ABSTRACT
Prostate cancer is the most common cancer in men and the second leading cause of cancer mortality. Despite substantial changes in screening for prostate cancer over the last 40 years, transrectal ultrasound (TRUS)-guided prostate biopsy remains the diagnostic standard and is utilized to establish tissue diagnosis in the overwhelming majority of prostate cancer cases. A working knowledge of the technical aspects of the imaging modality will allow the practitioner to set optimal parameters for various clinical indications. While prostate TRUS without biopsy may be performed for a variety benign indications-including obtaining accurate prostate size measurements as part of evaluation for voiding dysfunction, evaluation of azoospermia, and suspected prostatic infection-this chapter will focus on TRUS-guided prostate biopsy. Contraindications to TRUS-guided prostate biopsy including active urinary infection, coagulopathy, and rectal anomalies that preclude the procedure. Although a commonly performed procedure, TRUS-guided prostate biopsy may be associated with potential morbidity which can have substantial impact on both the patient and the healthcare system.
