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How Are Prostate Exams Performed

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What Do You Want Men To Know About Prostate Cancer

What to Expect from a Prostate Exam

The important thing to know is that, if you live long enough, you will probably get prostate cancer. If you live into your 80s, about 80 percent of men have some sort of prostate cancer. That doesnt mean theyre going to die from prostate cancer because, as a percentage, very few men die from prostate cancer. It means its important to be aware of it and consider screening early, so if its a high-grade type, we can identify it and treat it.

Who Should Get A Digital Rectal Exam

Not all medical institutions agree on when men should begin screening for prostate cancer or even if a DRE should be part of the screening.

To help detect prostate cancer in its early stages, the American Cancer Society recommends that men talk to their doctors about the benefits, risks, and limitations of prostate cancer screening before deciding whether to be tested.

For most men at average risk, discussions about screening begin at age 50. However, some doctors recommend that men at higher risk of prostate cancer — African-American men or men with a family history of prostate cancer — start screening earlier.

Can’t I Just Get A Blood Test

If you have concerns about prostate cancer you certainly should have a Prostate Specific Antigen blood test. Knowing your PSA level can help to establish what’s normal for you so that a spike is more easily identified. But a blood test alone is not enough. The test has been known to deliver ‘false-positive’ results in some cases – leading men into have invasive biopsies for no reason. Up to 20% of men with prostate cancer show no increase in PSA levels*. So it’s best used to check against the result of a rectal exam but can’t be relied upon in isolation.

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Biopsy During Surgery To Treat Prostate Cancer

If there is more than a very small chance that the cancer might have spread , the surgeon may remove lymph nodes in the pelvis during the same operation as the removal of the prostate, which is known as a radical prostatectomy .

The lymph nodes and the prostate are then sent to the lab to be looked at. The lab results are usually available several days after surgery.

What To Expect During The Digital Rectal Exam

Ways to perform self prostate exam for most common ...

Your doctor may examine you either standing or lying down.

  • 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 doctor to give you a heads up before making any sudden movements.
  • Wearing surgical gloves, the doctor will coat a finger in lubricant.
  • The finger will be inserted into your rectum in 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 the doctor know immediately if there is pain.
  • Your doctor may have to wait a few seconds for your external sphincter muscle to relax, and may ask you to bear down as if you are having a bowel movement.
  • The doctor moves the finger in a circular motion in order to identify the lobes and groove of the prostate gland. The doctor checks for:Lumps on or around the prostate
  • Swelling
  • Hard spots or bumps
  • Abnormalities on the prostate
  • A normal prostate is usually around 2-4 cm long and has a triangular shape, with a firm and rubbery texture
  • Once finished, your doctor will probably tell you he is going to remove his finger. You may be offered some tissue or wipes to clean off the lubricant.
  • The whole procedure should take about 5 minutes from start to finish, and there are no special precautions that need to be taken prior to the exam.
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    Two Main Screening Tests

    There are two tests commonly used to screen for prostate cancer:

    • The Digital Rectal Exam : A doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.
    • The Prostate Specific Antigen Test: This exam measures the level of PSA in the blood. The levels of PSA in the blood are often higher in men who have prostate cancer. The PSA level may also be high in other conditions that affect the prostate.Usually, the higher the bloods PSA level is, the more likely it is that a prostate problem is present. But other factors, such as age and race, also can raise PSA levels. PSA levels also can be impacted by certain medical procedures, some medications, an enlarged prostate or a prostate infection.

      Since your PSA level may be high for other reasons, your doctor will need to interpret the test results.

    If the results of the PSA and/or DRE suggest that you might have prostate cancer, your doctor will need to do a prostate biopsy to find out. This means a sample of your prostate tissue will be removed with a needle and sent to a lab, where a specialist will determine if it contains cancer cells.

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    How To Check Your Prostate

    This article was co-authored by Robert Dhir, MD. Dr. Robert Dhir is a board certified Urologist, Urological Surgeon, and the Founder of HTX Urology in Houston, Texas. With over 10 years of experience, Dr. Dhirs expertise includes minimally-invasive treatments for enlarged prostate , kidney stone disease, surgical management of urological cancers, and mens health . His practice has been named a Center of Excellence for the UroLift procedure, and is a pioneer in non-surgical procedures for ED using his patented Wave Therapy. He earned his undergraduate and medical degrees from Georgetown University and was awarded honors in pre-medical studies, urology, orthopedics, and ophthalmology. Dr. Dhir served as chief resident during his urological surgical residency at University of Texas at Houston / MD Anderson Cancer Center in addition to completing his internship in general surgery. Dr. Dhir was voted Top Doctor in Urology for 2018 to 2019, one of the top three Best Rated Urologists in 2019 & 2020 for Houston Texas, and Texas Monthly has named him to the 2019 & 2020 Texas Super Doctors Rising Stars list.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article has 11 testimonials from our readers, earning it our reader-approved status. This article has been viewed 1,025,150 times.

