Prostate Exam

Procedure
1. The man is advised that a finger needs to be inserted into their rectum in order to examine the prostate gland.
2. Usually the man is asked to stand, feet apart, face the examination couch and bend forward so that arms or elbows are on the couch.
3. The doctor will put on a surgical glove and will cover a finger in lubricant
4. The doctor will most likely say that you will feel a little pressure but no discomfort
5. The finger will be inserted in a downwards angle as if pointing to the umbilicus (belly button)
6.A few seconds may elapse as the doctor waits for the external sphincter muscle to relax
7. You may be aware of some movement of the finger before it is removed.

Usually painless, the digital rectal exam, or DRE, takes a minute or less (though it may seem longer). The doctor will ask you to bend over or lie on your side; then he or she will insert a gloved, lubricated finger into your anus and check the rear surface of the prostate for abnormalities. Hardness or a lump, for example, might be a sign of prostate cancer.

Are there other tests for prostate cancer?
There's a blood screening known as the PSA test, but the digital rectal exam sometimes picks up cancers the blood test misses. The manual exam isn't an ideal screening tool; your doctor can't feel tumors that are on the front of the prostate or buried in the middle. But because the exam is cheap and simple, there's little reason not to have it.

What if the doctor finds a lump?
Don't panic; it doesn't necessarily mean you're in trouble. About half of the time, a suspicious bump in the prostate turns out not to be cancer. If both your exam and your PSA test suggest that cancer may be present, your doctor will likely order a biopsy so that a sample of tissue can be examined under a microscope.

What You Should Know About Your Ultrasound Examination?
Your doctor has just requested an examination...of your prostate using ultrasound. Although you may have heard about ultrasound before, or possibly been examined with ultrasound in the past, you still may have questions about your examination. The American Institute of Ultrasound in Medicine (AIUM) - an association of doctors, sonographers and scientists - has provided these questions and answers to explain how ultrasound works.

What Is Ultrasound?
Ultrasound is like ordinary sound except it has a frequency (or pitch) higher than human beings are able to hear. When sent into your body by an instrument called a transducer, the sound is reflected off your internal organs and the returning echoes are converted by an electronic instrument into images on a monitor, similar to a television screen. These continually changing images can be recorded on videotape or film. Diagnostic ultrasound imaging commonly is called sonography or ultrasonography.

Is Ultrasound Safe?
There are no known harmful effects associated with the medical use of sonography. Widespread clinical use of diagnostic ultrasound for many years has revealed no harmful effects. Studies in humans have revealed no direct link between the use of diagnostic ultrasound and any adverse outcomes. Although the possibility exists that biological effects may be identified in the future, current information indicates that the benefits to patients of the prudent use of diagnostic ultrasound far outweigh the risks, if any, that may be present.

What Is the Prostate?
The prostate gland is part of the male reproductive system. It is about the size and shape of a walnut and weighs about 1 ounce. The prostate is located between the bladder and the rectum. The prostate surrounds the urethra, a tube that carries urine from the bladder out through the penis. The main function of the prostate gland is to produce fluid for semen.

Why Should I Have an Ultrasound of my Prostate?
Many diseases and conditions involve the prostate gland, including structural abnormalities, infection, hypertrophy (enlargement), and cancer. Ultrasound images are used together with a physical examination and blood tests to identify these diseases or conditions. Specific diagnoses, such as cancer of the prostate, require a biopsy, which means that a tissue sample is obtained from the suspicious area. If a suspicious lesion is identified by ultrasound or by a rectal examination, an ultrasound- guided biopsy may be performed. This is done by advancing a needle into your prostate gland under ultrasound guidance. A small amount of tissue is taken for microscopic examination.

What is Prostate Cancer?
Prostate cancer is a disease that affects the cells of your prostate gland. Normally, cells grow and divide in an orderly way, but when cancer cells grow, they continue to divide when they are not supposed to, forming a tumor. Cancerous prostate tumors can block the flow of urine and, if untreated, can spread to other parts of your body.

How Is the Ultrasound Examination Performed?
Because your prostate gland is located immediately in front of your rectum, the transducer is covered with a condom, lubricated, and placed into your rectum. The sound will be required to travel only a short distance to your prostate, and this results in a high-resolution or good quality picture. The room in which the ultrasound exam is performed is usually darkened so that the images on the monitor can be seen clearly.

Who Performs the Ultrasound Exam?
The exam may be performed by a doctor or a specially trained person called a sonographer. When a sonographer performs the examination, a doctor will interpret the results of the exam. The findings will be reported to the doctor who referred you for the exam.

Is Specific Preparation Required?
For some patients, an enema is used before ultrasound of the prostate. If a biopsy is required, you may be given antibiotics, either in a pill form or through a shot, before and after the biopsy. Be sure to inform your doctor of any drugs you are taking and if you are allergic to any drugs.

Will It Hurt?
If a biopsy is not needed, an ultrasound examination of your prostate is similar in discomfort to a rectal examination performed by your doctor. If a biopsy is performed, additional discomfort, due to the needle insertion, is usually minimal because the rectal wall is relatively insensitive near the prostate. The discomfort of a biopsy is similar to that of a blood test.

How Long Will the Exam Take?
The amount of time will vary depending on the reason for your examination, whether a biopsy is needed, and how your prostate appears on ultrasound. The ultrasound exam or scan usually takes less than 20 minutes to perform but may take up to 45 minutes if a biopsy is needed.

How Will I Feel After the Examination?
As after any rectal examination, you may experience some mucous discharge or bleeding from your rectum, especially if you have hemorrhoids. In the case of biopsy, many patients will have a small amount of blood in the stool, urine, or semen after the procedure.

What are the Risks of This Examination?
If you have hemorrhoids or other rectal lesions, you may have discomfort during the exam. Mild bleeding may result if these conditions exist. If a biopsy is performed, you can have bleeding. This may last for a day to weeks after the biopsy, but is usually minor in nature. There is a small risk of infection from the biopsy. If you develop a fever or if other symptoms of infection occur after the biopsy, you should contact your doctor so that he or she can give you additional antibiotics. If an infection occurs, it is usually minor and can be treated easily if reported right away.