Prostate Ultrasound

What is a Prostate Ultrasound?

A prostate ultrasound is used to assess the organ suprapubically or transrectally. The latter, for example, is essential for guiding and systematically ordering prostate biopsies.

If the results for the DRE are different or the PSA levels are high, it can provide additional data for the diagnosis. In isolation, however, it is not very useful in diagnosing prostate cancer.

Identifying nodules that are only detected by ultrasound in patients who have had a DRE and have normal PSA levels should be relativised and regarded with some caution. It doesn’t mean that it is definitely cancer, so it isn’t necessarily obligatory to do a biopsy immediately.

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The Importance of Prostate Ultrasounds

This scan can provide valid information for staging the cancer, i.e., for helping to determine whether a specific tumour is limited to the prostate or not.

Abnormalities may be found around the prostate that suggest the tumour has spread outside the prostate capsule.

Patients must undergo a full and accurate prostate assessment by urologists experienced in diagnosing and treating prostate diseases.

No decision or treatment should be based merely on the results of a prostate ultrasound.

How is the Prostate Ultrasound Procedure Performed?

Either transrectally or suprapubically.

In the former, the patient lies on their side with their legs slightly bent and an ultrasound probe is inserted via the rectum.

This specially designed probe shows images of the prostate’s tissue, structure and blood flow in real time.

Though slightly uncomfortable, the process is fast and painless. It is the best ultrasound technique for identifying different prostate pathologies such as prostate cancer, benign prostate hyperplasia and prostatitis. In addition, it is a good method for detecting lesions on the seminal vesicles like nodules and cysts.

Suprapubic ultrasound is performed through the abdominal wall. While little information is obtained with regard to the prostate’s characteristics, it is possible to assess its volume, rough morphology, bladder capacity and post-void residual urine (amount of urine left in the bladder after urinating).

Both are quick scans that last no more than 5–10 minutes on average. If there is a need to assess the prostate’s anatomical structure in more detail, the scans can take longer.

Preparing for the Prostate Ultrasound

If a patient undergoes a transrectal ultrasound, they are usually advised to do a micro-enema for a rectal cleanse to facilitate the procedure.

For suprapubic ultrasounds, the patient should drink plenty of liquids (around half a litre) before the scan so their bladder is full.

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Dr. José Santos Dias

Clinical Director of the Instituto da Próstata

Bacherlor's Degree from the Faculty of Medicine at the University of Lisbon
Specialist in Urology
Fellow of the European Board of Urology
Autor dos livros "Tudo o que sempre quis saber Sobre Próstata", "Urologia fundamental na Prática Clínica", "Urologia em 10 minutos","Casos Clínicos de Urologia" e "Protocolos de Urgência em Urologia"

See Biography