What Happens During a Prostate Exam

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Men facing their first prostate exam may be nervous about what to expect and what happens during the process. Out of fear they may classify it with war, famine, drought and other natural disaster or man-made catastrophes—something to be feared and avoided at all costs. If you’re among the many who equate “prostate exam” with “apocalypse,” fear not. A little knowledge goes a long way, and learning about the prostate exam itself may help to put your mind at ease. At least a little bit.

Why Have a Prostate Exam?

Prostate exams may be part of a routine physical screening. Your doctor may also recommend it if you are of a certain age group or if you complain of symptoms like difficulty passing urine. If you are at a high risk of prostate cancer, your doctor might recommend having a prostate exam. Prostate exams, or digital rectum exams (DREs), allow your doctor to detect any abnormalities, such as growths or enlargements of the prostate. Your doctor can also use it to diagnose hemorrhoids or to collect a stool sample to check for blood.

When to Have a Prostate Exam

If you are at a high risk of prostate cancer (African-American men and those with a family history), your doctor might recommend that you begin having prostate exams at about age 40 to 45. If you are age 50 or older, you should have one annually to check for abnormalities. If you have symptoms such as rectal bleeding, you should have an exam regardless of your age.

How to Prepare for a Prostate Exam

There really aren’t any special measures that you need to take to prepare for a prostate exam. No fasting or special medications are required. The most important thing to remember is that it’s best to try to relax. If you are especially anxious about the exam, takes some deep breaths and focus your mind elsewhere (think about your favorite hobby or make a mental to-do list for work). Tell your doctor if you are particularly nervous. He can tell you exactly what he is doing for each step of the exam, which may help calm your nerves.

What to Expect During a Prostate Exam

Here is exactly what happens during a prostate exam. Expect to disrobe below the waist. You will be provided with a paper or cloth covering. You may be asked to lie on the exam table on your left side with your knees bent. Otherwise, your doctor will instruct you to stand with your feet apart and your elbows on the exam table.

Your doctor will wear a glove and lubricate a finger. He will insert his finger into your rectum at a downward angle. He will wait a few seconds for the sphincter to relax. You may feel a little movement and/or pressure, but it is unusual to feel any pain from a prostate exam. Your doctor will then remove his finger and provide you with wipes to remove the lubrication.

Side Effects from What Happens During a Prostate Exam

Aside from some minimal discomfort, side effects from a prostate exam are rare. If you do have prostatitis, or an inflamed prostate, you may feel some pain. Most men do not experience bleeding, however you may notice a small amount of blood, particularly if you have hemorrhoids. You may feel an urgent need to urinate, which will typically subside at the conclusion of the exam. Rarely, some men may have a vasovagal response, which can cause lightheadedness or fainting.

Discussing the Results

If your doctor detects the presence of any abnormalities such as bumps, an area of increased hardness, an enlargement in prostate size, or any other issues, he will recommend additional tests. You may have a protein specific antigen (PSA) test, prostate biopsy, transrectal ultrasound, urinalysis, blood tests, or x-rays.