The digital rectal examination (DRE) is a short examination that gives information about the size, consistency and symmetry of the prostate and any hardness or irregularity on its surface. Assessed together with a PSA test, it provides a much fuller picture of the prostate; it can reveal a finding that needs further investigation even when the PSA is normal. That is why it has a place in the early diagnosis of prostate cancer.
As men get older, problems such as prostate enlargement, prostatitis and prostate cancer become more likely. Some of these conditions cause no symptoms in the early stages. That is why it makes sense to have regular check-ups after a certain age rather than waiting for symptoms to appear. Part of the check-up is the digital rectal examination, often simply called the "finger examination".
What Is a Digital Rectal Examination?
Wearing a glove and using lubricating gel, the doctor assesses the prostate with a finger through the back passage. In this way the size, consistency, symmetry and tenderness of the prostate can be assessed, along with any hardness or irregularity on its surface. This information helps some prostate conditions to be picked up early.
How Long Does It Take, and Does It Hurt?
Most patients say the examination is much shorter than they expected: 5 to 10 seconds on average. It is not painful, although you may feel brief pressure. Breathing calmly and relaxing your muscles makes the examination easier.
It Is Assessed Together with PSA
PSA is a value measured in the blood that is linked to prostate tissue; a raised level can point to some prostate conditions. When the examination and PSA are assessed together, a much fuller picture emerges. Even if the PSA is normal, something felt during the examination may call for further tests. Conversely, when the PSA is high, the examination also gives important information for understanding why.
Who Needs It, and When?
Prostate cancer is one of the most common cancers in men, and when it is caught at an early stage there are more treatment options. That is why men aged 50 and over are advised to have regular urology check-ups. Men with a family history of prostate cancer may start check-ups earlier.
The following symptoms may also call for an examination:
- Straining to pass urine
- Needing to pass urine often
- Getting up at night to pass urine
- A weaker urine stream
The examination is also done when the PSA is found to be high or there is another suspicious finding. Depending on the result, further tests such as imaging or a biopsy are planned if needed.
