[Transrectal echography of the prostate: current evaluation].

Abstract

Our results with transrectal ultrasonography of the prostate are updated herein. Since the specifically urologic ultrasound (Aloka SSD 520) equipped with a sectorial transrectal probe of 5 MHz, became available in our service in 1984, we have performed over 1,700 transrectal ultrasound procedures. From the outset, we established several lines of investigation whose partial results have been published over these past years. Our main interest has been and continues to be that of describing an unequivocal echo pattern that would define prostate cancer in any stage, particularly in its early stages. To date, no finding has proved to be pathognomonic. However, we believe that we have encountered some aspects that have been poorly described to date that allow us to determine the current role of transrectal US in the urologic setting. We support the concept of integral urologic ultrasonography, one that encompasses all of our activities. The present article is a synthesis of a major part of our investigative effort and includes our statistical data and current points of view. Our own experience has taught us that things may turn out to be different from what they initially appear to be. Thus, we cannot rule out that our views will not change in the future. We have therefore attempted not to be rigid with respect to our claims. We must add, however, that except for numerical changes and variations in the degree of significance of specific findings, no major modifications have had to be made during this period. We have divided the study into various parts. Each one reviews a specific pathology (cancer, prostatitis, adenoma...), some procedures (biopsy, puncture, sonometry), and a comparative study between classical and transrectal US (digital rectal examination and US). In all of the foregoing, we have presented our results and some considerations in the discussion. Finally, our current views regarding transrectal US are presented succinctly in the conclusions.