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The Digital Rectal Exam

What to Expect from the Digital Rectal Exam

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Updated June 10, 2014

The digital rectal exam (or DRE) is an essential part of the early detection and diagnosis of prostate cancer. It is also, however, a source of anxiety for many men.

What should you expect from the digital rectal examination?

Why Is the Digital Rectal Exam Performed?

The digital rectal exam is performed to detect abnormalities in the lower pelvis.

A number of important anatomic structures are located in the lower pelvis including the prostate and the rectum/lower colon.

By examining these structures, abnormalities can be detected that may otherwise have been missed with blood tests (like the PSA test) or imaging tests (like CT or MRI exams).

How Is the Digital Rectal Exam Performed?

To begin, you will be asked to remove any clothing below the waist. You may also be given a hospital gown to wear.

You will then be asked either to bend over at the waist with your hands on the examining table or to lay on your left side with your knees drawn up toward your chest. Both of these positions allow for better examination and improved comfort during the test.

Next, your doctor will put a gloved, lubricated finger into your rectum and examine the prostate. To do this properly, firm pressure will need to be applied to the prostate.

When the prostate has been thoroughly examined, the test is complete. The entire exam usually takes only a few seconds.

What Do I Need to Do Prior to a Digital Rectal Exam?

There is nothing that you need to do prior to a digital rectal exam. You can eat, exercise, and otherwise do what you normally do prior to this exam.

Potential Risks or Side Effects

Nearly all men state that a digital rectal exam is somewhat uncomfortable, but not painful. If the prostate is inflamed due to a condition such as prostatitis, the exam can be somewhat painful, however.

Because firm pressure needs to be applied to the prostate during the exam, this can cause you to feel that you need to urinate immediately. This sensation typically passes once the exam is completed.

You may have a very small amount of bleeding after the exam is done. This is more likely if you have hemorrhoids or other rectal problems. Most men have no bleeding.

It is also possible that the uncomfortable nature of the exam could cause you to have a vasovagal response. If this occurs, you may feel very lightheaded or possibly even faint. This, again, is rare and most men have no such issue.

Sources:

Tanagho EA, McAninch JW. Smith's General Urology, 17th Edition.

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