Transrectal Prostate Scan

A transrectal prostate scan, also known as a Transrectal Ultrasound (TRUS), is an imaging procedure used to examine the prostate gland using high-frequency sound waves. A small ultrasound probe is gently inserted into the rectum, allowing detailed images of the prostate to be produced.

The scan is commonly used to assess the size and appearance of the prostate, investigate elevated prostate-specific antigen (PSA) levels, evaluate urinary symptoms, and guide prostate biopsy procedures. It is a safe, minimally invasive investigation that does not involve radiation.

What are the Benefits of a Transrectal Prostate Scan?

A transrectal prostate scan provides valuable diagnostic information while being quick and well tolerated.

Benefits include:

• Detailed imaging of the prostate gland
• No exposure to ionising radiation
• Minimally invasive procedure
• Helps evaluate enlarged prostate (BPH)
• Assists in investigating abnormal PSA results
• Guides accurate prostate biopsy placement
• Can identify abnormalities such as cysts, calcifications, or suspicious areas
• Usually completed as an outpatient procedure

When is a Transrectal Prostate Scan Recommended?

Your urologist may recommend a transrectal prostate scan in several situations.

It is commonly used for:

• Investigation of elevated PSA levels
• Assessment of an enlarged prostate
• Evaluation of abnormal findings during a digital rectal examination (DRE)
• Guidance during prostate biopsy
• Investigation of lower urinary tract symptoms
• Monitoring certain prostate conditions
• Assessment of prostate anatomy before selected treatments

Although MRI has become increasingly important in prostate cancer assessment, TRUS remains a valuable investigation and is frequently used alongside other diagnostic tests.

What does Preparation for a Transrectal Prostate Scan Involve?

Preparation is generally straightforward and varies depending on whether the scan is being performed alone or together with a prostate biopsy.

Preparation may include:

• Review of your medical history and medications
• Temporary adjustment of blood-thinning medication if a biopsy is planned
• Use of a small rectal enema before the procedure in some cases
• Antibiotics if a biopsy will be performed
• Discussion of the procedure and any potential discomfort
• Wearing comfortable clothing for the appointment

Fasting is usually not required unless additional procedures are planned.

How is a Transrectal Prostate Scan Performed?

The scan is usually performed in an outpatient clinic and takes approximately 10 to 20 minutes.

You will be asked to lie comfortably on your side with your knees bent towards your chest. A small, lubricated ultrasound probe, approximately the width of a finger, is gently inserted into the rectum. The probe emits harmless sound waves that create real-time images of the prostate on a monitor.

During the examination, the urologist or specialist sonographer carefully assesses the size, shape, and internal appearance of the prostate gland. Measurements are taken, and any abnormalities may be documented.

If the scan is being used to guide a prostate biopsy, local anaesthetic is usually administered around the prostate before multiple small tissue samples are taken using a specialised biopsy needle. The ultrasound provides continuous guidance to ensure accurate sampling from different areas of the gland.

Once the examination is complete, the probe is removed, and patients can usually return home immediately.

What to Expect during Recovery after a Transrectal Prostate Scan?

Recovery following a transrectal ultrasound alone is immediate, and most patients return to normal activities straight away.

If only the scan has been performed, you may experience:

• Mild temporary rectal discomfort
• A feeling of pressure during the examination
• No significant recovery period

If a biopsy has also been performed, it is common to experience:

• Mild blood in the urine or semen for several days or weeks
• Small amounts of rectal bleeding
• Mild discomfort around the biopsy site
• Temporary urinary symptoms

Your healthcare team will provide instructions on when to seek medical attention if symptoms such as fever, heavy bleeding, or difficulty passing urine occur.

What are the Risks and Complications of a Transrectal Prostate Scan?

A transrectal prostate scan is considered a very safe procedure.

Possible risks include:

• Mild temporary discomfort
• Minor rectal irritation
• Small amount of rectal bleeding
• Temporary blood in the urine or semen if a biopsy is performed
• Urinary tract infection following biopsy
• Difficulty passing urine after biopsy, although uncommon
• Rare serious infection (sepsis) after biopsy requiring urgent treatment
• Temporary anxiety or embarrassment associated with the examination

Your urologist will explain why a transrectal prostate scan has been recommended, discuss whether a biopsy is required, and answer any questions before the procedure.