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A DRE (Digital Rectal Examination) is a procedure where the doctor inserts his finger (the Digit) in the patient's anus (the entrance to the Rectum) in order to feel the condition of the prostate. While this sounds rather uncomfortable it is not as bad as it sounds, especially if you know what to expect. The DRE is, or should be, a routine part of any doctor's routine medical exam for men over 40. If you've never had a DRE, you're probably under 40 or don't see a doctor.
The patient drops his underpants and bends over the examination table resting on his elbows. Some doctors believe it makes the whole procedure a little easier if the patient stands with his feet turned so that the toes are inward (pigeon-toed) and may so instruct the patient. While the patient is getting comfortable the doctor puts on a latex glove and applies a large amount of KY jelly to the index finger. The index finger is applied to the target area and slowly pushed inside.
Once the finger is inserted as far as it will go the doctor presses downward and moves his or her finger around to judge the size, shape, and degree of firmness of the prostate. It is also possible to detect small nodules or growths which may indicate the presence of cancer. The doctor will usually ask if the pressure on the prostate hurts. The patient should reply as truthfully as possible. This is not the place for male stoicism! A painful, swollen, prostate may have an abscess which could make further examination very dangerous.
The doctor should next press hard enough to force some prostatic fluid out for further tests. But many unfortunately do not, preferring instead to immediately prescribe an antibiotic and get on to their next patient. It is important not to tense up during this procedure. The patient may feel like he is about to urinate all over the nice clean floor but this will not happen. He may feel a few drops of prostatic fluid moving up the penis. The patient should relax as much as possible and allow the fluid to come out. The doctor will usually collect this fluid either on a microscope slide, on a swab, or in a small jar.
When the examination is completed the patient is given a box of tissues and is expected to wipe off the excess jelly before pulling his underpants back up. Some doctors will immediately examine the specimen under a microscope to see if there are any white blood cells (WBC). This is generally considered a sign that there may be an infection present.
Ideally the fluid will be sent to a lab for culturing and sensitivity testing to determine first, what the pathogen is, and second, which antibiotics can kill it. It may take up to a week or more to get the results of the culturing.
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