General

Do you still perform a digital rectal exam?

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16 Sep 2016 - General
 

Just recently I encountered a journal article that stating there’s enough evidence to abandon screening for prostate cancer through a digital rectal exam. In reality, this exam is highly uncomfortable and is dreaded by a lot of men, and is actually perceived as an “invasive” exam. In clinical practice, I have observed that a lot of urologists no longer do this and instead they request for PSA since it is less invasive and readily available. However, because I am a resident, I am expected to perform this when indicated. So my question is do you still perform this when screening for prostate cancer? If your DRE is negative, do you still request for a PSA?

Marinelle Castro We actually do digital rectal examination in almost every patient who present with an abdomen related complaint. Constipation is a very common problem in children, and it is very seldom that we see children complain of constipation. They say abdominal pain, and when you feel hard stool in the DRE you now it is constipation. DRE also gives an important clue to diagnose Hirschsprung's disease. ...
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Rajinda Asalage Thanks for sharing your insight about the topic. I was not aware of that study. Anyway I still do a digital rectal exam because I am still a resident trainee. But if I am in private practice, I'd probably request a PSA for prostate cancer screening purposes, rather than perform a DRE prior to requesting it. I agree that a normal DRE does not mean that you should request it. I think the most c...
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Digital rectal examination is very effective to have clues about various conditions. So prostatic conditions are. You can feel enlarged prostate by the digital rectal examination and the sensitivity is very high. But enlarged prostate does not indicate a prostate cancer. A study says that 60% of positive DREs are later found to be benign conditions and 30% are prostatic carcinomas and 10% are inflammatory conditions of the prostate gland. Prostatic specific antigen level can get rised even witho...
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