How to do Prostate Examination

Rectal examination

A rectal examination or rectal exam is an internal examination of the rectum such as by a physician or other healthcare professional.
Digital rectal exam; drawing shows a side view of the male reproductive and urinary anatomy, including the prostate, rectum, and bladder; also shows a gloved and lubricated finger inserted into the rectum to feel the prostate.

The digital rectal examination (DRE, Latin palpatio per anum or PPA) is a relatively simple procedure. The patient is placed in a position where the anus is accessible and relaxed (lying on the side, squatting on the examination table, bent over the examination table, or lying down with feet in stirrups). The physician inserts a gloved and lubricated finger into the rectum through the anus and palpates the insides for approximately 60 seconds.

The DRE is inadequate as a screening tool for colorectal cancer because it examines less than 10% of the colorectal mucosa; colonoscopy is preferred. However, it's an important part of a general examination, as many tumors or other diseases are made manifest in the distal part of the rectum.

• This examination may be used:
• 
  for the diagnosis of rectal tumors and other forms of cancers
• 
  in males, for the diagnosis of prostatic disorders, notably tumors and benign prostatic hyperplasia
• 
  for the diagnosis of appendicitis or other examples of an acute abdomen (i.e. acute abdominal symptoms indicating a serious underlying disease);
• 
  for the estimation of the tonicity of the anal sphincter, which may be useful in case of fecal incontinence or neurologic diseases, including traumatic spinal cord injuries;
  in females, for gynecological palpations of internal organs
• 
  for examination of the hardness and color of the feces (ie. in cases of constipation, and fecal impaction);
• 
  prior to a colonoscopy or proctoscopy
• 
  to evaluate haemorrhoids

The DRE is frequently combined with an FOBT (fecal occult blood test), which may be useful for diagnosing the etiology of an anemia and/or confirming a gastrointestinal bleed.Sometimes proctoscopy may also be part of a rectal examination.