THEscan is a medical imaging technique that relies on the use of ultrasound, thanks to which one can “visualize” the inside of the body.

THEprostate ultrasound, this gland located just under the bladder in humans and participating in the sperm production, can be done in two ways:

• Par suprapubic route : externally, by placing the probe above the pubis
• Par endorectal approach : internally, by inserting the probe into the rectum

Endorectal ultrasound of the prostate is more precise and provides a better quality image of the prostate. It also makes it possible to assess more precisely the volume of the gland as well as its “texture” and that of the annex glands (seminal vesicles).

Ultrasound is a painless and non-invasive examination: it is therefore prescribed as a first-line examination when the doctor suspects an abnormality in the prostate.

This may be the case:

• after a Rectal touch showing an abnormality (mass or enlargement) of the prostate
• in case of urinary symptoms (frequent cravings and emission of a small amount of urine, pain during urination, urinary tract infection, difficulty in urinating, etc.)
• in the event of a dosage showing an abnormal value of PSA (prostate antigen)
• to diagnose a benign prostatic hyperplasia (HBP)
• to guide the doctor when performing a biopsy and to help him visually detect suspicious areas in order to better target samples

However, endorectal ultrasound has no place in the diagnosis of prostate cancer because it is too imprecise, according to the High Authority for Health, except for performing prostate biopsies.

Besides biopsies, ultrasound is mainly used to assess prostate volume, which tends to increase with age, which can lead to urinary discomfort (benign prostatic hypertrophy).

Ultrasound consists in exposing the tissues or organs that one wishes to observe to ultrasonic waves. It does not require any preparation or anesthesia.

For endorectal ultrasound, an elongated (pencil-shaped) probe, covered with a condom and lubricated, is used. This is introduced shallowly into the anus, with the patient lying on his side with his knees bent.

If a biopsy is done at the same time, the doctor inserts a needle into the prostate, through the rectum wall, guided by ultrasound.

Whether it is to perform biopsies or to assess prostate volume, ultrasound helps in the diagnosis of prostate conditions, such as cancer (thanks to biopsies) or benign prostatic hypertrophy.

The choice of treatment will depend on the diagnosis but also on the age of the patient, the various risk factors, etc.

In case of’enlarged prostate troublesome, several drugs can be prescribed, including alpha-blockers and herbal medicine (African plum or pygeum, saw palmetto).