Urological Health Prostate Health What Is a Prostate Exam? Why and How It's Done By Jerry Kennard Jerry Kennard Jerry Kennard, PhD, is a psychologist and associate fellow of the British Psychological Society. Learn about our editorial process Updated on October 07, 2022 Medically reviewed by Jamin Brahmbhatt, MD Medically reviewed by Jamin Brahmbhatt, MD Facebook LinkedIn Jamin Brahmbhatt, MD, is a board-certified urologist and Chief of Surgery at Orlando Health South Lake Hospital. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Purpose Step-by-Step Results and Follow-Up A prostate examination is also called a digital rectal exam (DRE). During the exam, your healthcare provider inserts their finger into your rectum to feel your prostate gland. This gland is under your bladder and behind your penis. It's where semen is made. A prostate exam is done to check the shape of your prostate. If it is bigger than normal or has an unusual shape, it could be a sign of a condition like cancer. While it's common to feel uneasy about getting a prostate exam, it only takes a few minutes and usually does not hurt. This article will go over why a prostate exam is done and what to expect when you have one. Verywell / Michela Buttignol An Overview of Prostate Exams Purpose Prostate exams are very common. The exam is considered standard medical care. A prostate exam is part of the general health screening recommendations for people with prostates who are age 50 and over. They are also recommended for younger people who are at risk of getting prostate cancer. A DRE is also done if a person has symptoms of a prostate that is bigger than usual (an enlarged prostate) or symptoms of prostate cancer. Symptoms that could prompt a prostate exam include: Being unable to empty your bladder completely (urinary retention) Feeling strong, sudden urges to urinate (urinary urgency) Leaking urine Urinary dribbling What Causes Prostatitis? Screening Guidelines There are different guidelines for prostate screening for people who do not have symptoms. The screening can include a DRE or a PSA (prostate-specific antigen) blood test. PSA is a protein that is produced by some prostate cancers. Your provider might want you to have both tests. Usually, they can both be done during the same appointment. The American Cancer Society (ACS) recommends talking to your doctor about a prostate exam if you're age 50 or older. However, you might need to have the conversation sooner: If you are African American or have a first-degree relative that was diagnosed with prostate cancer before the age of 65, the ACS recommends talking to your provider about an exam before the age of 45.If you have more than one first-degree relative who was diagnosed with prostate cancer before the age of 65, the ACS recommends talking to your doctor about screening by the time you turn 40. PSA Levels and Prostate Cancer Why Do Guidelines Change? Screening recommendations change over time. They can also differ between organizations. The changes are necessary because of the cost of testing and the accuracy of the tests. The U.S. Preventative Services Task Force (USPSTF) stopped recommending screening with PSA in 2012. It has not issued a statement about DRE. One example is the rate of false positives and false negatives. This means that sometimes, a test says that a person has cancer when they do not. Other times, a person has cancer but the test says that they don't. This can happen with PSA and DRE tests, depending on how sensitive they are. If the test is too sensitive, a person might be diagnosed when they do not really have cancer. On the other hand, if the test is not sensitive enough, the diagnosis can be missed. Recap The prostate is a gland that makes semen. A healthcare provider can check the prostate's size and shape by inserting a finger into a person's rectum. If the prostate is large or shaped abnormally, it can be a sign of conditions like cancer.Most people with prostates need to start having screenings by the age of 50. If they have certain risk factors, like a family history of prostate cancer, they should talk to their provider about having a prostate exam sooner. What Is Benign Prostatic Hyperplasia? Step-by-Step After talking to your provider, you will need to give them permission to do the exam. This is called giving consent. A prostate exam usually doesn't hurt. You should not have side effects or problems when it's over. Before they do the exam, tell your provider if you have hemorrhoids or anal fissures. These conditions can be irritated by a prostate exam. Common Prostate Problems Results and Follow-Up Your provider will be able to tell how big your prostate is and what shape it is during the exam. They might compare it to a previous DRE exam if you've had one. A normal prostate gland is about two to four centimeters long, shaped like a triangle, and feels firm and rubbery. The results of a DRE depend on what your provider felt. In addition to screening for prostate cancer, a DRE can also tell if the prostate is enlarged or if there is a mass of the rectum or anus. How Prostate Cancer Is Diagnosed Follow-Up If your provider finds an abnormality on your prostate exam, you may need to have more testing. They might want you to do a PSA blood test, an imaging test, or a biopsy, to get a better idea of how your prostate is working. A test called transrectal ultrasonography (TRUS) can be used to take pictures of the prostate. It can also guide a provider when they're getting a sample of tissue to test (biopsy). Another imaging test your provider might use is magnetic resonance imaging (MRI). It can be used to get a better picture of the prostate and the areas around it like the lower spine and the bladder. These structures can be affected by prostate disease or cancer. If a PSA test was not done when you had a DRE, that might be the next step. If your PSA level is high, your provider will tell you what other tests are needed. What Is a Prostate Biopsy? Scheduling Your Next Exam After the age of 50, you will probably need to schedule prostate exams regularly. Usually, they are recommended every year if your first exam did not find any abnormalities and you are otherwise healthy. However, recommendations vary. Your provider will let you know when you need to have your next prostate exam. Cancer Statistics Men Should Know Treatment If your provider finds that you have a condition affecting your prostate, they might want to do more tests. You may need imaging tests, additional exams, or a biopsy. Once your provider gets more information from these tests, they can recommend the best treatment for your condition. For example, you might need to start medication, have surgery, or have radiation therapy. Recap If your exam is normal, your provider will let you know when to schedule your next screening for. If the exam is not normal, you may need to have more tests. An MRI, a biopsy, and a PSA blood test can help your provider figure out what is wrong.If you have a condition like cancer, your provider will discuss treatment with you. You may need medication, surgery, or other treatments. How Is Prostate Cancer Treated? Summary A prostate exam is also called a digital rectal exam (DRE). A healthcare provider places a finger into a patient's rectum to feel the prostate. This allows them to see if the prostate is normal in shape and size. If a person's prostate is larger than normal or unusually shaped, they can have other tests to figure out what is causing the abnormalities. Most people with a prostate need to start talking to their doctor about DREs when they're about age 50. However, people with certain risk factors, like a family history of prostate cancer, need to have the conversation sooner. A Word From Verywell Many people are anxious or scared to have a prostate exam. Sometimes, people put off having the exam completely even if they have symptoms that are concerning. It's understandable to be nervous about the exam or even feel embarrassed about it. However, it's a very important preventive health step to take. Prostate exams can help catch conditions like cancer early. Once you've had your first prostate exam, scheduling the next will be easier. You can talk to your provider about how often you need to have the exam, as well as whether you need other tests. Early Prostate Cancer May Have No Symptoms 9 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Naji L, Randhawa H, Sohani Z, et al. Digital Rectal Examination for Prostate Cancer Screening in Primary Care: A Systematic Review and Meta-Analysis. Ann Fam Med. 2018;16(2):149-154. doi:10.1370/afm.2205 National Clinical Guideline Centre (UK). The Management of Lower Urinary Tract Symptoms in Men. London: Royal College of Physicians (UK); 2010. (NICE Clinical Guidelines, No. 97.) 3, Summary of recommendations. Ilic D, Djulbegovic M, Jung JH, et al. Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ. 2018;362:k3519. doi:10.1136/bmj.k3519 Dean LT, Subramanian SV, Williams DR, Armstrong K, Zubrinsky charles C, Kawachi I. Getting Black Men to Undergo Prostate Cancer Screening: The Role of Social Capital. Am J Mens Health. 2015;9(5):385-96. doi:10.1177/1557988314546491 Grossman DC, Curry SJ, Owens DK, et al. Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(18):1901-1913. doi:10.1001/jama.2018.3710 Sklinda K, Frączek M, Mruk B, Walecki J. Normal 3T MR Anatomy of the Prostate Gland and Surrounding Structures. Adv Med. 2019;2019:3040859. doi:10.1155/2019/3040859 Wolin KY, Grubb RL, Pakpahan R, et al. Physical activity and benign prostatic hyperplasia-related outcomes and nocturia. Med Sci Sports Exerc. 2015;47(3):581-92. doi:10.1249/MSS.0000000000000444 Lopes PM, Sepúlveda L, Ramos R, Sousa P. The role of transrectal ultrasound in the diagnosis of prostate cancer: new contributions. Radiol Bras. 2015;48(1):7-11. doi:10.1590/0100-3984.2013.0010 Boesen L. Multiparametric MRI in detection and staging of prostate cancer. Dan Med J. 2017;64(2):B5327. Additional Reading Heijnsdijk EA, Denham D, de Koning HJ. The Cost-Effectiveness of Prostate Cancer Detection with the Use of Prostate Health Index. Value Health. 2016 Mar-Apr;19(2):153-7. doi: 10.1016/j.jval.2015.12.002. Epub 2016 Jan 14. Cui T,Kovell RC,Terlecki RP. Is it time to abandon the digital rectal examination? Lessons from the PLCO Cancer Screening Trial and peer-reviewed literature. Curr Med Res Opin.2016 Jul 4:1-7. [Epub ahead of print] Stone BV,Shoag J,Halpern JA,et al. Prostatesize, nocturia and the digital rectal examination: a cohort study of 30 500 men. BJU Int.2017 Feb;119(2):298-304. doi: 10.1111/bju.13613. Epub 2016 Aug 23. By Jerry Kennard Jerry Kennard, PhD, is a psychologist and associate fellow of the British Psychological Society. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit