Understanding Your Digital Rectal Exam Results

PSA Test
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The digital rectal exam (DRE) may be one of the more dreaded screening tests men face, but it is an important part of the early detection and diagnosis of prostate conditions such as prostate cancer and BPH (enlarged prostate). Your digital rectal exam results can give you and your doctor a great deal of information in a short amount of time. It is important to know what the results of your exam could mean.

During a DRE, your physician will insert a lubricated, gloved finger into your rectum. This allows him to examine the prostate and detect anything irregular, including the shape, size, or texture.

What's "Normal" and "Abnormal" on a DRE

If the prostate is found to be "normal" on a digital rectal exam, it will feel smooth and will not have any areas of increased hardness or bumpiness. Additionally, the prostate should not feel enlarged on the exam.

The prostate may be found to be "abnormal" on the digital rectal exam for any number of reasons including:

  • the presence of an area of increased hardness
  • the presence of a nodule or bump
  • an overall increase in size
  • feelings of being tender to the touch

What Happens If Your DRE Is Abnormal

The digital rectal exam is most helpful when it is coupled with the PSA test. If your PSA is high or increasing quickly, then your doctor will likely choose to test you for prostate cancer regardless of what the digital rectal exam shows. This is because, unfortunately, some men develop prostate cancer without any detectable abnormality on their digital rectal exam.

If your PSA is normal, but your doctor detects an area of increased hardness or a nodule, then he will likely choose to do a biopsy at a later date to determine whether or not this area is the result of prostate cancer. Only a biopsy can definitively determine if a man has prostate cancer.

If your PSA is normal or elevated and your prostate is simply enlarged without an area of hardness or a nodule, then your doctor may simply attribute this to BPH (a benign enlarged prostate). He may, however, want to do a biopsy to rule out prostate cancer.

Prostatitis, a temporary inflammation of the prostate that is not cancer, can also cause the prostate to swell and become tender on the examination.

The Bottom Line

The digital rectal exam provides considerable information to your doctor about the health of your prostate, but it is not a perfect test. When combined with the PSA test and other information about your health, it can help to guide your doctor to order more testing (such as a biopsy) so that prostate cancer or other important prostate conditions can be diagnosed early.

View Article Sources
  • Tanagho EA, McAninch JW. Smith's General Urology, 17th Edition.