What does a TRUS guided prostate biopsy involve

The transrectal ultrasound may be performed in your urologist's office or in the radiology department, depending on your institution. In preparation for the study, you may be asked to take an enema to clean stool out of the rectum and to take some antibiotics around the time of the study. You will be asked to stop taking any aspirin or nonsteroidal anti-inflammatory medications, such as ibuprofen (Motrin or Advil) for about 1 week prior to the biopsy to minimize bleeding. The doctor will ask you to lie on your side with your legs bent and brought up to your abdomen. The ultrasound probe, which is a little larger than your thumb, is then gently placed into the rectum. This can cause some transient discomfort that usually stops when the probe

Hypoechoic

In ultrasonography, giving off few echoes; said of tissues or structures that reflect relatively few ultrasound waves directed at them.

is in place and completely goes away when the probe is removed. Men who have had prior rectal surgery, who have active hemorrhoids, or who are very anxious and cannot relax the external sphincter muscle may have more discomfort. Once the probe is in a good position, the prostate will be evaluated to make sure that there are no suspicious areas on the ultrasound. Ultrasound looks at tissues by sound waves. The probe emits the sound waves, and the waves hit the prostate and are bounced off the prostate and surrounding tissue. The waves then return to the ultrasound probe, and a picture is developed on the screen. The sound waves do not cause any discomfort. Prostate cancer tends to cause less reflection of the sound waves, a trait referred to as hypoechoic, so the area often looks different in an ultrasound image than the normal prostate tissue. After the prostate has been evaluated, biopsies are obtained. The transrectal ultrasound allows the urologist to visualize the location for the biopsies. A minimum of six to eight biopsies are obtained and more frequently twelve. These biopsies are distributed between the top, the bottom, and the middle aspect of the prostate on each side. If you have a large prostate gland, have suspicious areas on ultrasound, or have had prior negative prostate biopsies, more biopsies may be obtained.

Side effects of TRUS guided prostate biopsy include transient discomfort related to the ultrasound probe, the needle guide, and the biopsy itself. After the TRUS biopsy one may experience blood in the urine, the semen (ejaculate), and/or in the stools. A urinary tract infection and/or acute prostatitis may occur and would present with frequency of urination, burning, and perineal discomfort and, in some cases, a fever.

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