A prostate ultrasound is a non-invasive medical procedure used to create images of the prostate gland. This guide provides an overview of the procedure, including what it involves, how to prepare, what to expect, and the potential risks.
Prostate Ultrasound In Singapore
What is Prostate Ultrasound?
A prostate ultrasound, also known as a transrectal ultrasound, is a diagnostic procedure that uses high-frequency sound waves to produce images of the prostate gland and surrounding tissue. The procedure is safe, painless, and does not involve radiation.
The ultrasound equipment consists of a computer console, a video monitor, and a transducer. The transducer, a small hand-held device that resembles a microphone, sends out inaudible, high-frequency sound waves into the body and listens for the returning echoes. These echoes are then converted into images that are displayed on the video monitor.
The Prostate Ultrasound Procedure
The prostate ultrasound procedure is a non-invasive diagnostic test that provides detailed images of the prostate gland. It is performed by a trained urologist and typically takes less than 20 minutes. However, if a biopsy is required, the procedure may take longer. Here’s a more detailed look at each step of the procedure:
- Patient Positioning: The patient is asked to lie on their left side on an examination table, with their knees bent towards their chest. This position allows for optimal access to the prostate gland, which is located directly in front of the rectum.
- Preparation of the Transducer: The urologist places a protective cover over the ultrasound transducer, a small hand-held device that emits and receives sound waves. The transducer is then lubricated with a special gel. This lubrication makes the insertion of the transducer more comfortable for the patient and helps the transducer move smoothly and create clear images.
- Insertion of the Transducer: The lubricated transducer is gently inserted into the rectum. The transducer is positioned as close to the prostate gland as possible to obtain the most accurate images. The patient may feel a sensation of fullness at this stage, but the procedure is generally not painful.
- Image Acquisition: Once the transducer is in place, it emits high-frequency sound waves that bounce off the prostate gland and surrounding tissues. These sound waves return to the transducer as echoes.
- Image Creation: The echoes collected by the transducer are sent to a computer, which converts them into digital images. These images are displayed in real-time on a monitor, allowing the urologist to examine the prostate gland from various angles.
- Image Capture: The urologist may capture several images from different angles to get a comprehensive view of the prostate gland. These images are saved for further analysis and can be used to diagnose a range of conditions, from benign prostatic hyperplasia (BPH) to prostate cancer.
After the procedure, the transducer is removed gently, and the patient can usually resume normal activities immediately.
Preparing for a Prostate Ultrasound
Proper preparation can help ensure clear images and a smooth procedure. Here’s a more detailed look at each step of the preparation process:
- Medication Management: Certain medications, particularly blood thinners, may need to be avoided for a period before the procedure. These medications can increase the risk of bleeding, especially if a biopsy is planned during the ultrasound. Your urologist will provide specific instructions about which medications to avoid and for how long.
- Clothing Selection: On the day of the appointment, patients should wear comfortable, loose-fitting clothing. This makes it easier to position the patient for the procedure and ensures their comfort throughout. In some cases, patients may be asked to change into a hospital gown.
- Bowel Preparation: In some cases, an enema may be required a few hours before the procedure to clean out the bowel. Stool in the rectum can interfere with the ultrasound images of the prostate gland. Your urologist will provide the enema kit and detailed instructions on how to use it at home.
- Fasting: While not always necessary, some urologists may ask the patient to fast (not eat or drink) for a few hours before the procedure. This can help prevent any discomfort or nausea during the procedure.
- Communication: Patients should discuss any concerns or questions they have with their urologist before the procedure. This includes any allergies, particularly to latex, which is often used in the protective cover for the ultrasound transducer.
Patients should always follow the specific instructions provided by their urologist to ensure the best possible results from their prostate ultrasound. These instructions may vary based on the patient’s overall health, the specific reason for the ultrasound, and the practices of the healthcare facility.
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Risks and Considerations
While a prostate ultrasound is a generally safe procedure, there are potential risks and considerations. Understanding these can help patients make informed decisions and prepare for the procedure.
Discomfort: The insertion of the transducer into the rectum can cause a sensation of fullness or pressure, which some patients may find uncomfortable, but his discomfort is typically mild and short-lived. The use of a lubricated cover on the transducer helps to minimise this discomfort. Patients should communicate with their urologist during the procedure if they experience any discomfort, as adjustments can often be made to increase comfort.
