Wise Men Over 40 Have A Prostate Exam.

A digital rectal exam (DRE) is usually the first prostate exam offered to all men over the age of 50 and is recommended to African American men over the age of 40.  It is believed the latter group are at higher risk of prostate cancer.

Your local doctor or nurse will insert a gloved finger (a digit) with lubricant applied to the tip, through the anus into your rectum. 

Uh what, wait a minute!

I know it sounds dreadful but compared to the constant worry about a cancer that might not even be there, or the knowledge of what to do next, this is worth the peace of mind.  It's also responsible health.  Through the rectal wall the practitioner can feel only part of the prostate gland but if there is swelling or a lumpy surface, this is enough information to offer an ultrasound as the next prostate test.  A digital rectal exam could also help identify other conditions, such as bleeding in the colon.

Prostate Exam


Any of the following 7 tests may be suggested, but if the digital rectal prostate exam reveals the likelihood of an abnormal prostate gland, usually the next step is a blood test for PSA level.  Then perhaps referral to a doctor who specialises in prostate screening and function, as well as urinary tract infections - a urologist.

Bladder Related

  • Urine test to check for the presence of blood or a urinary tract infection.
  • A urine flow study involves insertion of a catheter after local anaesthetic.  The catheter is connected to a computer.  As you pee into the catheter, the computer programme measures the flow of urine and how well, or not, your bladder muscle is working to hold and then push urine from bladder to ureter, and out of the body.
  • Ultrasound of the bladder can determine how much urine is still in there after urination .  This would be making you feel like your job in the bathroom isn't finished (incomplete), yet there is nothing more happening.
  • A cystoscopy, in which a thin tube containing a camera is inserted through the penis so that blockages like bladder stones or abnormal tissue is seen in the urethra and the bladder.  Mostly though, screening for stones is done with x-ray or CT (computerised tomography) of kidneys, ureter and bladder (KUB).  A cystoscope can also be used to access the prostate for prostate biopsy (see below).

Prostate Related

  • Blood test to check the prostate specific antigen level (PSA).  This is done to detect the possibility of prostate cancer and not BPH.  However, it might be elevated just because the prostate is bigger than normal in BPH.  Depending on other factors in your medical history a further prostate examination will be recommended, for example,
  • Transrectal ultrasound (TRUS) is a probe into the rectum which can more accurately measure the size, shape and irregular texture of the prostate gland.  This is often the ‘with ultrasound guidance’ part of,
  • A transrectal ultrasound guided prostate biopsy, when the probe is loaded with biopsy needles to take tissue samples.

So, compared to the above list,

A digital prostate rectal exam doesn’t sound so bad does it?

Don’t wait to be offered.

Ask your doctor to do a prostate exam at your next visit.

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