This article was co-authored by Gary Hoffman, MD. Dr. Gary Hoffman is a board certified Colorectal Surgeon and the Clinical Chief of the Division of Colon and Rectal Surgery at Cedars Sinai Medical Center. With over 35 years of experience, Dr. Hoffman has helped to advance laparoscopic and robotic surgery for the treatment of colon and rectal cancer. Dr. Hoffman holds a BS from the University of California, Irvine, and a Doctor of Medicine (MD) from Vanderbilt University. He completed his surgical internship at Los Angeles County-USC Medical Center and his surgical residency at Louisiana State University-Charity Hospital of New Orleans Medical Center. Dr. Hoffman is an Attending Surgeon in the Division of General Surgery and Colon and Rectal Surgery at Cedars Sinai Medical Center. He is also an Associate Clinical Professor of Surgery at The David Geffen School of Medicine, University of California, Los Angeles. Dr. Hoffman is a member of The American Society of Colon and Rectal Surgeons, The Southern California Society of Colon and Rectal Surgeons, The American College of Surgeons, and The American Medical Association.
There are 27 references cited in this article, which can be found at the bottom of the page.
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A rectal exam is a screening test for both genders that helps to detect abnormalities in the rectum, anus, and prostate gland (men only), such as cancer, infections and various injuries.  X Research source These exams should be done fairly regularly (yearly or so) as part of your health physical. Trained medical professionals are the only people who should give rectal exams since untrained individuals can injure the delicate rectal/anal tissues while probing.
The rectal exam is important to make sure causes of rectal bleeding such as hemorrhoids are not missed. Additionally, understanding how to palpate the prostate gland is important for looking for cancer and diagnosis prostatitis.
Introduction to the Rectal Exam
A rectal exam should be performed on most patients with abdominal pain and any concern for blood loss. Here, we review some important steps of a compete rectal exam.
Rectal Exam Technique
There are multiple positions that you can ask your patient to stand or lie. These include:
- Standing position: patient standing with toes pointing in, then leans over a table
- Right lateral decubitus (Sims position): patient lies on right side with right hip/leg straight and the left hip/knee is bent
- Knee to chest: patient with lying on table facing down with knees up to chest bent forward
* (Both the standing and knee to chest positions are optimal for the prostate exam)
Inspection of Anus
Look for external hemorrhoids, fissures (90% of time they are located in midline posteriorly), skin tags, warts or discharge
Palpate Rectum and Prostate
- Use a small amount of lubricant on the index finger and ask the patient to take a deep breath and insert the finger facing down (6 o’clock position)
- Appreciate the external sphincter tone then ask the patient to bear down and feel for tightening of the sphincter
- Palpate the prostate gland. Note the following:
- Approximate size of the prostate gland (normally about the size of a walnut, 2-3 cm but wider at the top)
- Feel for tenderness (prostatitis)
- Feel for nodules or masses
- Palpate the rectal wall starting from the 6 o’clock position clockwise to the 12 o’clock position. Then return to the 6 o’clock position and palpate the other half of the rectal wall feeling for masses, nodules and tenderness.
Occult Blood Test
Check any fecal material for occult blood with a guaiac kit.
The digital rectal exam (also referred to as the DRE) is used to evaluate the anus, distal rectum, pelvis, and prostate. More specifically, it is used to inspect for anal tumors, obtain fecal samples for a fecal occult blood test, assess the function of the anal sphincters, evaluate for the cause of rectal bleeding (such as hemorrhoids), and evaluate the prostate gland.
Review of anorectal anatomy
To understand how to perform a DRE, a brief review of anorectal anatomy is pertinent. The anus is the most distal portion of the large intestine. The anorectal junction is about 5 cm superior to the anal verge (e.g., the anal orifice). The anal verge is the most distal portion seen externally.
The anal canal is the lumen located between the anal verge and the rectum. The dentate line (e.g., the pectinate line) is about 2 cm superior to the anal verge and is in the transitional zone.
Figure 1. The anal canal is located between the anal verge and anorectal junction, and is divided into two sections by the dentate line.
