Per rectal ultrasound in the investigation of prostatic disease

Primary prostatic disease is usually assessed by digital palpation of the prostate. This method lacks objectivity and has been shown to be inaccurate, especially in the staging of primary prostatic cancer. This paper describes the investigation of 200 subjects using per rectal ultrasound. Of 70 patients with histological evidence of carcinoma of the prostate, 96% were correctly diagnosed ultrasonically and 87% correctly diagnosed by digital palpation. Of the 37 patients with ultrasonic evidence of a capsular breach, only 65% were diagnosed as such by digital palpation. A study of 10 cadaver specimens confirmed the accuracy of per rectal ultrasound as a technique for staging primary prostatic cancer . The ultrasonic appearances of the prostate, seminal vesicles and bladder base are described. Per rectal ultrasound is acceptable to patients, and its use is recommended in all cases where accurate assessment of primary prostatic cancer is required.