In this paper, we proposed a new method (CSR+OSD) for the extraction of irregular open prostate boundaries in noisy extracorporeal ultrasound image. First, cascaded shape regression (CSR) is used to locate the position of prostate boundary in the images. In CSR, a sequence of random fern predictors are trained in a boosted regression manner, using shape-indexed features to achieve invariance against position variations of prostate boundaries. Afterwards, we adopt optimal surface detection (OSD) to refine the prostate boundary segments across 3D sections globally and efficiently. The proposed method is tested on 162 ECUS images acquired from 8 patients with benign prostate hyperplasia. The method yields a Root Mean Square Distance of 2.11±1.72 mm and a Mean Absolute Distance of 1.61±1.26 mm, which are lower than those of JFilament, an open active contour algorithm and Chan-Vese region based level set model, respectively.