Transrectal ultrasound uses an ultrasound probe in the rectum to examine the prostate, not unlike the finger examination done by urologists. It provides images of the prostate and structures adjacent to it, from which prostate size can be measured, contributing to the assessment of prostate conditions.
Transrectal ultrasound can be combined with prostate biopsy to take samples of tissue from the prostate for the diagnosis of prostate cancer. Prostate biopsy does have some risks, particularly infection and bleeding. Infection is usually prevented by taking antibiotics in advance and for a few days afterwards. Nevertheless, infection can develop occasionally, either in the prostate, urine or bloodstream, typically a few days after the procedure. Symptoms may include burning on passing urine, fever, shaking or general malaise. It is therefore important to take antibiotics as instructed, and to complete the full course after the procedure.
A limited amount of bleeding is not uncommon, in the urine, semen or bowel. This usually settles within a few days, though blood in the semen may take several weeks to clear. Additional precautions prior to biopsy are necessary in patients who have a bleeding tendency or take medication that thins the blood.
You will be asked to sign a consent form before the biopsy is carried out. Local anaesthetic solution is infiltrated around the prostate to reduce the discomfort of the procedure. The procedure itself takes about 10 minutes, and afterwards you will be able to travel home.
Several prostate tissue samples are taken with a needle mounted on an ultrasound probe in the rectum. The number of samples depends on the size of the prostate. The tissue samples are then sent to a laboratory for examination by a histopathologist.
It is recommend that you are accompanied and avoid driving for the remainder of the day. You should avoid strenuous activity until you have completed the course of antibiotics. If you feel unwell you should call your urologist and take medical advice.
While the risk of prostate cancer relates to levels of prostate-specific antigen in the blood, and abnormalities on digital rectal examination, none of these tests are reliable for detection of prostate cancer in its early stages (see cancer screening>prostate). Unfortunately, prostate biopsy remains the only definitive means to diagnose the disease in its early stages.
For further advice on urological investigations, please call us on +44 (0)20 3651 6065 to book an appointment, with Mr. Mark Feneley at The London Clinic, 120 Harley Street, London, W1G 7JW
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