Rectal examination is an exam indicated to identify prostate problems, such as prostate cancer or benign prostatic hyperplasia, but it can also be performed to evaluate changes in the rectum and anus, such as anal fissures, hemorrhoids or nodules.
In addition, a rectal examination can also be done during a routine gynecological examination in women, as it helps to detect problems in the vaginal canal or uterus, such as ovarian or uterine cancer, for example.
The digital rectal examination is quick, carried out in the doctor’s office, does not interfere with sexuality or cause pain, however, it can cause some discomfort if the person has anal fissures or a rectal infection. Understand what hemorrhoids are and how they are treated.
What is it for
The digital rectal exam is indicated to evaluate and/or identify changes in the anus, rectum and initial portion of the intestine, prostate, uterus or vagina, for example.
Thus, the digital rectal exam can be carried out by the urologist to identify changes in the prostate, by the proctologist or gastroenterologist, to evaluate the anus and rectum, or by the gynecologist, to evaluate gynecological changes.
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When to do
The digital rectal exam is indicated to identify or evaluate changes in the prostate, anus or rectum, such as:
- Prostate, anus or rectal cancer;
- Prostatitis or benign prostatic hyperplasia;
- Trauma, ulcers or nodules in the rectum and anus;
- Hemorrhoids or anal fissure;
- Inflammations or abscesses in the final portion of the intestine.
In addition, a digital rectal examination may be indicated to investigate the cause of abdominal or pelvic pain, constipation, fecal incontinence or intestinal obstruction. Understand what can cause an intestinal obstruction and what the risks are.
A digital rectal exam can also be done when a person has rectal bleeding or blood in the stool, in order to try to identify its cause. Find out the main causes of blood in the stool.
Female rectal exam
In the case of women, a digital rectal exam can also be performed, but in these cases, it is used to palpate the posterior wall of the vagina and uterus, so that the gynecologist can detect possible nodules or other abnormalities in these organs, such as cancer. uterine or ovarian cancer, for example. Check out the main gynecological exams.
When should a man do a rectal exam?
Rectal examination is most commonly performed by a urologist to screen for changes in the prostate, such as an increase in its size, common in benign prostatic hyperplasia, and to help with the early diagnosis of prostate cancer, increasing the chances of a cure. Know how to identify the symptoms of prostate cancer.
Therefore, in these cases, rectal examination is especially indicated for men over 50 years of age with or without signs and symptoms of changes in the prostate, and in men over 45 years of age who have a family history of prostate cancer before the age of 60. .
How to prepare for the exam
The digital rectal examination does not require any preparation to be carried out.
How is done
Rectal examination is performed by inserting the index finger, protected by a latex glove and lubricated, into the person’s anus, allowing the person to feel the orifice and sphincters of the anus, the mucosa of the rectum and the final part of the intestine, and can also palpate the region. posterior part of the prostate, in the case of men, and the vagina and uterus, in the case of women.
Most of the time, the exam is performed in the position lying on the left side, which is the most comfortable position. It can also be performed in the geno-pectoral position, with the knees and chest supported on the stretcher, or in the gynecological position.
Rectal examination for prostate exam
When the objective of the examination is to evaluate the prostate, the doctor evaluates, through touch, the size, density and shape of the prostate, in addition to checking the presence of nodules and other abnormalities in this organ.
The rectal examination can also be done together with the PSA measurement, which is an enzyme produced by the prostate that, when its concentration in the blood is increased, can indicate some abnormality. See how to understand the results of the PSA exam.
Although they are two very effective tests to help diagnose prostate cancer, if they are altered they cannot conclude the diagnosis, which is only done through biopsy.
Furthermore, the rectal examination only allows palpation of the posterior and lateral portions of the prostate, without evaluating the entire organ. Find out which are the main tests that evaluate the prostate.
Bibliography
- SA SILVA JUNIOR, MM; et al. Digital rectal examination impact on PSA derivatives and prostate biopsy triggers: a contemporary study. Int Urol Nephrol. 54. 9; 2117-2123, 2022
- NGUYEN, A.; et al. Digital Rectal Exam in the Acute Hospital Setting: Bridging Patient Experience and the Physician Perspective. J Community Hosp Intern Med Perspect. 12. 6; 64-68, 2022
- CHANG, CM; et al. Does a screening digital rectal exam provide actionable clinical utility in patients with an elevated PSA and positive MRI?. BJUI Compass. 2. 3; 188-193, 2021
- MACCINI, MA; et al. The effect of digital rectal exam on the 4Kscore for aggressive prostate cancer. Prostate. 78. 7; 506-511, 2018
- TEOH, M.; et al. Digital Rectal Examination: Perspectives on Current Attitudes, Enablers, and Barriers to Its Performance by Doctors-in-Training. Cureus. 15. 6; e40625, 2023
