound waves from the probe rebound off the surrounding organs and tissues, creating what’s known as an echo. The echoes then form computerized images of certain parts of the body, like the rectum, prostate (in men), ovaries (in women), and pelvic lymph glands. Your doctor can view the images on a screen.

Ultrasound technology is considered safe and non-invasive, according to the Radiological Society of North America (RSNA). Depending on your situation, the ultrasound may be performed by a radiologist, urologist, or a radiology technician.

There are a variety of signs, symptoms, and lab tests which may compel your doctor to order this particular test to gather additional information about your situation. They include:

• Having a rectal exam that may indicate prostate cancer
• Receiving blood work that might point to prostate cancer
• Assessing the condition of the prostate gland
• Checking the female pelvic region when transvaginal ultrasounds aren’t viable options
• Diagnosing certain cancers
• Pinpointing the location of a tumor in the anus or rectum
• Examining the size of a tumor
• Assessing whether or not a tumor has spread to the lymph nodes or other tissues in the body
• Determining if there’s a cause for fertility issues, such as cysts on the reproductive organs, of both men and women.

Additionally, TRUS may also be used by your healthcare provider to administer medical procedures such as:

• Assisting in obtaining tissue samples of the prostate for a biopsy in men
• Administering treatments for cancerous and non-cancerous conditions like brachytherapy, high-intensity focused ultrasound (HIFU), or cryosurgery
• Aspirating or draining abscesses

In the days leading up to the ultrasound, make sure your doctor is aware of any allergies you have to medication.  It’s especially important to notify them of allergies you have to antibiotics.

Depending on the reason for your test, you may be asked to follow certain instructions to prepare for the exam. For example, if you’re taking certain medications, like blood thinners, you might be asked to discontinue them for a designated amount of time before your appointment.

Also, your doctor might want you to have an enema prior to the test to clean out the rectum and colon.

On the day of the ultrasound, wear loose-fitting, comfortable clothing. You’ll likely be asked to remove all or part of your clothing, and you may be asked to wear a gown. Additionally, your healthcare provider might ask you to urinate so that you have an empty bladder before the test. A TURF may include the following steps:

• You may be asked to lie on your side and bend your knees towards your chest
• The ultrasound probe, or sensor, is covered with a condom and lubricated with jelly
• Generally, the probe is about the size of a finger
• After it’s been covered with jelly, it’s inserted into the rectum where you may experience a pressure sensation similar to when you have a bowel movement
• Once the doctor or technician has positioned the probe in place, images of your internal tissues and organs will begin to appear on the screen
• During the TURS, the doctor may collect a tissue sample for a biopsy

A typical TURS takes between 15-30 minutes to complete. Your doctor will provide you with any follow-up instructions you may need.

Transrectal ultrasounds provide a safe testing method to get images of what’s going on inside of your body while avoiding exposure to radiation. If the doctor doesn’t do a biopsy during the test, most people won’t experience any side effects.

If the doctor performs a biopsy, there may be some side effects like:

• Rectal bleeding
• Soreness and pain
• Difficulty urinating or pain with urination
• Blood in the urine
• Blood in the semen
• An infection

These side effects should subside within a few weeks following the procedure. If you experience lingering problems, be sure to talk with your doctor.

Transrectal ultrasounds may cause a minimal amount of discomfort similar to when your doctor performs a rectal exam. If your doctor does a biopsy during the ultrasound, you may experience a more intense sensation in the rectum each time they retrieve a sample. However, a numbing agent is used to put you more at ease when you have a biopsy. If you find that the TRUS is too painful, let your technician or physician know so that they can try to make you more comfortable.

Generally, you should be able to engage in your usual activities following the TRUS, but you’ll want to follow any individualized recommendations your doctor gives you. If you had a biopsy during the ultrasound, your doctor would likely prescribe a course of antibiotics to reduce the risk of infection.