Digital Prostate Exams Gone!?

On Friday I had my annual physical with my very attractive 20 something APRN. I look forward to this event every year mostly because I get the cursory hernia exam and a digital prostate exam from her and these are the highlights of my day/week. Everything went as planned on Friday, but before she did the prostate exam she told me that more recent medical information is disputing the value of these exams because it is questionable whether they actually identify an issue. She also said that most Doctors continue to perform them out of habit and she said that as long as I was comfortable with the procedure she would perform it. Of course I said I was and she completed the exam to my enjoyment, but could it be possible that this exam will go away in the future?? If so, I may have to invent other reasons to get her to perform the exam! Maybe I will fain rectal issues! Thoughts?

It will be interesting to see what some of our medical professional members have to say about this issue. From what I remember based on media reports is that the blood test- PSA was now given more weight as indicator of prostate cancer vs. what a physician could detect during a DRE and so the exam was less important. Not sure if that is what you doctor was indirectly referring to, but I am guessing that is the reason for not doing the DRE.

I for one think the DRE is of value because when it is combined with the PSA (at least it is on my physical) having two pieces of data provides a more precise picture of your prostate health.

My doctor still does the rectal exam.

Bill

DREs are done for more reasons than to evaluate prostate malignancy. They're used to evaluate possible prostatic hypertrophy, rectal malignancy and the presence of occult blood. They are used to evaluate anal sphincter tone and female genitals. External hemorrhoids can be evaluated but not internal ones. They are still useful exams and won't go away anytime soon.

In my case the PSA revealed cancer and none of Doctors felt anything with the DRE. Had it removed and no further trouble 16 1/2 years.

Course

I failed to mention I am still receiving DRE exams and PSA every year.

I really don't see a downside to doing DREs. They are easy to do and can reveal lots of problems beyond prostate cancer as Liquidsky noted. I always feel it is better to know something than to be ignorant.

I think DREs should be part of any physical exam regardless of age.

Now if the patient is adamantly against having it done for whatever reason then no don't do it.

I don't do screening or routine physicals. Since I'm an emergency physician I do focused exams. I don't do them on routine exams for uncontrolled diabetes and many other conditions. I just know when to do them. Again, the history dictates the physical exam.

My FP doesn't do DRE's anymore. He relies on PSA's solely. Since my chemo for colon cancer, my PSA's are one tenth of the normal person's.

My doctor still does DPE and checks my PSA at every physical.

My PCP relies on labs. My urologist uses the DRE and PSA.

I heard they are in the process of changing from digital to analog rectal exams.

I heard they are in the process of changing from digital to analog rectal exams.

Actually, with computers getting faster and cheaper all the time, it's best to stick with the digital exams. Plus your results will be a much clearer binary answer rather than the larger, more granular scale of values that you'd get with an anal-og exam. 😃

As much as I enjoy the thought of an attractive woman MD, PA, or nurse handling my package, I've never had to suffer the finger up the ass. Not yet anyway.

If current trends are any indications, the full physical exam is becoming a lost art anyway.

I was bummed out that my female doc didn't do the prostate exam at my last physical in October 2015. Seems to be the trend.

Though I like stimulation "back there," as much or more than the next guy, I would be delighted if DRE's vanished from the medical scene. I despise my male doctor sticking his finger up my butt. In a medical setting, I would despise it only slightly less if performed by a woman doctor. Now, in another setting...

It has not been my experience that digital rectal exams are gone. I still get one during every physical exam. Haven't had a doctor in many years who skipped that part. The type of doctor may make a difference. A physical exam by an internal medicine doctor is likely to be more thorough than with a regular family doctor who has many patients to see each hour. I got my first DRE in my 20s from an internist. I realize now that he wasn't checking my prostate. He was checking for other abnormalities in the rectum such as tumors. I have had one DRE from a physician's assistant too. The only doctors who haven't done DREs for a physical were general practitioners who did physicals in five or ten minutes. If you are not getting a DRE and you are 40 or older, then you are seeing the wrong kind of doctor.

A DRE performed by my urologist in 2002 found a small tumor on the prostate. Needle biopsy done a week later confirmed the worst. The PSA numbers were well within the normal range for a 58 year old man. The numbers did increase a month later. Do not depend on the PSA by itself.

Prostatectomy a few months later took out the cancer. Guys, get the finger, it might save your life.

Neither the DRE nor the PSA test are going anywhere. They are complimentary. Very few men develop infections after prostate biopsy and even fewer die.

My wife has been nagging me to get a routine physical. Last one I had was over 5 years ago. It's been close to 15 years since I've had a DRE. I'm 47 now. Perhaps I shouldn't get my hopes up, but if I don't get a DRE at a physical this year I'll feel ripped off.

Should I ask for one if it is not forthcoming as the exam progresses?

Just ask for it. Any physician will oblige you. Just don't expect more than a ten second exam!

There are some studies suggesting the elimination of routine PSA's. A big part of it is the false positives and the cost of biopsies. This is pandering to the insurance companies.

My feeling is, if a test is positive, then my doctor and I can discuss if it warrents a biopsy or not. Perhaps watching it is a better course. But if I don't have the test, I'll not have that option.

Same for me at my most recent complete physical. Even after going over my medical history and family medical history (my father having prostate issues) the doctor did not do a DRE. He said they are a thing of the past.

I had my first visit with my new doc Monday. I had to ask for the Dre and I have a first degree relative who has had both prostate AND colon cancer.

When he passed me the cleanup mzrerials, he jsut stripped his gloves and didn't even think about the occult blood screen.

At least he listened. .But I still.need to have a long talk, as Uncle Jed used to say...

As long as I'm your "doctor" you can ALWAYS count on being bent over my exam table. 😉

You boys are so hot. I would have so loved to have been a fly on the wall in that hotel room. Wowza!

Mashie

You boys are so hot. I would have so loved to have been a fly on the wall in that hotel room. Wowza!

Mashie

You can be the nurse in the room next time 😃

I would so love that! Count me in!

Mashie

While my F.P. Doc doesn't do them anymore, my urologist does. I always prep. for them with an 8 oz. bulb of war water. I'd be mortified if he pulled out the gloved finger, dirty.

Looks like you guys got the short end...Digital inspection I think is an important element of mens prostate health