Transrectal ultrasound performed immediately after prostate biopsy: Imaging features and ultrasound-guided compression to bleeding biopsy tract

Purpose: To evaluate the imaging features of transrectal ultrasound (TRUS) performed immediately after prostate biopsy, and to determine whether TRUS-guided compression can stop active bleeding. Material and Methods: Systematic 12-core biopsy was performed in 57 consecutive patients, 24 of whom underwent additional target biopsy. The imaging features of grayscale and power Doppler TRUS performed immediately after biopsy were prospectively analyzed, and the complication rate following TRUS-guided bleeding compression was registered. Results: Hyperechoic, hypoechoic biopsy needle tracts, or both were seen in 88% (50/57), 72% (41/57), or 61% (35/57), respectively. Power Doppler TRUS performed immediately after biopsy showed 76 bleeding needle tracts in 43 of the 57 (75%) patients, of which 17 were on the right part of the gland and 59 were on the left (P < 0.01). TRUS-guided compression times ranged from 1 to 8 min (mean 2.9 min). Hematuria was seen in 38 of 57 patients (67%), with a mean duration of 2.6 days. Hematochezia was seen in 19 of 57 patients (33%), with a mean duration of 0.6 days. Hematuria lasting longer than 3 days occurred in 16 of 57 patients (28%). Hematospermia occurred in 13 of 40 cases (33%). Conclusion: TRUS performed immediately after biopsy depicted various imaging features and may control postbiopsy bleeding.