Doctor’s Orders: Here’s What to Expect During a Prostate Exam

A step-by-step guide to your first (or next) Digital Rectal Exam (DRE)

The exam consists of two simple components.
The exam consists of two simple components. Joe Raedle/Getty Images

At some point in his life every man will be advised to have a prostate exam. Prostate exams consist of two different procedures. The first is a blood test that looks for the prostate-specific antigen, or PSA, in the blood, which is an early sign of cancer. The second part of the exam is a digital rectal exam (DRE), which doctors usually recommend as part of a routine exam—though it may also be done because of trouble with urination or other symptoms.  

Although the procedure only takes a minute or two and is usually painless, many men dread having to have a DRE. Knowing what to expect can alleviate any fears that a man might have:

Digital Rectal Exam:

First, your doctor will want to know whether you are experiencing any prostate health-related symptoms, such as a weak urine stream, dribbling, or straining to urinate. Your doctor may also ask you if any first degree relatives, such as your father or any brothers, had prostate cancer.

The next step is the digital rectal exam. Before the doctor performs this exam, let him know if you have hemorrhoids. During the exam, remember to breathe slowly in and out through your mouth, and don’t hold your breath. A digital rectal exam can be embarrassing for some men, but just detach and try to relax.

Here is a step-by-step explanation of how a DRE is done:

  • The doctor will explain that he will need to insert a finger into your rectum in order to examine the prostate gland.
  • You may be asked to stand facing the examination table while bending forward with your feet apart. Any time you are feeling anxious or nervous about what is going on, always ask your doctor to describe each step to help you relax.
  • After putting on a surgical glove, the doctor will cover a finger in a lubricant.
  • The finger is inserted in a downwards angle as if pointing to the belly button. At this point you may feel some pressure, but it should not be painful. If it does hurt, tell your doctor right away.
  • Once the finger is inserted, the doctor will wait for the external sphincter muscle to relax which can take a few seconds.
  • While the doctor examines the prostate, you may be aware of some movement of the finger before it is removed. The doctor is moving his finger in a circular motion in order to identify the lobes and groove of the prostate gland while he is checking on the size and shape of the prostate.  
  • The doctor will tell you before he removes his finger.
  • After the exam is done, the doctor will offer you some tissue or pre-moistened wipes to clean off the lubricant.
  • At this point, you will be allowed some privacy to get dressed before discussing the results with your doctor. If any areas of concern are found, additional testing may be required.
  • Your regular activities can be resumed immediately following a DRE with only slight bleeding from the rectum afterward.

PSA blood test:

The PSA test is a blood test that is used to screen for prostate cancer. The test measures for the amount of prostate-specific antigen (PSA) in your blood, which is a protein produced by both cancerous and noncancerous tissue in the prostate. Following the completion of the blood test, it may take a few days to get the results.  

The test itself is simply withdrawing blood from your arm, which the doctor will send to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter (mg/mL) of blood.

Both procedures—the PSA blood test and the DRE exam—are important health screening tools for all men. They are necessary tests performed at regular intervals during a man’s life. If you are a male over the age of 40 and have never been screened for prostate cancer, contact your doctor and make an appointment as soon as possible. It could save your life.

Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital and professor of urology at Hofstra North Shore-LIJ School of Medicine. He is a medical correspondent for the Fox News Channel’s Medical A-Team Learn more at Visit Dr. Samadi’s blog at Follow Dr. Samadi on Twitter, Instagram, Pintrest and Facebook.

Doctor’s Orders: Here’s What to Expect During a Prostate Exam