How A Doctor Performs A Prostate Exam
The male reproductive system relies on a healthy prostate to function. The prostate is a relatively small gland. It is the size of a chestnut . The prostate produces a fluid that combines with sperm.
The prostate fluid helps to nourish sperm. In turn, reproduction is possible, and semen can survive in the acidic environment of the vagina.
There are times when a prostate may give a man problems. Several complications have been linked to the prostate gland. Benign prostatic hyperplasia is generally considered the most common type of prostate condition.
Other common issues that men are concerned about include prostate cancer and prostatitis.
Prostate screening is one of the first diagnostic tools used to detect these problems.
While men generally find this to be an uncomfortable procedure, its benefits need to be considered.
We take a look at how a prostate exam is done. The post also considers why a prostate exam is done.
Who Should Get Screened For Prostate Cancer
Prostate cancer typically starts in men around 55 to 70 years old. For men who are not at a higher risk of developing the disease should begin a conversation with their doctor about getting screened in their fifties and repeat the screening about every two years.
Men who are at higher risk for developing prostate cancer should begin screenings at age 40. Those at higher risk for prostate cancer include:
- Black or African-American men
- Men with a family history of prostate cancer
- Men who have been diagnosed with prostate cancer before
- Men who have a family history of colon, breast, ovarian, or pancreatic cancer
Screening Tests For Prostate Cancer
Screening is testing to find cancer in people before they have symptoms. Its not clear, however, if the benefits of prostate cancer screening outweigh the risks for most men. Still, after discussing the pros and cons of screening with their doctors, some men might reasonably choose to be screened.
The screening tests discussed here are used to look for possible signs of prostate cancer. But these tests cant tell for sure if you have cancer. If the result of one of these tests is abnormal, you will probably need a prostate biopsy to know for sure if you have cancer.
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How Do Men Feel About The Rectal Exam
I think most men are willing to do it, but some men are exceptionally opposed to it. They might be happy to hear that there are studies ongoing in the United Kingdom looking at using magnetic resonance imaging as a screening tool to be able to avoid doing a digital rectal exam in the future. There is a large African immigrant population in London with a higher incidence of prostate cancerthey didnt want to have the prostate exam because they had a lot of opposition to it. They were uncomfortable with it.
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Transrectal Ultrasound With Prostate Biopsy
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 The Test Performed
To perform a DRE, your doctor will gently insert a gloved, lubricated finger into your anus. This allows them to feel for any abnormalities. For example, an enlarged prostate feels like a bulge behind the rectum wall. Prostate cancer may feel like bumps on the normally smooth surface of the prostate.
Read more: What do you want to know about prostate cancer? »
Men may feel pain or the urge to urinate during the exam. This is because your doctor is applying firm pressure to the prostate.
A DRE is typically done as part of a routine physical examination for both men and women. During a gynecological exam, your doctor may perform a DRE to check the space between the rectum and the vagina for any abnormalities. Most men and women feel only minor discomfort during the procedure. People with hemorrhoids or anal fissures may experience a small amount of bleeding.
A DRE isnt suitable for detecting colon cancer. Only a small portion of the lower colon may be accessed during a DRE. However, a DRE may be used to obtain a stool sample. If blood is present in the stool, it may indicate colon cancer or other problems.
Blood isnt always visible to the naked eye in a stool sample, so your doctor may wish to conduct a fecal occult blood test to confirm.
Factors That Might Affect Psa Levels
One reason its hard to use a set cutoff point with the PSA test when looking for prostate cancer is that a number of factors other than cancer can also affect PSA levels.
Factors that might raise PSA levels include:
- An enlarged prostate: Conditions such as benign prostatic hyperplasia, a non-cancerous enlargement of the prostate that affects many men as they grow older, can raise PSA levels.
- Older age: PSA levels normally go up slowly as you get older, even if you have no prostate abnormality.
- Prostatitis: This is an infection or inflammation of the prostate gland, which can raise PSA levels.
- Ejaculation: Thiscan make the PSA go up for a short time. This is why some doctors suggest that men abstain from ejaculation for a day or two before testing.
