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Transrectal ultrasound (TRUS) is an ultrasound examination of the prostate gland performed through the rectum, allowing for a more precise and detailed evaluation of the organ and the surrounding tissues, as well as the detection of existing pathologies. Sexual function, urinary system performance, and the psycho-emotional state of a man depend on the full functioning of the prostate gland. Therefore, timely consultation with a urologist is very important for maintaining physical and sexual health.
Indications for TRUS
The prostate gland in the male body performs three main functions: secretory, motor, and barrier. If even one of these functions is impaired, the genitourinary system suffers, and reproductive function is disrupted. Therefore, the characteristic symptoms of prostate diseases can be divided into three groups.
The prostate consists of two lobes. With age, the site of their junction thickens, compressing the urethra and causing urinary problems:
difficulty during voiding,
painful sensations,
urinary outflow disorders,
frequent urination,
change in urine color,
presence of blood,
feeling of incomplete bladder emptying.
Pain and discomfort may also occur in the following areas:
perineum,
scrotum,
lower back,
sacrum.
A common sign of prostate problems is deterioration of sexual function:
loss of sexual interest,
disappearance of morning erection,
change in semen color,
insufficient penile rigidity during intercourse,
infertility,
discomfort or pain during intercourse,
abnormal urethral discharge,
imbalance between orgasm and ejaculation.
Diseases Diagnosed with TRUS
The prostate is located adjacent to the rectum, which has thin walls. Therefore, the ultrasound probe, when introduced into the rectum, is positioned very close to the prostate, allowing the physician to detect even the smallest structural changes.
This enables diagnosis of a wide range of conditions:
Vesiculitis (spermatocystitis) — inflammatory process in the seminal vesicles, most often caused by infections spreading via blood or pelvic organs.
Cysts — infectious cysts occur more often in men practicing casual and unprotected sexual intercourse; non-infectious cysts may result from trauma, constipation, or sedentary lifestyle.
PIN (prostatic intraepithelial neoplasia) — a precancerous condition.
Calcifications — crystals formed from inorganic calcium salts.
Prostatitis — previously considered an age-related disease, it is now common among men aged 20–40, mainly caused by sexually transmitted infections (gonorrhea, chlamydia, etc.).
Prostatic abscess — accumulation of pus in prostate tissues, often secondary to prostatitis or purulent infections.
Benign and malignant tumors — prostate cancer is the most common oncological disease in men over 50, with risk factors including genetic predisposition, exposure to toxic substances, and testosterone synthesis alterations.
Prostatic adenoma (benign prostatic hyperplasia, BPH) — according to WHO, affects men over 40; after age 80, prevalence reaches 95%. Unbalanced diet and obesity are contributing factors.
Cystitis — though rare in men, it can be detected. It is inflammation of the bladder mucosa, leading to dysfunction.
Contraindications and Limitations
TRUS is an effective diagnostic method for detecting genitourinary disorders. However, in rare cases, the procedure is contraindicated, such as:
acute hemorrhoids,
inflammatory processes in various parts of the rectum (proctitis, paraproctitis),
anal fissures,
history of rectal resection,
enuresis.
Preparation for Prostate TRUS
The examination is performed only after proper preparation of the bowel and bladder. Preparation includes three stages:
Dietary restrictions — for 2–3 days prior to the procedure, foods causing gas formation must be excluded (dairy products, carbonated and alcoholic beverages, cheese, legumes, vegetables, flour-based and sweet products). The last meal should be 10–12 hours before the procedure.
Bowel cleansing — the rectum must be completely emptied to avoid discomfort and ensure accurate imaging. This can be done using an enema or laxatives.
Bladder filling — one hour before the procedure, the patient should drink 700–800 ml of still water and avoid urination until examination.
How the Procedure Is Performed
The patient lies on the examination couch, turns onto the left side, and pulls the bent legs towards the abdomen. This position provides optimal access to the prostate.
The physician inserts an endoscope with a special ultrasound probe into the anus, advancing it about 5–6 cm into the rectum. The prostate is examined in longitudinal and transverse sections to assess its size, capsule integrity, and structure. If suspicious areas are identified, a prostate biopsy is performed.
In the absence of rectal pathology, TRUS is painless. The procedure lasts 20–30 minutes.
Advantages of Ultrasound at Expert Clinics
Application of advanced therapeutic methods.
Specialists with expertise in integrative anti-aging medicine.
Individual treatment programs, addressing also internal aging factors.
