Mention the words “prostate exam” in a room full of middle-aged men and you will see blanched and contorted faces. It has become routine in the annual physicals for older men and it can be both uncomfortable and fear-inspiring. The main reason is that a prostate exam is also known as a rectal exam. Due to the prostate’s proximity to the rectum, it can actually be felt through the thin rectal walls.
Irrespective of the squeamishness and uncomfortable social connotations of the exam, it is a very necessary test for the early detection of an enlarged prostate or even prostate cancer and should not be taken lightly. Catching prostate cancer early can be the difference between life and death. In addition it can help to diagnose an enlarged prostate which, if it continues to grow, will cause urinary problems for the patient.
How is it Performed
It is conducted by a physician who inserts their fingers into the rectum and feels for the gland. The external area of the rectum is first examined for hemorrhoids or fissures. The patient will need to be in a position to make the anus accessible for the doctor and there might be mild discomfort during the exam. T he rectal walls are very thin and any abnormalities will stand out. They will check to make sure that the prostrate lobes are symmetrical and not bulging into the rectum. If abnormalities are located than further tests will need to be run. The back of the prostate cannot be felt with prostate exam so these tests will be able to narrow down the cause. The rectal exam is an initial screen examination.
Further Testing
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If there are suspicions of an enlarged prostate, blood tests will be conducted, including a test of elevated levels of prostate specific antigen (PSA). An ultrasound of the testicles, prostate and kidneys will rule out other conditions. PSA levels can also be an indicator of prostate cancer. The only full confirmation of prostate cancer is removing small pieces of the prostate for microscopic examination, also called a biopsy. However, a cytoscopy will exam the urinary tract from inside the bladder via the urethra and a transrectal ultrasonography will make a picture of the prostate using sound waves.
A prostate exam is a necessary evil and despite the discomfort and social taboos that surround it are minor compared to the benefits of detecting any prostate problems.