The dentate line is the division between the ectoderm and endoderm mucosa, which is important because of their embryological origins. Above the dentate line, the mucosa is endoderm, has splanchnic innervation, and is insensitive to pain. Below the dentate line, the mucosa is ectoderm, has somatic innervation through the inferior rectal nerve, and is sensitive to pain.
Figure 2. The dentate line represents the junction between the endoderm and ectoderm portions of the anal canal.
The internal anal sphincter surrounds the upper two-thirds of the anal canal. It is formed from a thickening of the involuntary circular smooth muscle in the bowel wall. The external anal sphincter surrounds the lower two-thirds of the anal canal and is a voluntary muscle.
Figure 3. The internal anal sphincter is a ring of involuntary smooth muscle that surrounds the upper two-thirds of the anal canal, and the external anal sphincter is a ring of voluntary muscle that surrounds the lower two-thirds of the anal canal.
How to perform a digital rectal exam
Start by communicating with the patient about why a DRE is necessary, what is involved, and how the exam will be performed. Prepare the patient for a little bit of discomfort with the exam.
If possible, have the patient lay on their side in the left lateral decubitus position (e.g., with their right side up). A standing rectal exam can also be performed, but it may not be as comfortable for some patients. Usually, a standing exam is only performed for a prostate examination.
To perform a DRE, put on gloves, and perform these five steps:
- Visually inspect the anus
- Palpate the anal sphincters
- Palpate the rectal wall
- Palpate the prostate (in males)
- Collect a fecal sample if indicated
Step 1: Visually inspect the anus
First, inspect the anus. Look for any external hemorrhoids, skin tags, anal fissures, discharge, drainage, and any other abnormalities.
Step 2: Palpate the anal sphincters
Use your index finger of your dominant hand and place some lubricant jelly on it. Ask the patient to take a deep breath in, exhale, and relax. Insert your index finger into the anus, with the finger facing anteriorly, which we will refer to as the six o’clock position.
Note the external anal sphincter tone. Ask the patient to bear down and feel for tightening of the sphincter against your finger.
Step 3: Palpate the rectal wall
Palpate the rectal wall for masses, nodules, and tenderness. From the six o’clock position (e.g., the anterior direction), rotate your finger clockwise to the twelve o’clock position (now in a posterior direction), and then return to the six o’clock position.
Step 4: Palpate the prostate
In males, the prostate gland lies anteriorly at the six o’clock position. Palpate the prostate gland and note the approximate size. Feel the prostate gland for tenderness, nodules, or masses.
Step 5: Collect a fecal sample if indicated
If the patient has any signs or symptoms of anemia or unintended weight loss, then a guaiac kit to test fecal matter for occult blood is indicated.
Figure 4. Steps to performing a digital rectal exam include, 1) visually inspecting the anus, 2) palpating the anal sphincters, 3) palpating the rectal wall, 4) palpating the prostate (in males), and 5) collecting a fecal sample if indicated.
That’s it for now. If you want to improve your understanding of key concepts in medicine, and improve your clinical skills, make sure to register for a free trial account, which will give you access to free videos and downloads. We’ll help you make the right decisions for yourself and your patients.
- de Dombal, FT. 1988. The OMGE acute abdominal pain survey. Progress report, 1986. Scand J Gastroenterol Suppl. 144: 35–42. PMID: 3043646
- Jin, XW, Slomka, J, and Blixen, CE. 2002. Cultural and clinical issues in the care of Asian patients. Cleve Clin J Med. 69: 50, 53–54, 56–58. PMID: 11811720
- Tseng, W-S and Streltzer, J. 2008. “Culture and clinical assessment”. In: Cultural Competence in Health Care. Boston: Springer.
- Wong, C. 2020. Liver fire in traditional Chinese medicine. verywellhealth. https://www.verywellhealth.com
About the Author
Olutayo A. Sogunro, DO
Acute Care and Trauma Surgeon at St. Vincent’s Medical Center and Assistant Professor of Surgery at Netter School of Medicine, Quinnipiac University, USA.
A rectal examination is where a doctor or nurse uses their finger to check for any problems inside your bottom (rectum). It’s usually very quick and you should not feel any pain.
