Ultrasound Protocol Library / Transrectal Ultrasound Protocol
Examination protocol
Transrectal Ultrasound Protocol
A structured demonstration of transrectal ultrasound preparation, probe orientation, complete prostate and seminal-vesicle survey, measurements, and documentation.
Protocol demonstration
Transrectal Ultrasound (TRUS) Examination Protocol
Watch the complete examination once, then repeat it while following the preparation and documentation guide below.
Before the examination
Preparation
- Verify the indication, patient identity, consent, relevant history, and any procedure-specific time-out requirements.
- Prepare the endocavitary transducer, approved probe cover, gel, and accessories according to the manufacturer and institutional protocol.
- Position the patient with appropriate support, draping, privacy, and a clear explanation of the examination.
- Follow current high-level disinfection, barrier, medication, anticoagulation, antibiotic, and safety policies whenever applicable.
During the examination
Scanning sequence
- Identify orientation, then survey the entire prostate in axial and sagittal planes from apex through base.
- Obtain three orthogonal prostate dimensions and calculate volume using the practice-approved method.
- Evaluate symmetry, echotexture, contour, capsule, seminal vesicles, ejaculatory ducts, and surrounding structures as indicated.
- When guidance is performed, maintain needle visualization and follow the approved procedural and specimen-mapping workflow.
Required record
Images and documentation
- Representative axial and sagittal images at the apex, mid gland, and base with consistent orientation labels.
- Three orthogonal prostate dimensions and calculated volume.
- Focal or relevant findings in two planes, with measurements and Doppler when appropriate.
- Procedure guidance images, location labels, and specimen mapping when required by the performed procedure.
Quality review
Common pitfalls
- Failing to include the apex or base during a shortened or incomplete sweep.
- Excessive probe pressure that deforms the gland or alters measurements.
- Inconsistent orientation labels or failure to distinguish sonographic findings from a tissue diagnosis.
- Proceeding with a guided procedure without completing the required time-out, safety checks, or equipment review.
Knowledge check
Check your understanding
Answer each question before opening it to compare your response with the teaching point.
Why are both axial and sagittal sweeps required?
The two orthogonal planes establish orientation, help cover the gland from apex to base, and allow findings to be confirmed and measured in more than one plane.
What is needed for a reproducible prostate volume?
Obtain three correctly oriented orthogonal dimensions without excessive compression and use the practice-approved calculation method.
Can grayscale or Doppler ultrasound alone confirm or exclude prostate cancer?
No. Ultrasound findings must be interpreted in clinical context and cannot substitute for the appropriate diagnostic pathway or tissue diagnosis when indicated.