A digital rectal exam (Digital Rectal Exam or familiarly abbreviated as DRE) is one of the main ways that doctors use to examine your prostate. This examination includes the doctor's procedure of inserting a finger into your rectum for a short time to feel for any possible abnormalities. The disorder can include symptoms associated with prostate cancer, benign prostate hyperlasia and prostatitis (inflammation of the prostate usually due to infection). Medical professionals do not recommend that you try to do the self-examination as it takes training to reach accurate conclusions based on the examination. However, if you want to do a self-examination, you should be familiar with the techniques used by the examining doctor.
Step
Part 1 of 2: Determining If You Need a Prostate Check
Step 1. Determine the importance of the examination based on your age
The American Cancer Society organization recommends an annual prostate exam for all men 50 years of age and older. However, some circumstances may cause the examination to be performed at a younger age. These include:
- Men over the age of 40 who have more than one first-degree relative (son, brother, or father) who had prostate cancer before age 65.
- A 45-year-old man with one first-degree relative who had cancer before the age of 65.
- Black men at the age of 45 because they have a higher risk of prostate cancer.
Step 2. Watch for any symptoms related to your urinary system
Problems related to the bladder, urethra, and penis can all be related to prostate problems. Because of its proximity to these systems, the prostate can enlarge and put pressure on these organs, causing dysfunction. If you have prostate problems you may experience the following:
- Slow or weak urine flow
- Difficulty urinating
- Frequent urination at night
- Burning feeling when urinating
- There is blood in the urine
- Erectile difficulties
- Painful ejaculation
- Lower back pain
Step 3. See your doctor
If you are experiencing symptoms of urinary tract problems, various minor ailments may be the cause that cannot be diagnosed with DRE alone. In addition, the DRE is only one of several tests your doctor may use to determine the health of your prostate.
- Your doctor may order an ultrasound through your rectum (transrectal ultrasound is often abbreviated as TRUS) to check for suspicious tissue in your rectum.
- A biopsy may also be needed to confirm the presence or absence of cancer.
Step 4. Request a Prostate Specific Antigen (PSA) test
Your doctor may order laboratory tests to check levels of PSA (a special protein found in your prostate) if abnormalities in the prostate are found. Most doctors conclude that a PSA level of 4ng/ml or lower is normal.
- PSA levels can cause false positive or negative cancer results. The United States Preventive Task Force (United States Cancer Prevention Task Force) advises against prostate examination with PSA levels because of this risk.
- Ejaculation (recent sexual activity), prostate infection, DRE and bicycle riding (due to pressure on the prostate) can increase PSA levels. People who have no symptoms of prostate problems but have elevated PSA levels need to have a re-examination after two days.
- Repeated increases in PSA levels may require follow-up with a DRE examination and/or prostate biopsy (a needle is inserted to remove a piece of prostate tissue for analysis) if symptoms are present.
- Men with PSA levels below 2.5 ng/ml may only need to be rechecked every two years. Meanwhile, if the PSA level reaches 2.5 ng/ml or more, the examination should be done once a year.
Part 2 of 2: Checking Your Prostate
Step 1. Consider seeing a doctor
While it may seem easy enough to perform, a prostate exam requires the right technique and the ability to understand what you're feeling.
- Possible complications of this examination include bleeding from a nail puncture wound in a cyst or other mass. This can lead to infections or other complications that you cannot treat at home and must be taken to the doctor anyway.
- In addition, if there are abnormalities from the results of the examination that you did yourself and then you seek advice from the doctor, chances are that the doctor will still repeat the examination to confirm the results.
Step 2. Take the correct position
When performed in the office, the doctor will place you either in a side-lying position with your knees up or standing leaning forward with your hips flexed. This position gives the doctor easier access to your rectum and prostate.
Step 3. Check the area to see if there are any skin problems
This will require the help of a handheld mirror or the assistance of your partner. Visually inspect your rectal area to see if there are any skin problems such as cysts, warts or hemorrhoids.
Step 4. Put on sterile gloves
You or your partner should wear sterile latex gloves to perform the DRE test. Make sure you wash your hands before touching the gloves to put them on. You will only use your index finger for this examination, but you will still need to wear gloves.
Make sure your fingernails are trimmed short before washing your hands and putting on gloves. Even if it's wrapped in latex, you can still scratch the rectal area or accidentally puncture a cyst or other mass
Step 5. Lubricate the glove
Lubricants such as Vaseline or KY Jelly will allow easier and less stressful penetration into your rectum. Apply a generous amount of lubricant to the index finger of the glove.
Step 6. Feel the walls of your rectum
You or your partner will insert your index finger into your rectum. Rotate your finger in a circular motion to feel for lumps or lumps that could indicate cancer, tumors or cysts on the entire surface of your rectal wall. If there are no abnormalities, the rectal wall will feel smooth with a consistent shape.
Use gentle pressure
Step 7. Feel the walls of the rectum toward your belly button
The prostate is located above/in front of the rectal wall. Abnormalities that you can find when you feel the rectal wall toward the prostate include areas that are hard, bumpy, not smooth, enlarged and/or tender.
Step 8. Remove your finger
In a professional practice, this entire examination will take approximately ten seconds. So don't spend too much time checking it because it will only increase your discomfort due to the examination. Throw away the gloves and don't forget to wash your hands right away.
Step 9. Call the doctor
Do not forget to contact your doctor for examination and further consultation. If you think the examination reveals an abnormality, you should immediately make an appointment with a doctor. Don't forget to tell your doctor that you've had a self-examination if it's done less than two days before. This test may result in elevated PSA levels on other tests.
Warning
- Be aware that cancer can still occur even with normal PSA and DRE test results.
- Trim your nails short first.
- Consensus regarding the reliability of this test varies, some organizations and doctors recommend it, while some organizations and other doctors do not. Consult your family medical history, age, and symptoms with your doctor so that you can make the right decision.
