TRUS-Guided Biopsy Of Prostate

For transrectal ultrasonography (TRUS), the probe should be placed in a controlled manner, with light but slowly increasing pressure applied against the probe as its tapered end dilates the sphincter during entry. Because the anal canal may be slightly angled in one anatomic direction or another, using this technique to allow the probe to find the path of least resistance should minimize pain. Holding the end of the probe between the thumb and forefinger allows a greater range of motion than a tight-fisted grip would and makes biopsy easier on the surgeon.

The physician should remain mindful of the topical anatomy throughout the procedure (see the image below). Just as the laparoscopic surgeon should observe the body during instrument entry and exit, so should the ultrasonographer observe the probe to ensure that it points in the direction of the rectal course during placement