A digital rectal examination of the prostate allows a doctor or experienced health care professional to determine if the prostate is enlarged, hard, or see if there are any irregularities in it. The digital rectal examination procedure also gives your doctor an idea of how extensive any abnormality of the prostate might be and helps the doctor to plan and direct a potential biopsy, in which a sample of tissue is removed and examined under a microscope. Additional testing can determine the cause of any abnormality.
The prostate gland is located just in front of the rectum, which means that part of it can be felt through the rectum. The doctor gently places a gloved, lubricated finger into the rectum to feel the part of the prostate that is just under the skin of the rectum. A digital rectal examination (DRE) should be performed as part of any screening process for prostate cancer and should be performed by a physician, physician’s assistant, or nurse practitioner who is experienced in performing these procedures.
A digital rectal examination can help detect both prostate and rectal cancer. The digital rectal examination and standard screening is often part of a thorough physical examination of an adult man. The DRE is also used after a man is diagnosed with prostate cancer to help determine if the cancer has spread beyond his prostate gland and is used to detect cancer that has returned after treatment.
The doctor may ask you to bend over the edge of the examination table or lie on the table on your side with your knees held close to your chest for this procedure. The procedure may cause some discomfort, but it is not painful and is usually very brief.
DRE and PSA testing are usually done together because neither test alone provides adequate testing for prostate cancer. About one fifth of prostate cancers do not produce enough PSA to make the blood PSA level abnomal. The PSA test therefore may not detect these cases.
DRE alone does not provide adequate screening for prostate cancer. It is difficult for a doctor’s finger to reach all parts of the prostate gland through the rectum, although it reaches the back part of the gland, where most prostate cancers begin. Small prostate cancers may be difficult to feel and therefore difficult to detect through DRE.
To give you a better idea of what is involved in a DRE, watch the digital rectal examination video by a doctor who explains what to expect from a DRE.