- Riding a bicycle: Some studies have suggested that cycling may raise PSA levels for a short time , although not all studies have found this.
- Certain urologic procedures: Some procedures done in a doctors office that affect the prostate, such as a prostate biopsy or cystoscopy, can raise PSA levels for a short time. Some studies have suggested that a digital rectal exam might raise PSA levels slightly, although other studies have not found this. Still, if both a PSA test and a DRE are being done during a doctor visit, some doctors advise having the blood drawn for the PSA before having the DRE, just in case.
- Certain medicines: Taking male hormones like testosterone may cause a rise in PSA.
Some things might lower PSA levels :
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Can A Swollen Prostate If Untreated Cause Prostate Cancer
We have no evidence of that. Theyre completely unrelated problems. The area of the prostate that causes urinary symptoms is usually a different part of the prostate than where cancer is likeliest to develop.
Doctors divide the prostate into different zones. The zone that is associated with BPHand the majority of prostate growthis the transition zone. Prostate cancer occurs there much less often than in the peripheral zone, which is the outer area.
How To Locate Your Prostate
This article was medically reviewed by Erik Kramer, DO, MPH. Dr. Erik Kramer is a Primary Care Physician at the University of Colorado, specializing in internal medicine, diabetes, and weight management. He received his Doctorate in Osteopathic Medicine from the Touro University Nevada College of Osteopathic Medicine in 2012. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine and is board certified.There are 11 references cited in this article, which can be found at the bottom of the page. This article has been viewed 140,179 times.
The prostate is a walnut-sized organ in males that plays a major role in the production of semen. The easiest way to access the prostate is by way of an index finger carefully inserted into the rectum. The processes for accessing the prostate as part of a medical exam or for sexual pleasure are the same, and the same precautions should be taken. You should also keep an eye out for signs of potential prostate problems and contact your doctor as needed.
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Routine Tests For All
There are some examinations that everyone should undergo on an annual basis. Depending on the specific markers and symptoms you may be exhibiting, having a year to year baseline to compare your numbers to can be of great benefit to getting to the root of any medical problems. The routine tests everyone should undergo include:
Yearly screenings, even when you feel healthy are crucial to assessing our risk for future problems, can encourage a healthier lifestyle, allows you to build a relationship with your healthcare provider, update any vaccinations and of course, screen for any health issues you may be having at the moment.
Depending on whether you are male or female, there may be additional tests that you should also undergo.
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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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The Psa: Its More Complicated
An additional test for prostate cancer involves testing your blood for PSA levels. PSA is a protein that helps liquefy semen. Some forms of prostate cancer can lower your PSA, although there may be other reasons why your PSA levels are off.
To guarantee an accurate test, a patient must not have a urine infection, must not have ejaculated for 48 hours before the test, must not have exercised heavily in the previous two days nor had a prostate biopsy within the last six weeks.
You may decide to do the test every one or two years. If the PSA level is high, youre likely to be asked to have more tests done. These might include an examination of the prostate gland and a prostate biopsy. This will depend on your age, family history, ethnicity, body weight and previous medical history.
You will need to consult your doctor about the pros and cons of having a PSA test done. This test may result in false positives and false negatives for prostate cancer. It could lead to additional testing and treatment and may not be recommended for everyone.
Symptoms And Characteristics Of Prostatitis
From the clinical symptoms it can be seen that the main symptoms of prostatitis are shown at somewhere else. That is, many symptoms are outside the lesion. So for the initial patients who are suffering from the disease, it is most likely to delay the disease and the best timing of treatment. We can conclude them into the following three categories:
1, Symptoms of prostate pain
The pain mainly appears at the back, perineum, lower abdomen, bilateral inguinal area, testes, anus, etc. A slight pain and a feeling of bulge discomfort. In the clinical we found that some young patients, due to abdominal pain which we should get into deeply investigation, but in the end doctors treat it as gastroenteritis. This will ultimately be invalid and even delay the treatment of the disease.