When a rectal examination may be needed
A rectal examination is sometimes needed to investigate:
- bleeding from the bottom
- pain in the bottom
- being unable to control when you go to the toilet (incontinence) – including bowel incontinence or urinary incontinence
Men sometimes need a rectal examination to check for problems with the prostate.
What is the prostate?
The prostate is a small gland that only men have. It:
- produces fluid that mixes with sperm to create semen
- often gets larger with age
- may cause problems with how easily you pee and how often you need to go
Before having a rectal examination
Your doctor or nurse should explain what’s going to happen and why you need a rectal examination.
They’ll know that some people can feel embarrassed, but it’s a common procedure.
Let the doctor or nurse know if:
- you’d prefer a man or woman to perform the examination
- you’d like someone else in the room – it could be a friend, family member or another doctor or nurse
- you have severe pain in your bottom – they may be able to use local anaesthetic to numb the area
What happens during a rectal examination
First, you’ll be asked to undress from the waist down. If you’re wearing a loose skirt, you can usually just remove your underwear.
Let the doctor or nurse know if you’d like to get changed behind a curtain or be alone in the room.
The doctor or nurse will:
- Ask you to lie down on your left side, with your knees lifted up towards your chest. This is the easiest position to examine your rectum.
- Put on some gloves and look at the outside of your bottom for any problems.
- Put some lubricating gel on 1 finger and gently slide it into your rectum. This should not be painful, but may be a little bit uncomfortable.
- Sometimes ask you to squeeze around their finger so they can assess how well the muscles are working.
If you’re a man, the doctor or nurse may press on your prostate. This can make you feel the urge to pee, but it should not hurt.
Once you’re dressed, they’ll discuss the results of the examination with you.
Page last reviewed: 23 December 2020
Next review due: 23 December 2023
A rectal exam, otherwise known as a digital rectal exam or DRE, is an examination of the inside of the rectum and can be one way to detect signs of colon cancer or other indicators that a colonoscopy may be necessary. During the procedure, a physician inserts a gloved, lubricated finger into the rectum to feel for abnormalities. No colon cleansing is necessary. The test happens quickly and usually does not hurt at all. However, the test can only detect problems in the lower rectal area, not the colon. Additional screening tests would need to be performed to find polyps or lesions deeper inside.
Rectal Exam Procedure
During a regular physical exam, after other tests and checks have been administered, a doctor or nurse will ask you to undress completely while he or she leaves the room for a few minutes. A paper hospital gown will be left in the room for minimal coverage.
When the doctor re-enters the room, you will need to position yourself in a way that the anus is accessible to the doctor. This may mean you will need to lie on your side on top of the examination table with your knees pulled toward your chest, to assume a squatting position on the table or to stand flat-footed on the floor while bent over. Some doctor’s offices may be equipped with an apparatus that allows patients to lie comfortably on their backs, at a slight tilt, while their feet rest on stirrups, giving the doctor access to the rectum and anal area between the patients’ legs.
The doctor will then use hands, protected with sterile latex gloves to prevent contamination, to spread the buttocks apart while he or she examines the external area surrounding the anus and perineum. If there are any signs of inflammation or abnormal growths, the doctor will be able to study them at this point of the exam. Common conditions detected on the external part of the colorectal area include rashes and hemorrhoids.
For the second, internal part of the rectal exam, the patient will be asked to relax while the doctor inserts his or her gloved finger into the rectum and through the anus, feeling the patient’s insides for signs of health problems. Most doctors will use a lubricator to allow smoother access. This part of the rectal exam lasts only about a minute.
Patients checking for the following conditions may undergo a digital rectal exam as a preliminary screening test: colorectal cancer, hemorrhoids, prostate cancer in men and ovarian cancer in women.
If your doctor detects cancerous or even non-cancerous tumors during a rectal exam, it is possible that you have one of several health conditions. Patients checking for the following conditions may undergo a digital rectal exam as a preliminary screening test: colorectal cancer, hemorrhoids, prostate cancer in men and ovarian cancer in women. A digital rectal exam is often administered before a regular colonoscopy, as well.
Further Testing After A Rectal Exam
Talk to your GI doctor if you are experiencing constipation—rectal exams can also be used to evaluate the hardness of a patient’s feces. The exam also tests the tonicity of the anal sphincter, for patients who have experienced severe injuries or are having problems controlling their bowel movements. The test is often ordered in conjunction with routine blood tests such as fecal occult blood test (FOBT) or fecal immunochemical test (FIT) for patients who might be bleeding internally.
