The trues behind TRUS in the setting of chronic prostatitis/chronic pelvic pain syndrome

Objective: We sought to explore the yield of transrectal ultrasound (TRUS) in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Materials and methods: The records of all patients, who were referred for TRUS caused by CP/CPPS, were retrospectively reviewed. Digital rectal examination (DRE) was performed before TRUS. The following parameters were recorded: prostatic length; width; height; volume; external border; peripheral zone (PZ); transitional zone (TZ); TZ/PZ border; seminal vesicles appearance (SV); presence of median lobe; dilation of vas deferens (VD) or ejaculatory duct (ED); and presence of significant postvoid residual (PVR). Unique sonographic findings, if present, were recorded as well. Data were compared to those of an age-matched control group that had undergone the same imaging for other reasons. Results: Two hundred and sixteen patients with suspected CP/CPPS underwent DRE and TRUS. Per DRE, their prostates appeared smaller and homogeneous compared with the control group. Differences seen in TRUS between the study and the control groups, respectively, were as follows: fewer irregularities, fewer hypoechoic areas in PZ; fewer cystic spaces, fewer enlarged median lobes in TZ; less ED dilation; more calcifications; more VD dilation; and more periurethral vascularity. No differences were seen in SV parameters and in PVR. None of the patients has been given different diagnosis or treatment following TRUS. Conclusion: The findings of TRUS studies in patients with suspected CP/CPPS are not pathognomonic for this entity, and TRUS is therefore considered as having very little yield in this setting.