2, Urinary tract symptoms
The symptoms mainly show as dysuria, such as hard voiding, prolonged voiding, unclean urination, thinner urine, urine interruption, or even a bit like droplets or urination dysfunction. Some of these patients were found to have mild bladder irritation symptoms. And they have received treatment according to urinary tract infection with long-term ineffectively. What is more, it will also delay the best time for treatment.
3, Sexual dysfunction symptoms
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What Is The Prostate
The prostate is a walnut-shaped gland that is part of the male reproductive system. It has two or more lobes, or sections, enclosed by an outer layer of tissue. The prostate is located in front of the rectum and just below the bladder, where urine is stored. It surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen.
Specialist Referral And Biopsy
Your doctor will discuss your prostate check results with you. If the PSA and DRC results suggest you have a high risk for prostate cancer, your doctor will refer you to a urologist .
The specialist will discuss having a prostate biopsy, in which a small sample of your prostate gland cells are taken for examination.
The aim of the biopsy is to confirm whether or not you have prostate cancer and, if so, whether it needs treatment. The treatment options will then be discussed with you.
If the biopsy shows no evidence of cancer, you may be advised to attend future check-ups.
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How Should I Prepare For The Exam
Men need to understand how they should prepare for a prostate exam. The first thing to know is how the process works. Men should know exactly what to expect. This will help them to remain relaxed during the procedure. The man will also be able to breathe normally if they know how the procedure works.
Men do need to ensure that they tell the doctor if they have any problems with their anus or rectum. This includes telling the doctor about hemorrhoids. The man should also tell the doctor if they have an anal tear.
When the man needs to undergo a PSA test, there are a few things they should tell their doctor too.
A list of medications and supplements taken by the man should be noted to the doctor. There are a few products that can interfere with the results of a PSA test. The doctor will be able to determine if any drugs the patient takes may alter the PSA test results.
The man also needs to understand that ejaculation can affect their PSA levels. If the man had recently ejaculated, they should note this to the doctor too. Men should also ensure they do not ejaculate too closely to a PSA test. A doctor will be able to tell the patient if they need to avoid having sexual intercourse prior to the test.
What Does A Dre Involve
You might have a DRE at your GP surgery or at the hospital.
The doctor or nurse will ask you to lie on your side on an examination table, with your knees brought up towards your chest. They will slide a finger gently into your back passage. Theyll wear gloves and put some gel on their finger to make it more comfortable.
You may find the DRE slightly uncomfortable or embarrassing, but the test isnt usually painful and it doesnt take long.
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How Soon Will Prostate Test Results Be Available
Results for simple medical tests such as some urodynamic tests, cystoscopy, and abdominal ultrasound are often available soon after the test. The results of other medical tests such as PSA blood test and prostate tissue biopsy may take several days to come back. A health care provider will talk with the patient about the results and possible treatments for the problem.
What Kind Of Doctor Will I See For A Dre
A primary care doctor or a gynecologist usually does a DRE. A gynecologist is a doctor who specializes in the health of women’s reproductive system. Other types of doctors, including gastroenterologists, surgeons, and oncologists may do DREs. A gastroenterologist is a doctor who specializes in the gastrointestinal tract. An oncologist is a doctor who treats cancer.
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What Are The Symptoms Of Prostate Problems
The symptoms of prostate problems may include
- urinary retentionthe inability to empty the bladder completely
- urinary frequencyurination eight or more times a day
- urinary urgencythe inability to delay urination
- urinary incontinencethe accidental loss of urine
- nocturiafrequent urination at night
- trouble beginning a urine stream
- weak or interrupted urine stream
- blockage of urine
- urine that has an unusual color or odor
- pain after ejaculation or during urination
Different prostate problems may have similar symptoms. For example, one man with prostatitis and another with BPH may both experience urinary urgency. Sometimes symptoms for the same prostate problem differ among individuals. For example, one man with BPH may have trouble beginning a urine stream, while another may experience nocturia. A man in the early stages of prostate cancer may have no symptoms at all. Because of this confusing array of symptoms, a thorough medical exam and testing are vital.