A digital rectal exam is only a preliminary step in determining whether you have colon cancer. As the test is limited to less than 10 percent of the colon wall, the test is not a keen indicator of colon polyps, colon pouches, or pre-cancerous growths existing deeper inside the GI tract.
Overall, a digital rectal exam is only a preliminary step in determining whether you have colon cancer. As the test is limited to less than 10 percent of the colon wall, the test is not a keen indicator of colon polyps, colon pouches or pre-cancerous growths existing deeper inside the gastrointestinal (GI) tract. Oftentimes, regular screenings with colonoscopy, sigmoidoscopy or certain x-ray procedures may be ordered, even if a rectal exam produces negative results.
Does the thought of examining your patients’ rectums leave your head spinning? I understand: The thought of performing your first anoscopy can be rather intimidating. However, the procedure is actually quite simple, and I’m here to help you through it.
So take a deep breath and gather your supplies. Ahead, you’ll learn what you need for this exam, and I’ll walk you step by step through how to use an anoscope.
Before you know it, you’ll be ready to perform this procedure on your own, and all qualms about conducting anal exams will have faded from memory. But first, read on to become an expert at using an anoscope.
What You Will Need When Using an Anoscope
This is a procedure that is usually performed on an outpatient basis in a doctor’s office or a hospital setting. To perform an exam on a patient, you will need the following supplies:
The primary tool used for this procedure is an anoscope. This two-part device is comprised of a hollow outer sheath and a solid inner obturator. The obturator has a rounded end to ease insertion. This piece is removable after insertion.
Anoscopes can be made of metal or plastic. Typically, metal anoscopes are reusable, but they must be sterilized between uses. Most plastic anoscopes are disposable.
Not only do disposable plastic anoscopes require less preparation and post-procedure cleaning, but they are also advantageous because of their clear construction. You can see through the transparent material to detect fissures or other concerns with the tissue under the scope.
Typically, an anoscope is about 2 inches wide, which is comparable to the width of a normal bowel movement. In other words, the body is used to accommodating an object of that size. Even still, inserting a probe from the opposite end can require some coaxing.
Therefore, it is important to generously coat the instrument with lubricant before attempting insertion. This will ease the effort required of the medical practitioner and will increase comfort for the patient. A water-based, medical-grade lubricant is recommended.
To perform a careful and thorough exam, the rectal area must be fully illuminated. Practitioners have several options for this requirement. Some anoscopes have built-in lights.
Others do not come with attached lights, which gives the doctor the freedom to use the preferred light of his or her choice. A penlight or other handheld device can work well because it allows the practitioner to direct the beam precisely where it is needed. If you do not have a free hand, an assistant can hold the light.
Another option is to use a light that is mounted on your forehead.
A rectal exam opens up the anus and the rectum so you have access to the tissue inside. Once access has been granted, you may need swabs with which to clean the passage or to examine the health of the region.
For example, long cotton swabs are useful for wiping away fecal matter or excess lubricant in the examination area. Culture swabs may be necessary if an infection is suspected.
Gloves or Other Protective Garments
The doctor and nurses involved with the procedure should dress in the appropriate protective gear to reduce the transmission of infection and to protect their clothing during the exam.
Rectal (PR) examinations are performed for a number of clinical reasons, such as altered bowel habit, rectal bleeding, or urinary symptoms. It is a skill surgeons perform on all patients and as such it is commonly examined as it is an important skill to know.
For the purpose of examinations you will be provided with a mannequin, however you should pretend it is a real patient and talk to it as such as this forms part of the marking scheme.
Wash your hands, introduce yourself to the patient and clarify their identity. Explain what you would like to do and obtain consent. This is a slightly uncomfortable procedure so you should warn the patient of this.
A chaperone is required for this examination.
Ensure you have all of the necessary equipment for the station:
Positioning of the patient in this procedure is very important. Ask them to lie on their left hand side with their knees drawn up towards their chest, their feet pushed forward and their anus exposed.
