One of the more common medical procedures for males is the prostate exam. However, because the exam isn't offered to a man routinely until he's middle-aged, many males are unfamiliar with the exam and what happens during one.
Preparation
When the man enters the examination room, the doctor gathers medical history if it hasn't been done already. The doctor may ask what has prompted the patient to schedule the prostate exam. After this discussion, the doctor may ask the patient to change into a clinic or hospital gown, and the doctor will wash his hands and put on a pair of gloves. If the doctor doesn't have the patient change into a gown, the patient is asked to pull down his pants and underwear.
The Exam
The doctor places lubrication on one gloved finger. He then asks the patient to bend forward, legs apart, so that he can access the patient's anus and rectum. The patient sometimes is asked to inhale, and the doctor inserts the gloved, lubricated finger gently into the anus as the patient exhales. A good doctor asks the patient at this point if he's comfortable enough and waits for the patient to relax so that the sphincter muscle opens and the procedure is less painful. Once the patient has relaxed, the doctor quickly feels around to examine the prostate. When the exam is over, the doctor removes his finger and provides the patient with a few tissues or some toilet tissue to wipe off any excess lubrication left on the patient's posterior. The patient may be directed to use a restroom if needed, because the procedure can tend to prompt a bowel movement.
Length and Purpose
A standard prostate exam (not including getting the patient's medical history and such) typically takes a minute or less. However, in that short minute, the doctor looks for the shape, size and texture of the prostate gland. Normally the prostate is about an inch to an inch and a half, has a firm, rubbery feel, and is triangular in shape. Deviations from these norms can signal a problem, particularly cancer. The purpose of the exam is thus to detect prostate cancers so that treatment can begin if the cancer is found. The doctor will alert the patient after the exam if a potential problem is suspected, and may schedule a PSA blood test or biopsy to confirm whether cancer is present.
Pain
Most patients who undergo a prostate exam don't experience pain during the procedure. They may feel a bit of discomfort, but sometimes the procedure is completed with no discomfort at all. This depends on how well the patient is able to relax and the sensitivity and skill of the physician.
Problems
One problem that can occur during a prostate exam is an erection in the male. This occurs simply because the prostate is located so close to the male reproductive organ. Other problems include the passing of gas or stool. There's little need for the patient to be embarrassed. Physicians who conduct prostate exams are well aware of how the male body can react to the exam and aren't surprised if the male encounters an issue.
Considerations
Digital rectal exams for prostate cancers still miss up to 40 percent of prostate cancers, and most of the cancers that are found are found too late for effective treatment to be administered. This is why most doctors also schedule blood tests in conjunction or in place of the exam. The exam, however, can catch cancers missed by the blood test.
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