Prostate exam also known as digital rectal examination is offered when you present with either urinary tract symptoms or if you present with gastrointestinal symptoms. Term prostate means the prostate gland that sits in the male urinary tract.
Prostate gland enlarges over time as a result older males have more prostate problems than younger people. Thus when a male patient comes with urinary problems, the doctor will do a digital rectal examination to assess the size of the prostate and also to see if the prostate has any suspicious signs for being cancerous.
Digital rectal examination is also offered in patients presenting with gastrointestinal tract problems, to assess the anal canal and lower rectum. Although the idea on this occasion is to assess the bottom end of the gastrointestinal tract, it is the same examination as the prostate examination.
So let's talk about the urinary tract problems, that you might develop due to prostate enlargement. When prostate gland is enlarged, male patients will have what your doctor might call a bladder out flow obstruction. That is the enlarged prostate gland blocking the urinary flow from your bladder. When this happens you have to strain to pass urine in order to overcome the obstruction by the prostate. Also you might not be able to empty the bladder in one go. You will have to go to toilet several times in quick succession in order to completely empty the bladder.
When this obstruction lasts longer, pressure builds up in the bladder and that can cause your bladder to become thickened and overactive. When the bladder become over active the bladder will start contracting more frequently, thus requiring you to run to toilet more frequently. This can affect your sleep specially when you need to goto toilet several times in the night disturbing your sleep.
When these problems persists for longer time, the urinary bladder can collect large amounts of urine causing what is called a chronic urinary retention. This leads to leak urine out from the urinary tract with out the urge to pass urine leading to incontinence. This is an advance stage of the disease and can lead to embarrassing situations.
So what happens during the prostate examination. Your doctor will explain the procedure to you. you will be lying left side on the couch with knees bent and held high to expose your bottom. Doctor will use some cold jelly to lubricate the anal canal and examine the anal canal and prostate gland. He or she will assess the size of the prostate gland, texture of it, presence of any nodules or discrepancies in symmetry that will alert the doctors to perform further investigations to rule our prostate cancer.
At the end of the examination your doctor will explain the findings and let you know if they have been able to come to a diagnosis.
Possible diagnoses that a doctor could arrive at after prostate examination,
- Benign Prostate Hypertrophy (BPH)
In BPH prostate will be enlarged than a normal prostate gland but will be symmetrical and there will not be any nodules.
- Prostate Cancer
In prostate cancer, prostate will be hard and nodular. Most often the nodules make it asymmetrical. All these features lead to suspicion of cancer in prostate gland. If this is the case, your primary care doctor will do a test called PSA (Prostate specific antigen) and refer you to a urologist who will arrange more tests in the form of MRI of prostate to confirm the diagnosis.
- Prostatitis
Prostatitis is an infection in the prostate gland. This can be caused by urinary tract infections as well as STIs (Sexually transmitted infections)
- Normal prostate
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