How is a digital rectal examination performed? Rectal examination technique
Before PRI, the urologist often puts a rubber glove on his right hand (if the doctor is right-handed), lubricates it with Vaseline and inserts his index finger with a slight movement into the anus (anus). At a distance of 40–50 mm from the anus, the lower pole of the prostate gland is palpated. Next, the urologist very carefully slides his index finger over the surface of the prostate, assesses the contours of the gland, size, consistency, shape, condition of the interlobar groove and sensitivity of the prostate. When performing DRE, you need to compare the right and left lobes. Analysis of pancreatic secretions is also important.
Normal prostate: shape, consistency, surface, boundaries, dimensions
A normal prostate is the size of a small chestnut, with the top facing down. In most cases, the urologist's finger freely and easily reaches the upper border of the non-enlarged prostate. In a normal state, during palpation, the doctor distinguishes 2 lobes of the prostate, with a clearly defined interlobar groove between them. The average size of the lobes is approximately the same, approximately 14 by 20 mm. The surface of the gland is normally smooth, the boundaries are clear, and the consistency is elastic. The mucous membrane of the rectum (rectum) over the lobes of the prostate gland is usually easily displaced.
What happens at the reception
At the NEARMEDIC network of clinics, you come for an appointment at a pre-selected time: the appointment schedule is strictly observed. Initially, the doctor conducts a conversation during which he clarifies the complaints, the duration of the presence of ailments, finds out the presence of diseases in the past and other details that can clarify the nature of the symptoms and the possible causes of their occurrence.
A specialist will definitely conduct an initial examination.
Is preparation necessary for the inspection?
At home, you need to take a shower, especially thoroughly wash the areas being examined. Preparation for examining the rectum is minimal: sometimes you need to do a microenema to empty the lower part of the rectum for examination.
Deep and thorough cleansing cannot be carried out without a doctor’s prescription! For certain types of diseases or damage to the intestines, enemas are prohibited.
How does the prostate gland change in men with inflammation and chronic prostatitis?
Private medical practice Sarklinik (Saratov, Russia) indicates a clear correlation between the condition of the prostate and the stage of chronic prostatitis (CP).
Stage 1 CP is characterized by an increase in size and severe swelling of the gland. The prostate is very painful on digital rectal examination. The consistency is uniform, densely elastic. There are no areas of compaction or softening. The boundaries of the gland are unclear due to the infiltration of fiber surrounding the prostate.
Stage 2 of CP is characterized by a slight enlargement of the gland, sometimes normal sizes are observed. The pain decreases. There is uneven consistency, areas of softening alternate with areas of compaction. Sometimes prostate stones can be felt. The boundaries of the pancreas are clearer. There may be flabbiness and atonicity. Stage 3 of CP is characterized by a decrease in the size of the pancreas. The mucous membrane of the rectum above the prostate is moderately mobile. Pain, dense consistency, and clear boundaries are noted. If sclerosis of the pancreas has developed, the secretion is poorly released.
Preparation
To make the procedure less uncomfortable and more informative, it is recommended to prepare for it:
- Normalization of intestinal function. You need to avoid foods that are too fatty and spicy, as well as foods that contribute to flatulence and bloating. These include legumes and fresh fruits.
- Diet restriction. A digital rectal examination is performed exclusively on an empty stomach, so the last meal should be taken in the evening, at least 12 hours before the scheduled diagnosis.
- Drinking regime. In addition to maintaining proper nutrition, you need to drink plenty of fluids.
- Purgation. Immediately before the procedure, it is recommended to perform a cleansing enema.
- If the patient has problems with stool (constipation), then mild laxatives may be prescribed, which must be taken three days before the procedure.
What is a sickle symptom? How to correlate the sickle symptom and androgen levels in men?
With prostate atrophy, with androgen deficiency, male menopause, with a decrease in testosterone levels, the prostate takes the shape of a sickle, which is open upward. The upper segment of the gland sinks and flattens, the lower segment in the form of a roller borders the resulting depression. The sickle symptom was described in 1982 by the famous and outstanding urologist, andrologist, sexologist, and sex therapist Ivan Fedorovich Yunda. It can be used to indirectly judge the level of androgens in a man’s body.
1. + the initial symptom of sickle is a slight decrease in androgenic function.
2. ++ positive sickle symptom – there is a decrease in androgen levels by 1.5 – 2 times. The sunken part has a diameter of up to 1.5 - 2 cm.
3. +++ sharply positive sickle symptom - a decrease in androgen levels by 3 times. The sunken part has a diameter of up to 2.5 - 3 cm.
TRUS of the prostate is a modern method of examining the prostate gland
A modern and informative method for examining the prostate in Saratov and in Russia is transrectal ultrasound examination of the prostate (TRUS). With this diagnostic method, there are practically no unpleasant pain sensations, the entire structure of the pancreas is clearly visible, and the dimensions are determined with an accuracy of mm. Ultrasound examination allows for differential diagnosis of chronic prostatitis and other prostate diseases, monitoring and evaluation of treatment effectiveness.
On the sarclinics website you can ask the doctor a question about your health absolutely free of charge and receive a comprehensive answer. Ask detailed, big questions that comprehensively describe all your male problems, complaints, and a detailed history of the disease. All this information will allow us to understand your problem and recommend the most effective way out of the current situation in Saratov, Russia.
Sigmoidoscopy
As prescribed by a specialist, the mucous membrane of the rectum and the lower portion of the sigmoid colon is examined using a sigmoidoscope.
