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Prostate Cancer Screening

The Prostate Ultrasound Exam

An ultrasonic examination of the prostate is quite straightforward and often performed on the first consultation with a urogolist. This will serve as a reference point for establishing the state of the prostate and urinary system and enable comparisons to be made with future exams.

An ultrasound scan of the prostate is carried out using a probe introduced into the anus. The exam isn’t normally painfu.

This exam provides additional information to add to that determined by the Digital Rectal Exam (DRE) with which it is always associated.

This ultrasonic exam of the prostate enables:

• precise measuring of the prostate. This is useful in interpreting the results of a PSA test or in choosing a surgical technique to operate on an adenoma.
• detection of “doubtful” zones where it might be necessary to carry out a biopsy.

What Happens During an Endorectal Ultrasound (ERUS) Scan of the Prostate

The endorectal prostate ultrasound exam is carried out during a visit to a urologist or radiologist.

Prior to the exam, the bladder should be full. The doctor will apply some gel to the abdomen (just as with pregnant women!) prior to inserting the probe.

You will stretch out on the examination table lying on one side as the doctor gently introduces the ultrasound probe into the anus. The probe is about the size of a finger and it is inserted with the aid of some lubricating gel. The image is produced by using ultrasonics and not using x-rays as with radiography. The resultant image enables studying the prostate in close detail.

The ultrasound image will enable the doctor to determine:

• the condition of the bladder : the presence of stones, possibility of tumor, general appearance and post-urination residue;
• size of the prostate;
• condition of the kidneys where a possible dilation of the cavities could also indicate the presence of BPH.

The Complete Prostate Exam

About a hour before the exam it’s necessary to drink about a litre (2 pints) of water so that the bladder is full. The exam then will take place along the following lines:

• First on the back : ultrasonic exam of the two kidneys, then the bladder.
• Then onto the left side : Digital Rectal Exam (DRE) followed by endorectal ultrasound exam.
• Urination into a flow meter.
• Another ultrasound scan of the bladder to study the post-urination residue.

See also: Prostate DRE - Prostate PSA
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