What to Expect During a Prostate Exam

A prostate exam is done by a healthcare provider to feel for problems with the prostate, a walnut-sized gland located between the bladder and penis. It's also called a digital rectal exam because it involves the insertion of a gloved, lubricated finger into the rectum.

A prostate exam can check for an infected, enlarged, or inflamed prostate. If you have symptoms such as trouble urinating, your healthcare provider may recommend a prostate exam to find the cause.

A digital rectal exam is also used to screen people who are at risk for prostate cancer. Prostate cancer screening recommendations are based on your age (usually over 50), overall health, and risk factors.

How often you need a prostate exam depends on your age and health. This article will explain what a prostate exam is used for, what to expect during and after a prostate exam, and what the results of a prostate exam mean. You'll also learn how often you should have a prostate cancer screening.

How a Prostate Exam Works
Verywell / Michela Buttignol

Who Should Get a Prostate Exam?

A prostate exam is usually recommended if you have symptoms that indicate a problem with your prostate such as difficulty passing urine. However, you may benefit from a prostate exam even if you have no symptoms, especially if you're at risk for prostate cancer.

How Common Is Prostate Cancer?

In the United States, the risk of a man being diagnosed with prostate cancer is 11%. The risk of dying from prostate cancer is 2.5%, and the average age of death from the disease is 80.

Your risk for prostate cancer increases if you:

  • Are over the age of 50 years old
  • Are African American
  • Have a family history of prostate cancer

Signs and Symptoms of Prostate Problems

Signs and symptoms of a problem with your prostate include:

  • Difficulty starting or stopping urination
  • Straining when urinating
  • Having the urge to urinate again soon after urinating; not emptying the bladder completely
  • Increased urinary frequency or urgency 
  • Getting up multiple times at night to pee
  • Weak urine stream
  • Prolonged dribbling of urine
  • Blood in the urine or semen

Are Urinary Symptoms a Sign of Prostate Cancer?

While urinary problems can be a sign of prostate cancer, there are also causes that are not cancer, like an infected, inflamed, or enlarged prostate.

You should know that prostate cancer does not always have symptoms. That's why prostate cancer screening is important—especially as you get older.

Prostate Exams to Screen for Cancer

There are two types of tests that healthcare providers use to screen for prostate cancer:

  • A prostate-specific antigen (PSA) test is a blood test that measures the amount of PSA in the blood. Sometimes, high levels of PSA are linked to prostate cancer.
  • A digital rectal exam (DRE) is a physical examination where a provider places their gloved finger into the rectum to feel the edges of the prostate gland.

It's normal to feel nervous or even embarrassed about having a digital rectal exam (DRE). It will help to know what to expect during a prostate exam and understand why it's so important to have one.

What Happens During a Prostate Exam?

You don't need to do anything specific to prepare for a DRE. Your provider will walk you through the steps of a DRE, but ask them questions if any parts of the exam are not clear.

A DRE can be done while you are standing or lying down. Your position will depend on factors like the layout of the exam room and any health conditions you may have.

If you're going to stand during a DRE:

  1. First, you will be asked to face the exam table or bed, with your feet apart, your body bent forward, and your arms or elbows on the table or bed.
  2. Next, your provider will coat their gloved finger in lubricant.
  3. Then, they will put their finger into your rectum at a downward angle. You may feel a little pressure or slight discomfort, but it should not hurt. It is important to relax, take deep breaths and let your provider know if you feel any pain during the exam.
  4. It may take a few seconds for the muscle that opens and closes when you have a bowel movement (external sphincter muscle) to relax. Your provider may ask you to bear down as if you are having a bowel movement.
  5. Then, they will move their finger in a circular motion to feel for the lobes of your prostate gland. 

What Does a Normal Prostate Feel Like?

A normal prostate is around 2 to 4 centimeters long. It has a triangular shape with a firm, smooth, and rubbery texture.

