Prostate Ultrasound

Find out more about a prostate ultrasound scan, including what it can diagnose, what it shows, how it works and when you need to get one.

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Written by Hannah de Gruchy

Last updated 23rd July 2025

Prostate Ultrasound: Info and Get a Scan

A prostate ultrasound, often also referred to as a transrectal ultrasound, or TRUS, is an examination of the prostate gland via the rectum, using a small device called an ultrasound probe. 

It’s a minimally invasive procedure that creates real-time images of the prostate. Doctors can then use these images to diagnose or rule out conditions of the prostate, including an enlarged prostate and prostate cancer. 

In this article, we’re going to go into more detail on what a prostate ultrasound is, why you might need one and what it can diagnose.

Key Takeaways:

  • The prostate is a small gland that forms part of the male reproductive system and is located in the pelvic cavity.

  • An ultrasound scan is a quick, routine scan that uses high-frequency sound waves to create an image of the inside of the body. They’re particularly useful for looking at the internal organs.

  • A prostate ultrasound is a minimally invasive procedure that uses a small ultrasound probe, inserted a short way into the rectum, to allow doctors to view the size and shape of the prostate and any irregularities, without the need for surgery.

  • During an ultrasound of the prostate gland, your doctor may perform a procedure called a biopsy under a local anaesthetic and take a small piece of tissue for further examination in the laboratory. 

  • Doctors use the results from ultrasound scans of the prostate to diagnose and rule out a range of conditions, including an enlarged prostate gland, prostate cysts and prostate cancer. 

What is a Prostate Ultrasound?

The prostate gland is a small, walnut-sized gland that forms part of the male reproductive system. It’s situated in the pelvic cavity of men, wrapped around the urethra (the tube that transports urine from the bladder through the penis when urinating), between the base of the penis and the bladder. 

Seminal fluid, a thick, white fluid that nourishes the semen, is produced by vesicles in the prostate gland. The prostate also plays a role in ejaculation, helping to push semen and sperm cells out. 

A prostate ultrasound is a routine medical procedure that takes images of the size, location, shape and internal structure of the prostate gland. 

Due to its location, prostate ultrasound images are best taken through the rectum, meaning that during the procedure, a small, finger-sized and shaped ultrasound probe is gently inserted into the anus (or back passage), a short way up into the rectum. The probe will be covered by a latex sheath and a clear lubricating gel that may feel cold and wet. 

Performed by a specialist radiographer called a sonographer, prostate ultrasounds are usually carried out on an outpatient basis, meaning you will be able to leave after your scan without staying overnight.

Why You Might Need a Prostate Ultrasound

Speak to your GP or specialist doctor about having an ultrasound of the prostate if you’re experiencing any of the following symptoms:

  • Difficulty urinating 

  • Needing to urinate more frequently, especially during the night

  • A sudden and frequent urge to urinate 

  • Feeling like your bladder can’t fully empty

  • Blood in your urine

  • Pain or burning during urination  

  • Blood in your semen 

  • Pain in the pelvic cavity, penis, testicles or rectum

  • Erectile dysfunction (the inability to achieve or sustain an erection)

  • Unexplained fatigue

  • Unexplained weight loss 

You may also have a prostate ultrasound if you’ve received an abnormally high PSA test result. PSA stands for prostate specific antigen and is a routine blood test used for checking the health of the prostate gland. A high result may indicate the presence of prostate cancer, but it can also indicate other, non-cancerous conditions. 

Doctors also use prostate ultrasound scans if they’ve detected a lump during a routine prostate screen and rectal examination (when a doctor feels around inside the anus and tip of the rectum with a gloved finger) or to monitor the progress or recovery of prostate cancer and other prostate conditions. 

What a Prostate Ultrasound Can Diagnose

Doctors routinely use prostate ultrasound scans to diagnose and rule out the following conditions:

  • Benign Prostatic Hyperplasia - non-cancerous swelling and enlargement of the prostate 

  • Prostate Cancer - cancerous tumours in the prostate gland 

  • Prostatitis - inflammation in the prostate, causing swelling and discomfort 

  • Prostate Abscess - a buildup of fluid within the prostate tissue, caused by an infection 

  • Prostate Cysts - pus-filled cysts that develop within the prostate tissue 

  • Prostate Stones - small mineral deposits that can build up in the prostate 

  • Seminal Vesicle Abnormalities - cysts and abscesses that can form in the seminal vesicles, the glands that help produce semen 

  • Ejaculatory Duct Obstruction - a blockage in the ducts that send semen through the penis during ejaculation 

  • Bladder Outlet Obstruction - a blockage in urine flow from the bladder, caused by an enlarged prostate

  • Enlarged Prostate - another term for benign prostate hyperplasia (see above) 

Types of Prostate Ultrasounds

Depending on your symptoms, you may have one or more of the following types of prostate ultrasound scans:

Transrectal Ultrasound (TRUS)

A transrectal ultrasound is the standard type of ultrasound that we’ve been describing in this article. Your doctor will insert a small, finger-sized ultrasound probe a short way into your rectum, while you’re lying on your side on a hospital bed with your knees bent upwards towards your chest. 

