What to Expect From the Digital Rectal Exam

Prostate Cancer Diagnosis (DRE)

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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 Is Prostate Cancer?

Prostate cancer develops in the prostate, a small gland that makes seminal fluid. It is one of the most common types of cancer in men. Prostate cancer usually grows over time and in the beginning usually stays within the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.

Prostate cancer that is caught early has a better chance of successful treatment.

Why It's 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 (such as the PSA test) or imaging tests (such as CT or MRI exams).

How It's 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.

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.

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Article Sources

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  • Mayo Clinic. Prostate Cancer
  • Tanagho EA, McAninch JW. Smith's General Urology, 17th Edition.