This great dilemma that men sometimes have when performing a rectal examination when visiting the urologist for the first time, and we must explain to the patient the importance of digital rectal examination, when it should be done, why and in what it benefits, with the intention of building and raise awareness of this and the family members who accompany him, so that they lose the fear of having such an exam.
Prostate cancer is the most common cancer after skin cancer, in men in the United States. By 2018, the American Cancer Society estimates that, in the United States: About 164,690 new cases of prostate cancer will be diagnosed and 29,430 deaths from prostate cancer will be reported.
-Benign Prostatic Hyperplasia (BPH): benign growth of the prostate glands, which due to its location produces a low obstructive syndrome known as prostatism. Its symptoms are related to the compression of the urethra with difficulty of urination and the retention of urine in the bladder producing bladder hypertrophy, urinary infection and development of cystitis.
-Prostate adenocarcinoma: occurs when some prostate cells mutate and begin to multiply uncontrollably. These may also spread from the prostate to other parts of the body, especially the bones and lymph nodes. When it spreads, it presents obstruction of the exit orifice of the bladder, acute urinary retention, hematuria (urine with blood) or urinary incontinence. When metastases occur, he presents with bone pain, mental confusion or pathological fractures.
Rectal examination is essential in a urological consultation after the age of 40, or before that age if necessary, together with PSA (prostate-specific antigen) are important to rule out prostate cancer.
How is rectal examination performed?
After putting on gloves, we add lubricant, and introduce the finger through the rectum while the patient is in position, can be in position on their back with their legs open, or on their side with their legs bent, or in a standing position supported in the elbows, then with the tip of the finger the surface of the prostate is palpated to see if there are nodules, or parts of hard or stony consistency, or areas that are irregular, all these findings are suspicious of cancer.
In many cases, not performing a digital rectal examination could result in inadvertent prostate cancer.
Rectal examination is so important that urologists not only assess the prostate at the time of touch, but they can also find hemorrhoids, tumors, low gastrointestinal bleeding, fistulas, abscesses, among other diseases. When in doubt visit a urologist.
SOURCE:
1.-American Cancer Society. Facts & Figures 2018. American Cancer Society. Atlanta, Ga. 2018.
2.-Notes of Urology General Smith and Tanagho 18A Edition