Definition

A digital rectal exam (DRE) is a clinical examination of the prostate gland by way of the rectum to to check for any abnormalities and is an essential element in screening for and identifying prostate cancer. The DRE is also helpful in identifying other related prostate illnesses such as benign prostatic hyperplasia (BPH) and prostatitis (infection of the prostate).

Why is the exam performed?

A digital rectal exam is performed to look for any signs of prostate cancer and in many instances is used in conjunction with a prostate-specific antigen test (PSA) to aid in diagnosing the presence of prostate cancer. It is recommended that men over the age of 50 years old begin screening for prostate cancer. If patients have any additional risk factors for prostate cancer in relation to race (African-American) or have a family history of the disease than screening can begin as early as 40 years old

The Procedure

Before beginning the examination your doctor will ask you to remove any clothing below the waist. You will also be provided with a hospital gown to wear for the duration of the exam. Your doctor will then instruct you to bend at the waist with your hands firmly placed on the examination table. In some instances you may be required to lay on the examination table on either your right or left side with your knees drawn towards your chest as close as possible. The latter position is considered to provide the most suitable comfort for the patient during the examination.

Your doctor will then gently place a lubricated gloved finger into the rectum to thoroughly examine the prostate. Once located your doctor will then apply firm pressure to the prostate in order to feel for any abnormalities or enlargement of the prostate. The examination will generally only last a few minutes to complete and following the procedure your doctor will discuss the findings.

Side effects/Risks

There are few if any side effects related to a digital rectal exam. During the procedure you may feel only a small level of pain or discomfort. There is also a chance of bleeding following the completion of the examination but this only occurs in instances when hemorrhoids or anal fissures are present. There is also the rare occurrence of experiencing a vasovagal syncope, which is a physical response causing a patient to become light headed and possibly faint. This as a result of fear from pain of having a finger placed within the rectal cavity and the uncomfortable nature of the exam.

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