Transabdominal Ultrasound

A transabdominal ultrasound is sometimes used to assess the prostate if a transrectal probe cannot be used. 

During a transabdominal ultrasound, a larger ultrasound probe is moved over the skin of the lower abdomen and doesn’t enter the body. You’ll need to drink 500ml of water, half an hour before the procedure, as it works best with a full bladder. 

Transperineal Ultrasound

A transperineal ultrasound follows the same procedure as a transrectal ultrasound. It’s used to help guide a biopsy needle through the skin of the perineum (between the rectum and the base of the penis) to take a biopsy of the prostate under a local anaesthetic. 

How an Ultrasound of the Prostate Works

Ultrasound machines send high-frequency sound waves into the body that cannot be heard or felt. When they enter the body, aided by a special conductor gel, they encounter dense bones, soft tissues such as organs and blood vessels, gases and liquids. 

When the sound waves encounter each tissue type, they bounce back, like an echo, to the transducer probe. Computers attached to the machine detect these echoes and turn them into black and white images that can then be interpreted by a radiologist. 

Different structures echo back in different ways. For example, dense bone reflects the sound waves quickly, while organs and soft tissue reflect them more slowly. These differences, and any abnormalities, are picked up by the radiologist analysing the images. 

Equipment Used

An ultrasound machine is a small medical device housed on a trolley next to a medical bed. Attached are the relevant ultrasound probes - transrectal and/or transabdominal - and computers that turn the high-frequency sound waves into black and white images that can then be interpreted by a specialist doctor called a radiologist. 

A special conductive, clear gel is also used on the skin or the ultrasound probe. This gel acts as a lubricant as well as a conductor for the sound waves to enter the skin. 

Benefits

Ultrasound scans are suitable for most people, and are a safe, quick and routine way of giving doctors a clear view of the inside of the body without painful or surgical procedures. 

Also, unlike x-rays and CT scans, they don’t pose a radiation exposure risk as they don’t use ionising radiation. 

Risks & Side Effects

There are no known risks or side effects to having a transrectal ultrasound. However, some patients find it uncomfortable having a probe inserted into their rectum. This shouldn’t be painful, but let your sonographer know if you feel any discomfort. 

If you have a piece of tissue for a biopsy removed during the procedure, you’ll have a local anaesthetic injected into the rectum to numb the area. You may feel a dull pain in the area afterwards. This should be short-lived and can be remedied by taking over-the-counter painkillers. You may also experience a small amount of bleeding from the back passage for a day or two following your biopsy and ultrasound. 

During a transrectal ultrasound, a latex sheath or condom is used to cover the ultrasound probe before it’s inserted into your rectum. Therefore, let your sonographer know if you have a latex allergy, and they’ll make alternative arrangements. 

Limitations

A prostate ultrasound isn’t suitable for men who’ve had their rectum removed. Men without a rectum may be suitable for an MRI scan of the prostate instead of an ultrasound. 

If your rectum contains too much stored stool (poo), the procedure may not create clear enough images. If this is the case, you may be given a light enema to make you go to the toilet before your ultrasound is continued. 

Not all prostate cancer tumours, if present, are visible on a standard ultrasound. If a PSA blood test suggests a higher chance of prostate cancer and you have symptoms, yet your prostate ultrasound didn’t show cancer, your medical team will perform another scan, usually an MRI scan, if they think it necessary. They will also take biopsies during a prostate ultrasound to test your prostate tissue for signs of cancer. 

How to Prepare for a Prostate Ultrasound

A prostate ultrasound requires little preparation, and you can normally eat and drink as you usually would beforehand. 

Take note of any special instructions provided by your doctor, such as having a full bladder for your appointment and stopping any blood-thinning medications in the days before. These requirements don’t apply to everybody, so if you have any questions, make sure you ask your doctor before the day of your appointment. 

The Procedure Explained: What to Expect

The procedure may vary slightly between clinics, but generally, an ultrasound scan of the prostate gland takes place in the following order: 

  1. Changing Into a Gown - You’ll be required to get undressed from your waist down, and you’ll be given a medical gown to wear for the duration of the procedure.

