A transrectal ultrasound (TRUS) is a procedure that uses ultrasound to examine the prostate gland. Often, during this examination, your doctor will take tissue samples from the prostate. This is known as a TRUS guided biopsy. It’s a crucial tool in diagnosing prostate cancer and other prostate conditions.
Before undergoing a TRUS guided biopsy, you’ll typically have an MRI scan. This MRI helps your doctor determine if a biopsy is necessary and pinpoint the specific areas from which to take samples, improving the accuracy of the diagnosis.
Understanding TRUS
Ultrasound scans utilize high-frequency sound waves to create images of internal body structures. A prostate ultrasound scan can detect changes in your prostate, including abnormal growths or other irregularities.
The ultrasound scanner employs a transducer, which emits sound waves. These waves bounce off the organs within your body, and the transducer picks up the returning echoes. This information is then processed by a computer, transforming the sound waves into a visual representation on a screen.
Image alt text: Transrectal ultrasound diagram illustrating probe insertion and prostate gland visualization.
What Does a TRUS Guided Biopsy Involve?
A TRUS guided biopsy is a type of needle biopsy performed to detect cancerous cells in the prostate. The procedure involves taking multiple small tissue samples from the prostate gland for microscopic examination.
The biopsy is performed through the rectum, utilizing an ultrasound probe to guide the needle to the precise location for sampling.
Preparing for a TRUS and Guided Biopsy
This procedure is generally conducted in an outpatient setting using local anesthesia. In rare instances, a general anesthetic may be administered in an operating room, rendering you unconscious and pain-free throughout the procedure.
Prior to the test, your doctor or nurse will provide comprehensive information about the procedure and request your signature on a consent form.
A TRUS biopsy cannot be performed if you have a urinary tract infection (UTI). Some hospitals may require a urine test to rule out a UTI.
Antibiotics are prescribed to prevent infection following the biopsy. Your doctor will specify when and for how long you need to take the antibiotics, typically for a couple of days after the procedure.
It’s essential that your bowels are empty before your appointment. This may require an enema, a liquid administered into your rectum to cleanse the bowel, or a liquid medication taken the day before to induce bowel movements. After taking the medication, ensure you have easy access to a toilet for several hours.
Refer to your appointment letter for specific instructions on how to prepare for your test.
Eating, Drinking, and Medications
Since a TRUS biopsy is typically performed under local anesthesia, you can generally eat and drink as usual both before and after the procedure.
Continue taking your regular medications unless instructed otherwise by your doctor. However, if you’re taking blood-thinning medications such as warfarin, you’ll need to discontinue them a few days before the biopsy. Your doctor will advise you on when to stop, usually about five days prior.
Inform your doctor if you’re also taking antiplatelet drugs, which prevent blood cells called platelets from sticking together and forming clots. These medications also need to be stopped a few days before the biopsy.
The TRUS Guided Biopsy Procedure: What to Expect
Before the Procedure
Upon arrival at the clinic or hospital, a staff member will ask you to undress from the waist down and change into a hospital gown.
Before the TRUS begins, your doctor will show you the ultrasound machine and the fine needle used to collect tissue samples during a TRUS guided biopsy. Be prepared for a potentially loud noise as the needle is deployed.
Your doctor will thoroughly explain the procedure before starting, giving you an opportunity to ask any questions.
During the Biopsy
You’ll be asked to lie on your side on the examination table, usually on your left side with your knees drawn up towards your chest. The specialist will inject a local anesthetic into your rectum to numb the area.
The doctor will then insert the ultrasound probe into your rectum to visualize the prostate gland. To obtain tissue samples, they’ll guide the fine needle along the ultrasound probe and into the prostate.
Image alt text: Illustration of a TRUS biopsy procedure, showing the ultrasound probe and needle placement within the prostate.
The doctor will use information from your MRI scan to guide the needle for targeted biopsies, focusing on suspicious areas. They’ll typically also collect samples from other areas of the prostate in a systematic approach. These are known as systematic biopsies. If your MRI did not reveal any specific areas of concern, only systematic biopsies will be performed.
Typically, between 12 and 15 biopsies are taken during the procedure, which usually takes about 20 to 30 minutes.
After the Procedure
After the test, you’ll rest and have something to drink. The medical team will monitor you for at least 30 minutes before you’re discharged home. It’s crucial to drink plenty of fluids for the next 24 hours.
Potential Risks Associated with TRUS Guided Biopsy
TRUS and guided biopsies are generally safe, but potential risks include:
- Blood in your urine, stool, and semen
- Infection
- Pain
- Insufficient biopsy samples
Blood in the urine is common for several days following the procedure. Increased fluid intake helps flush out the blood and reduces the risk of infection.
Contact your doctor or specialist nurse immediately if you experience signs of infection, such as:
- A high temperature
- Difficulty urinating
- Frequent urination
- Significant blood in your urine or stool
- Shivering or shaking
Receiving Your Results
You won’t receive results at the time of the scan. The prostate tissue samples are sent to a laboratory for microscopic analysis. Results typically take 1 to 3 weeks.
The wait for test results can be stressful. Ask your doctor or nurse about the expected timeline and contact them if you haven’t heard back after a couple of weeks.
You may have contact information for a specialist nurse who can provide information and support. Talking to a close friend or relative can also be helpful.
For additional support and information, you can contact cancer support organizations. They can offer advice on available resources and support services.
