What to Expect During a Prostate Exam

Though seemingly daunting, prostate exams don't have to be

Many men dread having a prostate exam.
Many men dread having a prostate exam. Malcolm Nigel Carse/Getty Images

At some point, most men will either be offered a prostate examination as part of general health screening, or it will be advised because of their age (usually 50+) or some problem relating to difficulty in passing urine.

The prospect of a prostate exam may leave some men with a feeling of dread and outright fear. In fact, this feeling can lead to some men putting off that exam or avoiding it altogether, while ignoring good advice and even warning signs of potential issues that a simple prostate exam can catch before they become serious problems. The examination takes only a minute or two and should be entirely painless.

The Prostate Exam Procedure

Prostate exams are very common, and standard practice for men in older age groups. A prostate exam is something nearly every man will, and should, have in the course of their lifetime. A visit for a prostate exam involves a blood test, which is a screen for early detection of prostate cancer and looks for prostate-specific antigen or PSA in the blood.

The visit also involves a digital rectal exam, or a DRE, which is the part that inspires the most anxiety in men. However, knowing exactly what to expect during an exam can help you relax and ease your anxiety about the procedure—a state that can make the whole process far less arduous than your overactive mind may imagine it to be!

Step-By-Step of What to Expect

Here's what to expect from a prostate examination:

  • The doctor will explain that he needs to insert a finger into your rectum in order to examine the prostate gland.
  • Usually, you will be asked to stand, feet apart, facing the examination couch while bending forward so that your arms or elbows are resting on the couch. If you're nervous about not being able to see what's going on, this is a good time to ask the doctor to describe each step to you before it happens.
  • The doctor will put on a surgical glove and will cover a finger in lubricant.
  • The finger will be inserted ​at a downwards angle as if pointing to the umbilicus (belly button). You may feel a little pressure, but there should not be any pain or discomfort. If it hurts, tell the doctor immediately.
  • A few seconds may elapse as the doctor waits for the external sphincter muscle to relax. Breathe normally to help yourself relax.
  • As the doctor examines the prostate, you may be aware of some movement of the finger before it is removed.
  • The doctor will likely tell you before he removes his finger so you are aware.
  • When the exam is completed, the doctor will probably offer you some tissue or pre-moistened wipes to clean off the lubricant.

What the Doctor Is Looking in a Prostate Exam

As mentioned earlier, the doctor will be looking for PSA in your blood test. During the DRE, the doctor moves his finger in a circular motion in order to identify the lobes and groove of the prostate gland. A normal-sized prostate gland is around two to four centimeters long and triangular in shape. He would also expect the prostate to feel firm and rubbery.