  2. Positioning on the Exam Table - Your sonographer will help you into a lying position, on your side, facing away from the ultrasound machine, with your knees bent and pulled upwards towards your chest. They’ll lift your gown and cover your bottom half with tissue. 

  3. Insertion of the Ultrasound Probe (TRUS) - They will then cover the ultrasound probe in a condom and a cold, clear gel and slowly and gently insert it into your anus and up a short way into your rectum.

  4. Imaging and Measurement - Once in place, they’ll use the ultrasound machine to take images of the prostate gland, which sits just above the rectum.

  5. Possible Biopsy (If Needed) - If your doctor thinks they need a tissue sample, the area will be numbed and a long, thin needle will be passed through the rectal wall into the prostate, guided by the ultrasound. You’ll have a local anaesthetic to help minimise any pain.

  6. Probe Removal and Clean-Up - Once complete, your sonographer will slowly remove the probe and wipe away any excess gel. 

  7. Post-Procedure Instructions and Results Discussion - If there’s anything urgent to discuss, you’ll speak to a doctor straight away; if not, you’ll be able to prepare to go home to await your results. 

What Happens After a Prostate Ultrasound?

Once your ultrasound scan has been completed, and your sonographer is happy that they have enough clear images of your prostate, the examination will be over. You’ll be able to return home and to your normal duties the same day. 

Getting the Results

The images taken during your ultrasound will be sent to a doctor called a radiologist for interpretation. Your radiologist will then discuss your results with your referring or specialist doctor, along with any other results from different scans and blood tests. 

You’ll then be called over the phone to discuss your results and any further tests or treatments that may be recommended. Some prostate conditions, such as prostatitis, can be treated with antibiotics. Others, including prostate cancer, require other medications and sometimes surgery.

How Much Does a Prostate Ultrasound Cost?

In the UK, a private ultrasound of the prostate costs between £200 and £400. 

Get a Prostate Ultrasound

If you’re concerned about your prostate or you’re experiencing any symptoms that are worrying you, arrange a private prostate ultrasound with us as soon as possible. 

Not all prostate symptoms or high PSA test results mean that you have cancer. But being concerned about having a prostate cancer diagnosis or the thought of being a cancer patient is understandably frightening and daunting. 

If you have symptoms that may indicate a prostate problem, the sooner you get them checked out, the sooner you can begin treatment if required, and the better your chances of being successfully treated. 

FAQs

How Is an Ultrasound of the Prostate Performed?

A prostate ultrasound is performed while you’re awake and lying on your side on a medical bed, with your knees bent and pulled up towards your chest. Your doctor will gently insert a lubricated ultrasound probe (that’s about the size and shape of a finger) into your anus and a short way up into your rectum. 

Can Ultrasound Detect Prostate Cancer?

Yes, an ultrasound scan is used to detect prostate cancer, along with physical tests including a tissue biopsy and a rectal examination, and blood tests including a PSA test. You may also have other scans, such as an MRI scan. 

What Does Prostate Cancer Look Like on Ultrasound?

Prostate tumours appear either as a lighter or a darker mass of tissue than the surrounding tissue on an ultrasound image. A radiologist is specially trained to detect tumours on an ultrasound image. 

How Long Does a Prostate Ultrasound Take?

A prostate ultrasound takes around 15 to 30 minutes, but you should allow an hour for your appointment to account for your medical team taking your medical history, and getting dressed and undressed. 

How Painful Is a Prostate Ultrasound?

A prostate ultrasound shouldn’t feel painful at all, but you may feel some discomfort as the ultrasound probe is inserted into your rectum. To help minimise this, your sonographer will use a latex sheath or condom and a lubricating gel on the ultrasound probe. 

References

Prostate/Rectal ultrasound. (2023, December 4). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/prostate-rectal-sonogram

Radiological Society of North America (RSNA) and  American College of Radiology (ACR). (n.d.). Ultrasound - prostate. Radiologyinfo.org. https://www.radiologyinfo.org/en/info/us-prostate

Transrectal ultrasound scan (TRUS) and biopsy for prostate cancer. (n.d.). Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/tests-and-scans/transrectal-ultrasound-guided-trus-biopsy

Professional, C. C. M. (2025c, July 9). Prostate ultrasound and biopsy. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/15817-prostate-ultrasound-and-biopsy

Transrectal ultrasound scan - Overview. (n.d.). Guy’s and St Thomas’ NHS Foundation Trust. https://www.guysandstthomas.nhs.uk/health-information/transrectal-ultrasound-scan

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