Indications for sigmoidoscopy:
- problems with bowel movements;
- difficulty defecating;
- pain in the anorectal and perianal area (of any nature and intensity);
- with discharge (blood, mucus);
- for differential diagnosis if the presence of malignant tumors is suspected.
The procedure is painless and is carried out without complications. Use is limited for acute inflammation, profuse bleeding and chronic anal fissures.
Prostate massage with a finger, how to massage the prostate?
Prostate massage with a finger is an old and ineffective method of treating the prostate gland. Fortunately, modern medicine allows the use of new methods of prostate treatment, which prostate massage with a finger or a toy . During the consultation, the doctor will tell you what a prostate massage is, what prostate massage techniques exist, how to do a prostate massage on your own, how a man feels after a massage, what a Russian prostate massage is, can a man do it to himself with his finger or penis, what are the the delights of prostate massage for a girl or a woman at home, what are the prices for prostate massage in Russia, are there any benefits and harms from a massage at home for a man or a guy. Treatment of the prostate with massage is an antediluvian method in urology, which has many contraindications and side effects. Do not do self-massage of the prostate at home, as this can harm yourself. Some men ask: “How to do prostate massage yourself in Saratov?” Before carrying out such manipulations, you first need to undergo an examination and find out the diagnosis, and then decide on treatment tactics. Is it possible to massage the prostate? Is it necessary? It is best to discuss the answer to these questions with your doctor.
Text: ® SARCLINIC | Sarclinic.com \ Sarclinic.ru Photo: © blueringmedia / Photobank Photogenica / photogenica.ru The people depicted in the photo are models, do not suffer from the diseases described and/or all coincidences are excluded.
Interesting information on the website: Chronic prostatitis
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Examination at NEARMEDIC
At any of the NEARMEDIC clinics you can make an appointment with a specialist at any time convenient for you. The clinics are equipped with modern informative equipment for various types of examinations. The institutions have created all the conditions for quick and accurate diagnosis of diseases, preventive and diagnostic examinations.
High-class specialists work here, many of them are authors of serious dissertations and members of professional associations.
In many cases, an examination by a rectal surgeon is combined with an examination by a proctologist, since the clinics employ specialists who are able to diagnose, prescribe treatment and carry out invasive and minimally invasive manipulations for the health of patients. In such cases, the patient does not need to undergo additional examinations, which saves time and money. It also reduces moral and physical discomfort when diagnosing delicate diseases.
Question a doctor online
What is a digital rectal examination of the prostate and what is it used for?
Andrey, Moscow
Dear Andrey!
Digital rectal examination of the prostate (prostate gland) is used for screening men and preliminary assessment of the condition of the prostate gland. The digital rectal examination method is often used by urologists; it is valuable for its simplicity and accessibility. Digital rectal examination is performed in 3 positions. 1. On the right side with the knees brought to the stomach. This position is often used when examining frail patients and the elderly. 2. In the position of the examined patient with the torso bent anteriorly. 3. Knee-elbow position - this is traditional for digital rectal examination. During palpation examination of the prostate (prostate gland), the index finger of the right hand (if the doctor is left-handed, then of the left hand) with a rubber glove on, is lubricated with Vaseline and inserted with a light, graceful movement into the anus (anus, anus). At a distance of approximately 4 - 5 cm, the lower pole of the prostate (prostate gland) is felt. Carefully, gently, the finger slides over the surface of the prostate gland and evaluates the contours of the prostate, the size of the prostate, the shape of the prostate, the consistency of the prostate, the sensitivity of the prostate, the condition of the interlobar groove of the prostate. The unchanged prostate gland is shaped like a small chestnut, with its rounded top facing down. The urologist's finger freely reaches the upper border of the non-enlarged prostate. In a normal state of the prostate, the urologist distinguishes 2 lobes of the prostate, with a clearly defined interlobar groove between them. The usual average dimensions of each lobe are from 14 to 20 mm, the surface of the lobes is smooth, the boundaries are clear, and the consistency is elastic. The mucous membrane of the rectum (rectum) above the lobes of the prostate gland is easily displaced. Digital rectal examination shows well the stage of chronic prostatitis, as it clearly reveals changes in the prostate at different stages of development of the chronic inflammatory process. The process of digital rectal examination is quite unpleasant, so transrectal ultrasound examination of the prostate (TRUS of the prostate) has been widely used in recent years. In higher medical institutions of Russia in the departments of urology, a video course of digital rectal examination of the prostate is used to train students.
Sarklinik wishes you a healthy prostate gland.
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Irrigoscopy
The procedure for examining the rectum using X-rays using a contrast agent.
Irrigoscopy is performed in the following cases:
- the need to clarify the diagnosis for fistulas and diverticulosis;
- the presence of adhesions in the intestines or if they are suspected;
- suspicion of chronic colitis.
To conduct the study, the colon is tightly filled with a suspension of barium, which acts as a contrast agent, and fluoroscopy is performed. The method allows you to see the shape and size of the colon in different areas, its location in the abdominal cavity, evaluate the elasticity of the walls and their compliance with the norm.
During the administration of the contrast agent, the functionality of various parts of the large intestine is also assessed. After the cavity is completely emptied, the doctor analyzes the relief of the intestine.
Double contrast with air supply is also used to detect polyps and neoplasms.
Irrigoscopy is contraindicated in case of intestinal perforation in any area.
