General Practice 2022

Digital rectal exam: what é, what it is for and when to do it

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Digital rectal exam: what é, what it is for and when to do it
Digital rectal exam: what é, what it is for and when to do it

Digital rectal examination is a test commonly known as performed by the urologist to analyze possible changes in the prostate that may be indicative of prostate cancer or benign prostatic hyperplasia.

It is also an important exam to evaluate alterations of the rectum and anus, by the coloproctologist, such as anal fissure, hemorrhoids or nodules. In addition, digital rectal examination can also be performed in routine gynecological examination in women, as it helps to detect problems in the vaginal canal or uterus, for example.

The digital rectal exam is quick, performed in a doctor's office, does not interfere with sexuality and does not 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.

When to do

Digital rectal examination is most commonly performed by the urologist to screen for changes in the prostate, such as an increase in its size, common in benign prostatic hyperplasia, and to assist in the early diagnosis of prostate cancer, increasing the chances of cure.. Here are the 10 signs that may indicate prostate cancer.

Thus, in these cases, digital rectal examination is especially indicated for men over 50 years of age with or without signs and symptoms of organ changes, and for men over 45 who have a history of prostate cancer in the family before age 60.

In addition to investigating changes in the prostate, digital rectal examination can be performed as part of the proctological examination, by the proctologist, for:

  • Identify lesions in the rectum and anus, such as ulcers, nodules or tumors;
  • Observe an anal fissure;
  • Evaluate hemorrhoids;
  • Look for causes of bleeding stool. Know the main causes of blood in the stool;
  • Search for causes of abdominal or pelvic pain;
  • Investigate the cause of an intestinal obstruction. Understand what can cause an intestinal obstruction and what the risks are;
  • Detect inflammation or abscess in the final portion of the intestine. Check out what a proctitis is and what it can cause;
  • Look for reasons for constipation or fecal incontinence.

In the case of women, this type of touch can also be performed, but in these cases, it serves to palpate the posterior wall of the vagina and uterus, so that the gynecologist can detect possible nodules or other abnormalities in these organs. Find out which are the 7 main exams recommended by the gynecologist.

Is there any kind of exam preparation?

Digital rectal examination does not require any preparation to be performed.

How it's done

Digital rectal examination is performed by inserting the index finger, protected by a latex glove and lubricated, into the patient's anus, allowing to feel the orifice and sphincters of the anus, the mucosa of the rectum and the final part of the intestine, you can also palpate the posterior region 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 lying position on the left side, which is the most comfortable position for the patient. It can also be performed in the geno-pectoral position, with the knees and chest supported on the stretcher, or in the gynecological position.

When the purpose of the exam is to evaluate the prostate, the doctor evaluates, through touch, the size, density and shape of the prostate, in addition to checking for the presence of nodules and other abnormalities in this organ. The digital rectal examination can also be done together with the PSA dosage, which is an enzyme produced by the prostate which, when it has an increased concentration in the blood, may indicate an abnormality.See how to understand the PSA exam result.

Although they are two very effective tests to aid in the diagnosis of prostate cancer, if they are altered they cannot complete the diagnosis, which is only done through biopsy. In addition, digital rectal examination only allows palpation of the posterior and lateral portions of the prostate, and the entire organ is not evaluated. Find out which are the 6 tests that evaluate the prostate.

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