Incidental discovery of ano-rectal disease during transrectal ultrasound performed for prostatic disease.
Transrectal ultrasound (US) has long been a routine investigation for the study of various diseases of the prostate. The use of 360 degrees transverse scanning probes and recently, of 3D probes, has been proposed as a suitable means of studying the rectal wall. Between January 1997 and February 2004, 3758 subjects suffering from lower urinary tract symptoms associated with micturition disturbances underwent transrectal ultrasound (TRUS) with a multiplane probe having a variable frequency ranging up to 7.5 MHz and, in the later period, with a transrectal 3D volumetric probe. In 489 patients (13%) TRUS yielded suspicious images of the rectal wall. This finding was verified by a proctologic and rectoscopic examination. In 132 cases (27%) it was shown to be a false positive, mainly due to imperfect cleansing of the anal canal; in 284 cases (58%) benign disease was demonstrated (hemorrhoids in 192 patients, abscesses in 21, perianal fistulas in 18, inflamed lymph nodes in 27, polyps in 16). In 34 patients (7%) a malignant tumor was found (infiltration of the anterior rectal wall by a prostatic adenocarcinoma in 13, and a primitive adenocarcinoma of rectal origin in the remaining 21). It can be concluded that transrectal US does not permit a certain diagnosis of the nature of rectal disease, but does raise a diagnostic suspicion that can orient the surgeon to schedule more invasive diagnostic investigations.
Martino
Pasquale
P
Dipartimento dell'Emergenza e dei Trapianti di Organi, Sezione di Nefrología Chirurgica e Trapianto, Italy.
Martino
Donato
D
Palazzo
Silvano
S
Altomare
Donato Francesco
DF
Garofalo
Lucio
L
Battaglia
Michele
M
Selvaggi
Francesco Paolo
FP
D006801:Humans; D033162:Incidental Findings; D008297:Male; D011469:Prostatic Diseases / Q000150:complications / Q000473:pathology*; D012002:Rectal Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D014463:Ultrasonography; D014555:Urination Disorders / Q000000981:diagnostic imaging* / Q000209:etiology