How a Healthcare Provider Performs a Prostate Exam

If you are a male, depending on your general health, your age (usually 50 years old and up), or if you are having difficulty passing urine, your healthcare provider may advise that you have a prostate examination. If you have no urinary symptoms but are concerned about your risk for prostate cancer, you may want to have a discussion with your healthcare provider regarding the risks and benefits of prostate cancer screening.

This article will explain what a prostate exam is used for, what you can expect during a prostate exam procedure, and how your doctor considers the results.

Prostate Cancer Screening

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

1. A prostate-specific antigen (PSA) test is a blood test that measures the amount of PSA in the blood. Sometimes high levels can be associated with prostate cancer.
2. A digital rectal exam (DRE) is a physical examination in which a healthcare provider places their gloved finger, or "digit," into the rectum to feel the edges of the prostate gland.

Some people are apprehensive about the DRE procedure. To ease your nerves, here is a breakdown of what a DRE entails.

What to Expect During the Digital Rectal Exam (DRE)

This examination can be done while you are either standing or lying down. This may depend on the examination room and any other health conditions that you have.

If standing, you will be asked to stand facing the examination bed, with feet apart, body bent forward, and your arms or elbows on the bed. Feel free to ask your healthcare provider to give you a heads up before each part of your exam.

Your healthcare provider will coat their gloved finger in lubricant. They will insert their finger into your rectum at a downwards angle. You may feel a little pressure or slight discomfort, but it shouldn't hurt. It is important to relax and take deep breaths and let your healthcare provider know immediately if you feel any pain.

It may take a few seconds for your external sphincter muscle (the muscle that opens and closes when you poop) to relax, and your provider may ask you to bear down as if you are having a bowel movement. They will move their finger in a circular motion in order to identify the lobes of your prostate gland. 

A normal prostate is usually around 2-4 cm long and has a triangular shape, with a firm and rubbery texture.

During this exam, the healthcare provider checks for:

• Lumps on or around the prostate
• Swelling 
• Tenderness
• Hard spots or bumps (the gland should be smooth) 
• Abnormalities on the prostate

Once finished, your healthcare provider will remove their finger from your rectum. You may be offered some tissue or wipes to clean off the lubricant. The whole procedure should take less than a few minutes from start to finish, and there are no special precautions that you need to take prior to the exam.

What Happens After the DRE

If any abnormalities are found during your DRE, your healthcare provider may order more tests, like an MRI of your prostate, and possibly schedule a prostate biopsy to see if there are any signs of cancer.

If your screening is normal, your doctor may use the results of your PSA blood test to determine the timing of your future prostate cancer screenings. PSA levels vary by age and other factors.

Ultimately, you and your healthcare provider will decide how often you should be screened. Your family history, diet, health, and lifestyle habits are all factors that affect the recommended timing and frequency of your prostate cancer screenings. Be sure to consult with your healthcare provider if you notice any changes in your health.