Having washed your hands and put on your gloves, separate the buttocks and inspect the area around the anus. Look for any abnormalities including skin tags, haemorrhoids and fissures.
After inspecting, lubricate your right index finger.
Tell the patient you are about to start the procedure. Place your finger on the anus so that it points anteriorly and apply pressure to the midline of the anus.
Maintain the pressure so that your finger enters the rectum. Initially you need to assess anal tone by asking the patient to squeeze your finger.
Systematically examine each part of the rectum by sweeping the finger both clockwise and anti-clockwise around the entire circumference. You should be feeling for any abnormalities such as impacted faeces, masses or ulcers.
One of the main reasons for performing a rectal examination in males is to assess the prostate gland. This lies anteriorly and should always be felt. You should check the size, consistency and presence of the midline groove.
Remove your finger and examine the glove for the colour of any faeces as well as the presence of any mucus or blood.
Clean off any lubricant left around the anus and remove and dispose of your gloves in the clinical waste bin.
Allow the patient to dress and thank them. Wash your hands and report your findings to the examiner.
Assessing the Benefits and Limitations of the Procedure
Monique Rainford, MD, is board-certified in obstetrics-gynecology, and currently serves as an Assistant Clinical Professor at Yale Medicine. She is the former chief of obstetrics-gynecology at Yale Health.
A rectovaginal examination is a manual physical examination of the rectum and the vagina, It is not a standard part of a medical or gynecological evaluation, but you might need it if there is a concern about issues such as rectal involvement of endometriosis, a rectovaginal fistula (an abnormal connection between the rectum and vagina), or rectal or vaginal cancer.
A pelvic exam is typically recommended for females for the purpose of evaluating symptoms such as irregular bleeding or discharge, and for screening for malignancy (cancer). Components of a pelvic exam can include a speculum exam, bimanual exam, and rectovaginal exam.
Purpose of a Rectovaginal Exam
A rectovaginal exam can allow your healthcare provider to examine and identify abnormalities in your pelvic area, including the cervix, uterus, ovaries, fallopian tubes, anus, and rectum.
The recto-vaginal exam is not a particularly accurate screening exam and is usually reserved for people who either have rectal or pelvic pain or are experiencing symptoms related to the genitourinary tract (such as pain, urinary urgency, or abnormal bleeding).
Other reasons for the exam can include:
- Identifying scarring or a mass that could indicate cancer or another disease
- Obtaining a fecal blood sample (blood in the stool)
- Diagnosing a tilted pelvis
Although a pelvic exam is considered important for identifying and treating cancer, sexually transmitted infections (STIs), and other genitourinary tract disorders, a rectovaginal exam offers uncertain benefits.
According to a 2016 review of studies in the Journal of the American Association of Nurse Practitioners, a rectovaginal exam has a low sensitivity in detecting uterosacral nodules, rectal compression, cervical involvement of endometrial cancer, and colorectal cancer. This means it misses many of these problems.
How a Rectovaginal Exam Is Performed
Normally, there is no special preparation needed before having a rectovaginal exam. As with any pelvic exam, you should not engage in sexual intercourse (including anal sex) for 24 hours prior to your appointment. In some cases, your healthcare provider may want you to take a laxative and will advise you about this beforehand.
A rectovaginal exam typically lasts for less than a minute, but it may last longer if your medical professional finds something concerning. It can be a little uncomfortable, but should not produce any real pain. Deep breathing and relaxing your pelvic muscles can help. If you feel any pain, let your healthcare provider know.
There are no risks involved with the procedure.
To do your rectovaginal exam, your practitioner will:
- Insert a gloved, lubricated finger into your vagina
- Insert another finger from the same hand into your rectum
- Palpate (examine by feeling) your abdomen with the other hand
During this procedure, your healthcare provider will evaluate the tissues in your rectum and vagina, the tone and alignment of your pelvic organs, including the ovaries and fallopian tubes, and the ligaments that hold the uterus in place.
When a Rectovaginal Exam Is Indicated
Your healthcare provider might consider doing a rectovaginal exam if you have pain, discomfort, or pressure that seems like it is coming from the anal or rectal area. They might also do this exam if they detect a possible growth or abnormality in or near your rectum while they are doing other parts of your pelvic exam.