During a DRE, your provider will be checking for:

  • Lumps on or around the prostate
  • Swelling 
  • Tenderness
  • Hard spots or bumps
  • Abnormalities in the prostate

After a Prostate Exam

When they are done with the exam, your provider will take their finger out of your rectum. You might be offered some tissue or wipes to clean off the lubricant.

From start to finish, a prostate exam only takes a few minutes. You don't need to do anything after the exam and can go about the rest of your day as usual.

What Your Prostate Exam Results Mean

If the results of your prostate screening are not normal, your provider may want you to have more tests done, like a magnetic resonance imaging (MRI) of your prostate. They might also want to do a prostate biopsy to look for signs of cancer.

If your prostate screening is normal, your provider can look at your PSA blood test results to figure out when you should have your next prostate cancer screening.

How Often Do I Need a Prostate Exam?

There are different factors that will determine how often you need to have a prostate exam and prostate cancer screening.

While PSA levels are one factor, they vary by age. Other factors like your family history, overall health, diet, and lifestyle, also play into how often you should have your prostate checked.

Your provider will take all of these factors into account when they are recommending the timing and frequency of your future prostate cancer screenings.

If you're not due for a prostate cancer exam yet but notice changes in your health or are having symptoms that you think might be related to your prostate, don't wait. You can always ask your provider for a checkup sooner.

Summary

A prostate exam or digital rectal exam (DRE) is when a healthcare provider uses a gloved finger to examine the prostate gland through the rectum. The exam only takes a few minutes and should not hurt.

Your provider can do a DRE as a screening tool for prostate cancer or to figure out if you have an infected, enlarged, or inflamed prostate that is causing symptoms.

The screening recommendations for prostate cancer depend on your age (usually when you're older than 50), overall health, family history, race/ethnicity, symptoms, and other risk factors.

A prostate-specific antigen (PSA) test is an additional screening or diagnostic tool. If your provider is concerned about your DRE results, they may want to do more tests, like an MRI or biopsy.

If you don't have symptoms but are worried about getting prostate cancer, go over the risks and benefits of having a prostate cancer screening with your provider.

Frequently Asked Questions

  • Can I do a prostate self exam at home?

    It's best to have your provider check your prostate for you. Not only would it be physically difficult to do a prostate self exam, but you would not have the skill and knowledge to know if something was wrong with your prostate.

    It's also possible that you might damage the tissue of your rectum if you try to examine your own prostate.

  • Why do you have to cough during a prostate exam?

    Your provider may ask you to cough during a rectal exam to see what happens when your rectal or anal sphincter contracts and relaxes.

    This information helps them get a sense of your pelvic floor strength and can help them determine if you have any problems with bladder control or urinary leakage (incontinence).

  • When should you get a prostate exam?

    The American Cancer Society recommends that average-risk men 50 and older talk with their providers about whether a PSA blood test to screen for prostate cancer is right for them.

    People at increased risk because of their family history or other factors may choose to start screenings earlier. A DRE can also be done as part of this screening.

  • What are symptoms of prostate diseases?

    Signs and symptoms of a problem with the prostate include:

    • Frequent need to urinate
    • Painful or burning urination
    • Painful ejaculation
    • Blood in urine or semen
    • Dribbling of urine
    • Pain or stiffness in the lower back, hips, pelvic or rectal area, or upper thighs
  • Does a prostate exam hurt?

    You may feel a little pressure or slight discomfort during a prostate exam, but it shouldn't hurt. Relaxing and taking deep breaths will help. If you do feel pain, tell your provider.

  • Can you live without a prostate?

    You can live without a prostate. It's not the first treatment used, but some people with prostate cancer have surgery to remove their prostate.

    You don't need your prostate, but some people have problems urinating or experience erectile dysfunction after they get their prostate taken out.

10 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.
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By Brandi Jones, MSN-ED RN-BC
Brandi is a nurse and the owner of Brandi Jones LLC. She specializes in health and wellness writing including blogs, articles, and education.

Originally written by Lisa Fayed