What Is a Prostate Exam?

A prostate examination takes a few minutes and is relatively painless. If you have not had a prostate exam before, you may be anxious about it. It is part of the general health screening recommendations for men age 50 and over, for younger men who have a risk of prostate cancer, and for men who have symptoms of urinary difficulties.

A prostate exam, also called a digital rectal exam (DRE), is a physical examination that your doctor uses to evaluate for enlargement or irregularity in the shape of your prostate. This test can help your doctor detect prostate abnormalities or cancer.

The most common symptoms of prostate enlargement or cancer include:

• Urinary retention
• Urinary urgency
• Leaking urine
• Urinary dribbling

Similar Tests

If your doctor identifies an abnormality on your prostate exam, you may need another test, such as a blood test, an imaging test, or a biopsy, to further asses your prostate anatomy or function. A PSA (prostate specific antigen) blood test is often done at the same visit as the DRE. PSA is a protein that is produced by some prostate cancers, and this blood test is used as a screening test, along with DRE, for early detection of prostate cancer.

Prostate exams are very common and are considered standard medical care. A DRE, the process by which a physician inserts his or her finger into the rectum to directly feel the prostate, can cause a great deal of anxiety for men who have not had it before. The procedure itself is not painful, and after having it, you should not feel any side effects or have any problems.

The steps of a prostate exam are:

• Your doctor will explain to you that you will have your prostate exam.
• You will be asked to remove your pants and underwear and to wear an examination gown.
• Usually, you will be asked to stand, with your feet apart, facing the examination table while bending forward so that your arms or elbows are resting on the table.
• 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. If you pay attention to your breathing, this can also help you stay calm for the next few minutes.
• Your doctor will put on a surgical glove and will cover a finger with a lubricant prior to inserting the finger into your rectum in order to examine your prostate gland.
• Your doctor will insert the finger ​at a downwards angle. You may feel a little pressure, but you should not feel any pain or discomfort. If it hurts, tell the doctor immediately.
• A few seconds may elapse as your doctor waits for your external sphincter muscle, which is the opening through which you poop, to relax.

Based on your DRE, your doctor evaluates the size and shape of your prostate and may compare it to your previous DRE exam if you had one. A normal-sized prostate gland is around two to four centimeters long, triangular in shape, and should feel firm and rubbery.

Follow Up

The prostate is part of the male reproductive system. It is located underneath the bladder and behind the penis. The prostate functions in producing semen. After age 50, you should have regularly scheduled prostate examinations every four years if you are otherwise healthy.

If you have prostate disease, you may need medication, surgery, or radiation therapy, as well as follow-up testing with DRE, blood tests, imaging, or biopsy.

A prostate exam can catch medical problems before they become serious. Many men are anxious or scared to have a prostate examination. In fact, this feeling of apprehension can cause some men to put off the exam or avoid it altogether, even ignoring warning signs of potential issues. You should be reassured that a prostate exam is a simple test without any adverse effects and that after you have one, you will not be apprehensive about having them again.