    Transrectal Ultrasound With Prostate Biopsy

    How is a Prostate Biopsy Performed?

    Transrectal ultrasound is most often used to examine the prostate. In a transrectal ultrasound, the health care provider inserts a transducer slightly larger than a pen into the mans rectum next to the prostate. The ultrasound image shows the size of the prostate and any abnormal-looking areas, such as tumors. Transrectal ultrasound cannot definitively identify prostate cancer.

    To determine whether a tumor is cancerous, the health care provider uses the transducer and ultrasound images to guide a needle to the tumor. The needle is then used to remove a few pieces of prostate tissue for examination with a microscope. This process, called biopsy, can reveal whether prostate cancer is present. A transrectal ultrasound with prostate biopsy is usually performed by a doctor in a health care providers office, outpatient center, or hospital with light sedation and local anesthesia. The biopsied prostate tissue is examined in a laboratory by a pathologista doctor who specializes in diagnosing diseases.

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    How Is A Digital Rectal Exam Performed

    A DRE is a physical exam of the prostate. The health care provider will ask the patient to bend over a table or lie on his side while holding his knees close to his chest. The health care provider slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies next to it. The DRE may be slightly uncomfortable, but it is brief. This exam reveals whether the prostate has any abnormalities that require more testing. If an infection is suspected, the health care provider might massage the prostate during the DRE to obtain fluid to examine with a microscope. This exam is usually done first. Many health care providers perform a DRE as part of a routine physical exam for men age 50 or older, some even at age 40, whether or not the man has urinary problems.

    Early Detection Saves Lives

    Its a fact: The sooner it is caught, the easier prostate cancer is to treat. Dont wait to speak with a doctor about screening for prostate cancer, especially if you are experiencing these common signs of prostate problems :

    • Frequent urination at night
    • Recurring bladder infections
    • Burning sensation when urinating

    Crystal Run Healthcares urologists are dedicated to mens health. No matter your age or stage of life, we will empower you with the information you need to make important and informed choices about your health.

    We offer consultation with prostate screening and cancer specialists, as well as primary healthcare practitioners so that you can understand your screening and treatment options. Discover how Crystal Run Healthcare can make a difference to your health and your life call 845-703-6999 to book your consultation.

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    Self Prostate Exam For Prostatic Hyperplasia

    Clinically we divided prostatic hyperplasia into three gradients, indicating the severity of benign prostatic hyperplasia disease. So, in our daily lives, how to perform self prostate exam? What are the evaluation criteria?

    According to the severity of the disease, each disease can be divided into mild, moderate and severe, benign prostatic hyperplasia is with no exception. So what are the typical symptoms for mild, moderate and severe prostatic hyperplasia? How can we male patients to perform self prostate exam?

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    Prostate Exam In Concord Mint Hill And Charlotte

    12 Deadly Symptoms Of Prostate Cancer That Must Not Be ...

    Some men are hesitant about getting tested, but a skilled urologist will give you confidence and knowledge about maintaining your prostate health. Dr. Richard Natale is here to help you maintain optimum sexual health and overall health as well.

    If you have any questions or would like to schedule an appointment with Dr. Natale, contact our friendly staff at Carolina Urology today by calling 786-5131 or by filling out our appointment request form online now. We look forward to serving you.

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    Whats The Best Treatment For Prostate Symptoms

    Treatments for prostate cancer include surgery to remove the prostate, radiation therapy, and ablation therapies, as well as active surveillance. Some treatments are better for some men and some prostates than others. There are side effects for each, so it really requires an informed discussion to help each man make an educated decision.

    One thing we do at Yale is use an MRI of the prostate to evaluate the location of the prostate cancer for surgical planning. Ive found it to be quite helpful. Its not done everywhere.

    Why Are Prostate Exams Performed

    A lot of men do not realize the importance of a frequent prostate exam. When a man goes for a general check-up with his doctor, a prostate exam may be advised. This is considered part of a general health check-up.

    It is generally advised that men undergo frequent health screenings once they reach the age of 40 . Research shows that this is the time when the risk of several prostate conditions increases.

    For this reason, after 40, a man should ensure they obtain a prostate exam as part of their health screening.

    The main reason why a doctor may advise on a prostate exam is to feel for any abnormalities with the mans prostate. This helps detect prostate disease. It is usually possible for a doctor to determine the health of the mans prostate through this examination. Further testing may be needed too.

    The doctor can detect different prostate problems through a prostate exam. It is often considered the initial diagnostic option. The prostate exam itself can give a doctor an indication if there is an enlargement or swelling in the prostate gland. It also helps to determine prostate health.

    In most cases, a prostate exam alone will not be the only diagnostic tool. After a digital rectal exam is done, the doctor will order additional tests if abnormalities are identified. This will help to diagnose problems like cancer and prostate enlargement.

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    Three Grades Of Prostatic Hyperplasia

    Doctors divide prostate into two layers: the inner layer is the mucosa and submucosal glands around the urethra. And the outer layer is the prostate gland. The latter constitutes the main body of the prostate, a fibrous membrane separates the two layers. Prostatic hyperplasia occurs mainly in the inner layer, it is between the bladder neck to the fine urethral part of the urethra gland, now the part is known as the transition zone with microscopic examination can see.

    Mild benign prostatic hyperplasia:

    The patient can show symptoms of frequent urination, urgency, urinary weakness and increase of nocturia.

    Moderate benign prostatic hyperplasia:

    The symptoms can be expressed as urinary endless, urinary pain, urinary incontinence , and the urination time was significantly longer.

    Severe benign prostatic hyperplasia:

    Urination is more laborious, and urination time is longer, urinary flow as the low-level curve or urine droplets, patients often get wet with their underwear.

    How Are Prostate Problems Diagnosed

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    To diagnose prostate problems, the health care provider will perform a digital rectal exam . The health care provider will also ask the patient

    • when the problem began and how often it occurs
    • what symptoms are present
    • whether he has a history of recurrent urinary tract infections
    • what medications he takes, both prescription and those bought over the counter
    • the amount of fluid he typically drinks each day
    • whether he consumes caffeine and alcohol
    • about his general medical history, including any major illnesses or surgeries

    Answers to these questions will help the health care provider identify the problem or determine what medical tests are needed. Diagnosing BPH may require a series of medical exams and tests.

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    What If We Find Something

    A rectal exam can give us an indication that cancer may be present but discovering a lump is not a cancer diagnosis. If the examiner finds the surface of your prostate to be hard and lumpy or your PSA levels are higher than expected you may be referred for additional tests. If you haven’t already seen a Consultant Urologist they may conduct another rectal exam to check the GP’s initial assessment.

    The next step is usually to have an MRI scan so an image of your prostate can be examined. If necessary, you may then be referred for a biopsy to take a sample from your prostate. Even then, finding cancer cells in your prostate doesn’t necessarily mean you’ll need cancer treatment. Find out more on the truth about prostate cancer diagnosis here.

    *Reference: NHS England

    How Does A Person Prepare To Receive A Prostate Massage

    One quick FYI is that prostate massages can make people feel like they have to pee, so the person having their prostate massaged should probably empty their bladder beforehand. Then you and your partner should take deep breaths. Deep breathing activates the bodys relaxation responsewhich is good for everyone involvedand a relaxed anal sphincter is a happy anal sphincter . Keep in mind that the more relaxed and turned on one is, the more comfort and pleasure theyre likely to experience.

    Another thing to remember: The physical position may make receiving a prostate massage feel better or more feasible. Its not a guarantee, but some people find that being on top makes anal penetration easier, SELF previously reported. Your partner can kneel with your hand between their legs, for instance. With that said, it will likely take some experimentation to figure out which position feels best for the person receiving a prostate massage.

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    Results And Follow Up

    After a DRE, your healthcare provider will know right away if there are any problems like lumps or a prostate that is larger than usual . You will discuss any findings with your provider and plan the next steps. The results from a PSA test typically take around two weeks to come back, and your healthcare provider will go over these with you.

    If all of your test results are normal, and you and your provider decide to continue screening, you will most likely need testing every two years. However, if the PSA test is abnormal, your healthcare provider may refer you to a urologist for additional testing.

    What Are Additional Tests For Detecting Prostate Problems

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    If the DRE or the PSA blood test indicates a problem may exist, the health care provider may order additional tests, including urinalysis, urodynamic tests, cystoscopy, abdominal ultrasound, transrectal ultrasound with prostate biopsy, and imaging studies such as magnetic resonance imaging or computerized tomography scan.

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    Weighing Your Options For Treatment

    If you test positive for prostate cancer, you have some options as to what youd like to do about it. Until recently, nearly everyone opted for surgery or radiation, while some patients choose not to undergo treatment, instead opting for active surveillance, during which the cancers are left alone but regularly monitored to be certain that theyre not growing.

    Certainly, screening can lead to earlier prostate cancer detection, and with earlier detection, youre eligible for multiple different treatments or active surveillance, said Sia Daneshmand, MD, associate professor of urology at Keck School of Medicine of USC and director of urologic oncology at the USC Institute of Urology at Keck Medicine of USC. So we encourage patients who are candidates for screening to discuss it with their urologist and/or primary care physician so that we can determine whats the best course of treatment for them.

    There also is a new option for those seeking prostate cancer treatment. Its called High-Intensity Focused Ultrasound , which uses ultrasound beams to non-surgically destroy prostate tumors.

    If you are in the Los Angeles area, schedule an appointment with one of our urologists by calling or by visiting Urology.KeckMedicine.org/request-an-appointment.

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