[Endosonography of the prostate].

Area of Science:

• Urology
• Oncology
• Medical Imaging

Background:

• Transrectal prostate ultrasonography (TRUS) effectiveness for prostate cancer screening is debated due to variable sensitivity and specificity.
• Digital rectal examination (DRE) combined with prostate-specific antigen (PSA) testing remains a cornerstone for prostate cancer detection.
• Prostate cancer is infrequently found in patients with normal DRE and PSA levels undergoing random biopsies (less than 4%).

Purpose of the Study:

• To evaluate the utility of TRUS in prostate cancer diagnosis and management.
• To clarify the specific clinical scenarios where TRUS provides significant value.

Main Methods:

• Review of existing literature on TRUS, DRE, and PSA in prostate cancer screening and diagnosis.
• Analysis of TRUS applications including prostate volume determination, ultrasound-guided biopsies, and pre-surgical staging.

Main Results:

• TRUS demonstrates low sensitivity and specificity for initial prostate cancer screening.
• DRE and PSA testing remain effective screening tools with a low incidence of cancer in normal results.
• TRUS is recommended for precise prostate volume measurement, guiding biopsies in suspicious cases, and staging prior to radical prostatectomy.

Conclusions:

• TRUS is not recommended as a primary screening tool for prostate cancer due to its limitations.
• TRUS plays a crucial role in specific clinical situations, including volume assessment, guided biopsy, and staging.