Bleeding: If a biopsy is performed during the ultrasound — a procedure where a small sample of prostate tissue is removed for further examination — there may be minor bleeding afterwards. This bleeding is usually minimal and stops quickly. Patients may notice a small amount of blood in their stool or urine for a few days after the procedure. If heavy bleeding occurs or if bleeding persists, patients should seek immediate medical attention.
Infection: There is a small risk of infection if a biopsy is performed. To minimise this risk, the biopsy needle is sterilised, and in some cases, antibiotics may be prescribed before and/or after the procedure. Signs of infection can include fever, chills, or persistent pain. Patients should contact their urologist if they experience any of these symptoms after the procedure.
While these risks and considerations may seem concerning, complications from a prostate ultrasound are rare. The procedure is considered safe and is routinely performed worldwide.
Dr Lee Fang Jann 
Dr Lee is a urologist and kidney transplant surgeon with a broad-based expertise of all urological disorders
He has subspecialty focus on men’s health and male infertility, and special interest in minimally invasive prostate enlargement therapy and kidney stone treatment. Dr Lee has received numerous awards for service excellence such as the Service With A Heart Award (2006-2008, 2011) and the Singapore Health Quality Service Award (2016).
- Bachelor of Medicine and Bachelor of Surgery (Singapore)
- Membership of The Royal College of Surgeons (Edin)
- Master of Medicine (Surgery) (Singapore)
- Fellowship of the Academy of Medicine (Urology)
- Clinical fellowship at Oxford Transplant Centre in the UK
Prior to entering private practice, Dr Lee served in the public sector for 16 years at SGH, where he initiated dedicated clinics evaluating and treating patients with complex men’s health and fertility issues. He also led the Renal Transplant Program and laparoscopic donor nephrectomy service as Surgical Director.
Apart from clinical work, Dr Lee is active in academia and believes in the importance of grooming the next generation of doctor. He was Senior Clinical Lecturer at NUS’ Yong Loo Lin School of Medicine and currently, Adjunct Assistant Professor at the Duke-NUS Medical School. Dr Lee is also regularly invited to share his experiences locally and regionally through lectures, workshops and surgical demonstrations.
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Frequently Asked Questions
What conditions can a prostate ultrasound help diagnose?
A prostate ultrasound can help diagnose a range of conditions affecting the prostate gland, including benign prostatic hyperplasia (BPH), prostatitis (inflammation of the prostate), and prostate cancer. It can also help detect abnormalities in the prostate, such as cysts, calcifications, and growths.
Can I drive myself home after a prostate ultrasound, or do I need someone with me?
After a prostate ultrasound, patients can usually resume their normal activities immediately, including driving. If a biopsy was performed during the ultrasound or if the patient has been given a sedative, they may need someone to drive them home.
How soon will I get the results of my prostate ultrasound?
The timing for results can vary, but in general, preliminary results may be discussed immediately after the procedure. The final report, especially if a biopsy was performed, may take several days to a week. Your urologist will inform you about when and how you will receive your results.
What does it mean if my urologist wants to perform a biopsy during the ultrasound?
If a biopsy is performed during the ultrasound, it means that the urologist has identified an area in the prostate gland that needs further examination. A biopsy involves taking a small sample of prostate tissue for laboratory analysis to check for cancer or other abnormalities.
What are the alternatives to a prostate ultrasound?
Alternatives to a prostate ultrasound may include a digital rectal exam (DRE), prostate-specific antigen (PSA) blood test, MRI, or CT scan. The choice of diagnostic test depends on various factors, including the patient’s symptoms, medical history, and the information needed for diagnosis or treatment.
Is there any special care required after the procedure?
After a prostate ultrasound, patients can typically resume their normal activities immediately. If a biopsy was performed, there may be slight discomfort or minimal bleeding. Patients should drink plenty of fluids and monitor for any signs of infection, such as fever, chills, or persistent pain.
What should I do if I notice heavy bleeding or signs of infection after the procedure?
If you notice heavy bleeding or signs of infection, such as fever, chills, or persistent pain after the procedure, you should seek immediate medical attention. These could be signs of a complication and need to be addressed promptly.