Purpose of Transrectal Ultrasound of Prostate

Patient

Q: Why would my doctor suggest a transrectal prostate ultrasound when my PSA is normal and the digital exam of my prostate was normal? I thought this ultrasound was only done as a follow up if one of those two things was abnormal. I did tell my doctor that I was urinating frequently on the day I saw him.

If this ultrasound is a good screening method for prostate cancer, why is it not routinely performed on all males of a certain age?

I am also worried about a false positive result for prostate cancer which I understand is quite common.

I would appreciate your response as I am quite anxious about whether to have this procedure done.

Symptoms:  intermittent mild vibrating sensation in penis and groin
Doctor

A:   Thank you for your question. Transrectal ultrasound is a common imaging method used to determine if there is any possible pathological findings in the prostate. It is not a diagnostic mechanism. The only way to diagnose prostate cancer is by biopsy (removing the prostate and testing for cancerous cells). It is likely that your doctor is concerned with your frequent urination, and would like to see if they missed any findings from the digital rectal exam. It is strange that your doctor would order this with normal PSA and digital rectal exam findings. It could be possible that your doctor would like to image the are to check for any surrounding pathology. This procedure is rather safe, with minor discomfort. If you are are apprehensive about your actual requirement for this procedure, we recommend that discuss this with your physician to see if it is actually necessary.

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