The sound in the urethra allowed the prostate to be directed posteriorly to facilitate palpation of the nodule and placement of the Silverman needle (Barnes & Emery, 1959). The patient would be anaesthetized and positioned in lithotomy. An initial digital rectal examination (DRE) was performed to ensure an empty rectum and an ounce of antiseptic solution was instilled per rectally for ten minutes. Agents used included Vioform (iodochlorhydroxyquin ) 3% Betadine (providone-iodine) or Triophyll (tri-iodophynol). A sound was inserted transurethrally by an assistant to displace the prostate dorsally and towards the anal outlet (figure 10)