Comprehensive approach including dietary, lifestyle, and habit correction.
Our mission is to prolong patients’ physical, intellectual, and sexual vitality.
Indications for TRUS
The prostate gland in the male body performs three main functions: secretory, motor, and barrier. If even one of these functions is impaired, the genitourinary system suffers, and reproductive function is disrupted. Therefore, the characteristic symptoms of prostate diseases can be divided into three groups.
The prostate consists of two lobes. With age, the site of their junction thickens, compressing the urethra and causing urinary problems:
difficulty during voiding,
painful sensations,
urinary outflow disorders,
frequent urination,
change in urine color,
presence of blood,
feeling of incomplete bladder emptying.
Pain and discomfort may also occur in the following areas:
perineum,
scrotum,
lower back,
sacrum.
A common sign of prostate problems is deterioration of sexual function:
loss of sexual interest,
disappearance of morning erection,
change in semen color,
insufficient penile rigidity during intercourse,
infertility,
discomfort or pain during intercourse,
abnormal urethral discharge,
imbalance between orgasm and ejaculation.
Diseases Diagnosed with TRUS
The prostate is located adjacent to the rectum, which has thin walls. Therefore, the ultrasound probe, when introduced into the rectum, is positioned very close to the prostate, allowing the physician to detect even the smallest structural changes.
This enables diagnosis of a wide range of conditions:
Vesiculitis (spermatocystitis) — inflammatory process in the seminal vesicles, most often caused by infections spreading via blood or pelvic organs.
Cysts — infectious cysts occur more often in men practicing casual and unprotected sexual intercourse; non-infectious cysts may result from trauma, constipation, or sedentary lifestyle.
PIN (prostatic intraepithelial neoplasia) — a precancerous condition.
Calcifications — crystals formed from inorganic calcium salts.
Prostatitis — previously considered an age-related disease, it is now common among men aged 20–40, mainly caused by sexually transmitted infections (gonorrhea, chlamydia, etc.).
Prostatic abscess — accumulation of pus in prostate tissues, often secondary to prostatitis or purulent infections.
Benign and malignant tumors — prostate cancer is the most common oncological disease in men over 50, with risk factors including genetic predisposition, exposure to toxic substances, and testosterone synthesis alterations.
Prostatic adenoma (benign prostatic hyperplasia, BPH) — according to WHO, affects men over 40; after age 80, prevalence reaches 95%. Unbalanced diet and obesity are contributing factors.
Cystitis — though rare in men, it can be detected. It is inflammation of the bladder mucosa, leading to dysfunction.
Contraindications and Limitations
TRUS is an effective diagnostic method for detecting genitourinary disorders. However, in rare cases, the procedure is contraindicated, such as:
acute hemorrhoids,
inflammatory processes in various parts of the rectum (proctitis, paraproctitis),
anal fissures,
history of rectal resection,
enuresis.
Preparation for Prostate TRUS
The examination is performed only after proper preparation of the bowel and bladder. Preparation includes three stages:
Dietary restrictions — for 2–3 days prior to the procedure, foods causing gas formation must be excluded (dairy products, carbonated and alcoholic beverages, cheese, legumes, vegetables, flour-based and sweet products). The last meal should be 10–12 hours before the procedure.
Bowel cleansing — the rectum must be completely emptied to avoid discomfort and ensure accurate imaging. This can be done using an enema or laxatives.
Bladder filling — one hour before the procedure, the patient should drink 700–800 ml of still water and avoid urination until examination.
How the Procedure Is Performed
The patient lies on the examination couch, turns onto the left side, and pulls the bent legs towards the abdomen. This position provides optimal access to the prostate.
The physician inserts an endoscope with a special ultrasound probe into the anus, advancing it about 5–6 cm into the rectum. The prostate is examined in longitudinal and transverse sections to assess its size, capsule integrity, and structure. If suspicious areas are identified, a prostate biopsy is performed.
In the absence of rectal pathology, TRUS is painless. The procedure lasts 20–30 minutes.
Advantages of Ultrasound at Expert Clinics
Application of advanced therapeutic methods.
Specialists with expertise in integrative anti-aging medicine.
Individual treatment programs, addressing also internal aging factors.
Comprehensive approach including dietary, lifestyle, and habit correction.
Our mission is to prolong patients’ physical, intellectual, and sexual vitality.
+7 (495) 154-21-44 
admin@expertclinics.ru 
Moscow, Starovolynskaya st., 12 bld. 1