In general, a rectovaginal exam is considered when symptoms or other examination findings raise the possibility of a problem involving both the rectum and the vagina. You and your medical professional will discuss this part of the exam and why it is being done.
Even if you have a rectovaginal exam, there is a high chance that your symptoms are not caused by a serious problem and that your symptoms can be effectively treated.
Other Female Rectal Exams
Besides a rectovaginal exam, there are other types of rectal exams, typically for evaluation of gastrointestinal problems.
- Stool sample: Generally, one of the most common reasons for a rectal exam is testing for blood in the stool. This could be a concern if you have obvious blood streaks in the toilet, blood on the toilet paper, black tarry stools, unexplained weight loss, vomiting blood, or diarrhea.
- Anal sphincter tone: Additionally, you might have a rectal exam if you have experienced stool incontinence or if you are unable to control your stool. In this case, your healthcare provider would do a rectal exam to check your anal sphincter tone, which can affect your control over your stool.
Pelvic Exam Recommendations
The American Congress of Obstetricians and Gynecologists (ACOG) guidelines include the following recommendations:
- The decision to have a pelvic exam should involve shared decision making between the patient and practitioner.
- A pelvic exam is recommended for people who have symptoms of an STI or other pelvic conditions.
- For people who do not have symptoms of illness, a pelvic exam is necessary before placement of an intrauterine device (IUD) but is not necessary before prescription of other forms of birth control.
Frequently Asked Questions (FAQs)
When is a rectovaginal exam indicated?
You may need to have a rectovaginal exam if you have an abnormal appearance, sensation, or control of your rectal and vaginal areas.
What is a healthcare provider checking for during a rectovaginal exam?
During this exam, your healthcare provider is checking for tenderness, structural irregularities, discharge, blood, and altered muscle tone.
Do I have to let my gynecologist perform a rectovaginal examination?
You do not have to agree to any exam you don’t want. Discuss alternate approaches that might help in diagnosing your problem.
Does a recotovaginal exam hurt?
It shouldn’t hurt, but it can be uncomfortable or even painful if you have a medical problem affecting your rectum or vagina.
A Word From Verywell
Gynecological examinations are often needed for screening or to evaluate symptoms. These physical examination techniques can help your healthcare provider decide about the next steps in your diagnostic evaluation or treatment plan.
If you have any questions or if you are hesitant about any part of your exam, be sure to talk about it either with your practitioner or with someone else on your medical team until you feel that your concerns and questions have been addressed to your satisfaction.
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What is a prostate/rectal ultrasound?
A prostate or rectal ultrasound is an imaging test that uses sound waves to look at your prostate or your rectum.
The healthcare provider uses a small probe called a transducer to make the images of your prostate or rectum. The transducer is about the size of a finger. It is gently placed into your rectum, where it sends out sound waves that bounce off your organs and other structures. The sound waves are too high-pitched for you to hear. The transducer then picks up the bounced sound waves. These are made into pictures of your organs.
Your provider can add another device called a Doppler probe to the transducer. This probe lets your provider hear the sound waves the transducer sends out. He or she can hear how fast blood is flowing through a blood vessel and in which direction it is flowing. No sound or a faint sound may mean that you have a blockage in the flow.
Why might I need a prostate/rectal ultrasound?
A prostate/rectal ultrasound may be used to check the size, location, and shape of the prostate gland and nearby structures. It may be used to look at the prostate gland for signs of cancer or other conditions. It’s often the next step after a finding of raised (elevated) prostate-specific antigen (PSA) during a blood test. Prostate/rectal ultrasound may be used to stage and watch treatment of rectal cancer. It is also used to look at the rectum for other problems.
Your healthcare provider may also use a prostate/rectal ultrasound to help place a needle to take a tissue sample (biopsy) . Or he or she may use it to help place radiation seeds used to treat prostate cancer.
Your provider may also use the test to see how well blood is flowing to the prostate or find masses.
Your provider may have other reasons to recommend a prostate/rectal ultrasound.
What are the risks of a prostate/rectal ultrasound?
An ultrasound has no risk from radiation. Most people have mild discomfort from the transducer being placed in the rectum.
