What is a prostate ultrasound?

A prostate ultrasound, sometimes called prostate sonography, is a test that produces black-and-white images of your prostate by bouncing sound waves off your body’s tissues. This test is used to examine your prostate for the presence of any abnormalities, cancer, or other prostate-related conditions.

This test is safe and can be done in less than an hour. It helps your doctor identify possible prostate conditions before they become more serious or unmanageable.

Read on to learn more about when you’ll need a prostate ultrasound, how the test works, and what your next steps may be after the test.

A prostate ultrasound is used to check your prostate gland using ultrasound imagery. The procedure provides your doctor with black-and-white images of your prostate and the surrounding tissues. Your doctor usually won’t do this as part of a physical examination, but they may recommend it if:

Your doctor may also do a prostate ultrasound if they find any abnormalities during a rectal examination.

Some symptoms that might prompt your doctor to recommend a prostate ultrasound include:

A prostate ultrasound can also be used to help your doctor take a tissue sample, or biopsy, from your prostate.

You don’t need to do much to prepare for a prostate ultrasound. It’s an outpatient procedure that usually takes less than an hour. Your doctor may refer you to a hospital or clinic that has the proper ultrasound equipment for this test. You may also need to sign a consent form before the test.

Some possible instructions that your doctor might give you before the test include:

  • Don’t eat for a few hours before the test.
  • Take a laxative or enema to help clear out your intestines a few hours before the test.
  • Stop taking any medications that can thin your blood, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin, about a week before the procedure. This is usually recommended if your doctor plans to take a biopsy of your prostate.
  • Don’t wear any jewelry or tight clothes to the clinic on the day of the procedure.
  • Take any medications recommended to help you relax during the procedure. Your doctor may recommend a sedative, such as lorazepam (Ativan).
  • Make sure someone’s available to take you home in case your doctor gives you a sedative.

When you get to the facility for the test, an ultrasound technician may ask you to take off your clothes and change into a gown. Then, the technician will ask you to lie down on your back or side on an examination table and bend your knees.

To perform a transrectal ultrasound (TRUS), the technician covers a small imaging tool called a transducer with ultrasound gel to help the tool broadcast good images. Then, the technician slowly inserts the transducer into your rectum and moves it around gently to get images of your prostate from various angles. For a biopsy, the technician will slowly insert a needle alongside the transducer into your prostate to remove the tissue.

Your rectum might feel like it’s swelling while the transducer’s inside, and the gel can feel damp and cold. Let the technician know if you’re uncomfortable during the procedure. Your technician may use local anesthesia or a sedative to help you feel you more comfortable.

Once the test is done, you can take off the gown and put your clothes back on. Your rectum may feel tender for a few days, but you won’t need to follow any specific aftercare instructions. Your doctor may prescribe an antibiotic to prevent infection.

In some cases, your doctor or technician may ask you to wait in the facility until your results are available. You’ll usually need to wait a few days for a radiologist to look at the images and diagnose any conditions, however. Depending on where the test was done, you may wait up to two weeks for results.

Your doctor will schedule a follow-up appointment to discuss your test results. If you have any abnormalities or conditions that are visible on the images, your doctor will point out these areas. Excess tissue, prostate enlargement, or cancerous tumors will appear on the ultrasound images as bright white areas that represent the dense tissue.

A prostate ultrasound is more accurate than an X-ray. This is because your technician can see the images as the transducer moves through your rectum rather than having to take a snapshot and develop the images. Ultrasound tests are also safer than X-rays because they don’t produce any dangerous radiation.

A prostate ultrasound is also faster than a computed tomography (CT) test, which provides 3-D images of your prostate and the areas around it. CT scans require more preparation and time for testing, and they don’t provide real-time images.

Your doctor may recommend follow-up tests if your ultrasound or biopsy shows any abnormalities in or around your prostate. If your doctor discovers any conditions, they’ll discuss a proper treatment plan for the condition and refer you to an urologist or another specialist who can treat you.

If your doctor believes you have benign prostatic hyperplasia (BPH), also called an enlarged prostate, they may recommend medications or surgery to help manage or treat the enlargement. BPH is not usually a serious condition, but it can cause a lot of discomfort and make urinating difficult.

If your doctor believes that you may have cancer, they’ll recommend a prostate-specific antigen (PSA) test to see how much of a particular protein you have in your blood. High levels of PSA may mean that you have prostate cancer. If you have prostate cancer, your doctor will discuss treatment plans to help manage and treat your cancer.