Rigi10™ Malleable Penile Prosthesis
Also Known As
DRE, rectal exam, rectal examination, digital examination of rectum, prostate examination, manual rectal examination
Definition
A digital rectal examination (DRE) is a medical diagnostic procedure in which a healthcare provider inserts a gloved, lubricated finger (“digit”) into the patient’s rectum through the anus to examine the lower rectum, anus, and in males, the prostate gland.1 The procedure allows clinicians to palpate and assess for abnormalities in texture, size, and shape of these structures.2 During the examination, the healthcare provider feels the prostate gland for anything concerning in the texture, shape or size of the gland.3 The examination is typically fast and painless, though some patients may experience mild discomfort or pressure during the procedure.1 No preparation is required for this examination, and it serves as an important diagnostic tool for detecting various conditions affecting the rectum, anus, and prostate.4
Clinical Context
The digital rectal examination is performed in various clinical contexts to assess and diagnose multiple conditions.1 In male patients, it is primarily used to evaluate the prostate gland for signs of benign prostatic hyperplasia (enlarged prostate), prostate infection (prostatitis), or prostate cancer.2 While historically used as a standalone screening test for prostate cancer, current evidence suggests its efficacy as a screening tool is limited, with a pooled sensitivity of 0.51 (95% CI, 0.36–0.67) and specificity of 0.59 (95% CI, 0.41–0.76) when performed in primary care settings.1
In both male and female patients, the DRE is used to:
- Diagnose rectal tumors or abnormalities4
- Assess for hemorrhoids or anal fissures5
- Obtain fecal samples for occult blood testing (to screen for gastrointestinal bleeding or colorectal cancer)4
- Evaluate the function of the anal sphincter in cases of fecal incontinence4
- Check for causes of rectal bleeding4
- In females, assess the space between the vagina and rectum4
The procedure is typically performed as part of a comprehensive physical examination by primary care providers, urologists, gastroenterologists, and other specialists.5 For prostate cancer detection, it is often used in conjunction with prostate-specific antigen (PSA) testing, though current guidelines vary regarding its routine use for prostate cancer screening.3 The U.S. Preventive Services Task Force does not recommend DRE as a primary screening tool for prostate cancer, while other organizations maintain it as part of their screening recommendations.5