Tell your healthcare provider if you are allergic to latex. The probe is placed in a latex covering before it is put into the rectum.
You may have risks depending on your specific health condition. Be certain your healthcare provider knows about all of your health conditions before the procedure.
Too much stool in the rectum may make the test less accurate.
How do I get ready for a prostate/rectal ultrasound?
Your healthcare provider will explain the procedure and you can ask questions. Make a list of questions and any concerns with your healthcare provider before the procedure. Consider bringing a family member or trusted friend to the medical appointment to help you remember your questions and concerns.
You may be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
You may be asked to stop taking blood-thinning medicines, such as aspirin, for a week or so before the test if it is being done as part of a biopsy.
You usually do not need to stop eating or drinking before the test. You also usually will not need medicine to help you relax (sedation).
You may be given a small enema before the test.
Follow any other instructions your provider gives you to get ready.
What happens during a prostate/rectal ultrasound?
You may have a prostate/rectal ultrasound done as an outpatient or during a hospital stay. The way the test is done may vary depending on your condition and your healthcare provider’s practices.
Generally, a prostate/rectal ultrasound follows this process:
You will need to remove any clothing, jewelry, or other objects that may get in the way of the procedure.
If asked to remove clothing, you will be given a gown to wear.
You will lie on an exam table on your left side with your knees bent up to your chest.
The healthcare provider may do a digital rectal exam before the ultrasound.
The provider puts a clear gel on the transducer and puts the probe into the rectum. You may feel a fullness of the rectum at this time.
The provider will turn the transducer slightly several times to see different parts of the prostate gland and other structures.
If blood flow is being looked at, you may hear a whoosh, whoosh sound when the Doppler probe is used.
Once the test is done, the provider will wipe off the gel.
A prostate/rectal ultrasound may be uncomfortable and you will need to remain still during the test. The gel will also feel cool and wet. The technologist will use all possible comfort measures and do the scan as quickly as possible to minimize any discomfort.
What happens after a prostate/rectal ultrasound?
You don’t need any special care after a prostate/rectal ultrasound. You may go back to your usual diet and activities unless your healthcare provider tells you otherwise.
- 1 University of Pittsburgh School of Medicine, 303 Church Ln, Pittsburgh, PA, 15238-1063, USA. [email protected]
- 2 Division of Gastroenterology & Hepatology, University of Wisconsin School of Medicine & Public Health, Centennial Building, 1685 Highland Ave, Madison, WI, 53705-2281, USA. [email protected]
- PMID: 26739462
- DOI: 10.1007/s11894-015-0478-5
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- 1 University of Pittsburgh School of Medicine, 303 Church Ln, Pittsburgh, PA, 15238-1063, USA. [email protected]
- 2 Division of Gastroenterology & Hepatology, University of Wisconsin School of Medicine & Public Health, Centennial Building, 1685 Highland Ave, Madison, WI, 53705-2281, USA. [email protected]
- PMID: 26739462
- DOI: 10.1007/s11894-015-0478-5
The digital rectal examination (DRE) is performed in children less often than is indicated. Indications for the pediatric DRE include diarrhea, constipation, fecal incontinence, abdominal pain, gastrointestinal bleeding, and anemia. Less well-recognized indications may include abdominal mass, urinary symptoms, neurologic symptoms, urogenital or gynecologic symptoms, and anemia. Indeed, we believe that it should be considered part of a complete physical examination in children presenting with many different complaints. Physicians avoid this part of the physical examination in both children and adults for a number of reasons: discomfort on the part of the health care provider; belief that no useful information will be provided; lack of adequate training and experience in the performance of the DRE; conviction that planned “orders” or testing can obviate the need for the DRE; worry about “assaulting” a patient, particularly one who is small, young, and subordinate; anticipation that the exam will be refused by patient or parent; and concern regarding the time involved in the exam. The rationale and clinical utility of the DRE will be summarized in this article. In addition, the components of a complete pediatric DRE, along with suggestions for efficiently obtaining the child’s consent and cooperation, will be presented.
Keywords: Anus; Child; Digital rectal exam; Pediatric; Pediatric rectal exam; Rectal exam.
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|Subject: Rectal exams|