How A Doctor Performs A Prostate Exam

The prostate, a compact yet essential component of the male reproductive system, plays a crucial role in men’s health and vitality (1). The prostate produces a fluid that combines with sperm.

The prostate fluid plays a role in supporting the health of sperm, potentially aiding in reproduction. It also assists in the survival of semen within the vaginal environment.

There are times when a prostate may give a man problems. Several complications have been linked to the prostate gland. Benign prostatic hyperplasia is generally considered the most common type of prostate condition.

Other common issues that men are concerned about include prostate cancer and prostatitis

Prostate screening, which typically includes a prostate exam, is an initial diagnostic tool for detecting these problems.

While men may find this procedure uncomfortable, it is essential to understand its benefits for their health.

We take a look at how a prostate exam is done. The post also considers why a prostate exam is done. 

Why Are Prostate Exams Performed?

Many men may not fully understand the importance of regular prostate exams. When a man goes for a general check-up with his doctor, a prostate exam may be advised. This is considered part of a general health check-up. 

It is commonly recommended that men consider regular health screenings starting around the age of 40. (2). Research shows that this is the time when the risk of several prostate conditions increases.

For this reason, after 40, a man should ensure they obtain a prostate exam as part of their health screening. 

One of the primary purposes of a doctor-recommended prostate exam is to check for any potential abnormalities in the prostate, which can be indicative of prostate conditions. This helps detect prostate disease. It is usually possible for a doctor to determine the health of the man’s prostate through this examination. Further testing may be needed too. 

The doctor can detect different prostate problems through a prostate exam. It is often considered the initial diagnostic option. The prostate exam itself can give a doctor an indication if there is an enlargement or swelling in the prostate gland. It also helps to determine prostate health. 

While a prostate exam is an important initial step, it is often followed by additional diagnostic tests, including a digital rectal exam, if any irregularities are detected. These tests help in the comprehensive diagnosis of conditions like cancer and prostate enlargement.

Early diagnosis

Another important reason for regular prostate exams is early diagnosis. Some conditions may worsen without treatment, including the potential for complications with cancer. In some cases, cancer cells can become metastatic. In this scenario, cancer spreads to other parts of the patient’s body, which can lead to life-threatening problems. 

Benign prostatic hyperplasia also becomes worse when the condition is left without treatment. This can lead to more severe lower urinary tract symptoms. The patient may also be at risk of a urinary tract infection and issues with their bladder. 

Early diagnosis of these conditions often leads to more successful treatment outcomes and may make treatment more manageable. It is also generally easier to treat a condition when it is still in an early developmental stage.

In cases of cancer, active surveillance may be recommended based on individual risk factors and medical advice. Routine screening helps ensure timely treatment when needed.

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Who Should Get A Prostate Exam?

Understanding the importance of prostate exams is essential for men to determine when a digital rectal exam (DRE) is necessary. While age is a significant risk factor, the timing of prostate exams should be guided by individual health assessments and medical advice.

Prostate exams become especially important as men reach the age of 60, as the risk tends to increase with age. It’s also crucial for men to seek a prostate exam if they experience certain symptoms associated with prostate problems. Consulting a healthcare professional for proper evaluation is recommended to address symptoms or pain in specific areas, as they could indicate various prostate issues or the possibility of prostate cancer.

While age is a significant risk factor for prostate problems, individual health assessments and medical advice should guide the timing of prostate exams. Thus, men over 40 should ensure they get regular health screening. The man should also provide a prostate exam as part of the health screening. 

Prostate exams become especially important as men reach the age of 60, as the risk of prostate problems tends to increase with age. Thus, at the age of 60, a man should never delay a prostate exam. 

There are other reasons for men to get a prostate exam, apart from age. 

Men who experience certain symptoms should ensure they get a prostate exam. A man should educate himself on common symptoms associated with prostate problems. 

The sooner the prostate exam is done once the symptoms appear, the earlier a diagnosis can be made. 

Most prostate conditions will cause an enlargement of the gland. Sometimes inflammation may affect the gland instead. The prostate gland is situated directly beneath the bladder. It also surrounds the urethra. This is why men will usually experience lower urinary symptoms when they have a prostate problem. 


Symptoms that men should look out for include (3):

  • There may be a frequent urge for the man to urinate. 

  • The man may need to get up frequently to urinate throughout the night. (nocturia)

  • Even though there is an urge to urinate, there may only be a few dribbles of urine, also known as urinary hesitancy.

  • Dribbling may sometimes occur after the man urinates. 

  • In some cases, blood may appear in the semen or urine of the man. 

  • When the man ejaculates, he may experience pain.


There are also cases where areas other than the groin may be affected by symptoms. Men should be concerned about the pain that develops in these areas:

  • Rectal region

  • Thighs

  • Lower back

  • Hips

  • Pelvis

Pain in these areas may be associated with various prostate issues, including the possibility of prostate cancer. Consult a healthcare professional for a proper evaluation. Prostate cancer screening is essential in such a scenario. Cancer screening helps to ensure this type of disease is diagnosed early. 

What Is A Digital Rectal Exam?

Men need to understand what exactly a rectal examination is. This education should be important, in addition to understanding why this process needs to be done. Prostate exams are commonly performed in male patients. 

A digital rectal exam is a procedure that doctors use to identify problems with the prostate gland. This is a standard method for doctors to analyze the health of the prostate in a male patient. It is also a procedure that does not require any invasive tools. The process is quick and easy for the doctor to conduct. 

Men need to realize that the test may be a little uncomfortable. It is still a non-invasive process, however. 

How it works

There is a specific step-by-step process that doctors use for a digital rectal exam. Here is an overview of how the procedure works:

  • The doctor asks the man to lay on their side. Some doctors rather prefer the man bends at their risk. If this is the case, the patient will stand up while the procedure is being performed. The knees will be bent forward if the man is asked to lie down. 

  • The doctor will place a glove over their finger or entire hand. The finger that will be used during the prostate exam is lubricated. The doctor uses a safe lubricant on the glove. This ensures no unneeded irritation occurs in the rectum of the patient. 

  • The doctor places the hand without lubrication on the man’s prostate.

  • A finger from the other hand is then slowly and gently pushed inside the rectum. The doctor will be gentle to avoid excessive discomfort. 

  • One the finger is inside the man’s rectum, the doctor will feel around to determine if there are any abnormalities with the man’s prostate. 

  • The doctor will also feel the prostate area on the outside while doing the prostate exam. 

The test does not last long. The doctor will be done within a couple of minutes. The man may experience a little discomfort during the procedure. Once the procedure is over, the discomfort will no longer be experienced. 

Some men experience an urge to urinate during the exam. The sensation may be more significant if the prostate is inflamed. The same can happen if the patient has an enlarged prostate

There are no serious risks associated with a digital rectal examination. 

Any abnormalities will be detected during this exam. If this is the case, the doctor will discuss their findings with the patient. The doctor may then advise the patient to undergo further testing. This will help to ensure suspected conditions can be identified. 

What Is A PSA Test?

If the doctor finds abnormalities during the DRE, then the patient needs to undergo more tests. A PSA test is very commonly requested. It is also called a prostate-specific antigen test, or a PSA blood test.

A PSA test measures the level of prostate-specific antigen in the patient’s bloodstream. This is an indicator of various prostate-related conditions. The doctor may use the results from a PSA test to determine the abnormality of the male patient’s prostate. 

Several conditions may be detected through a PSA test. This is because the level of PSA in the body increases when certain things affect the prostate gland. 

When the prostate is affected by inflammation, the PSA levels will generally increase. The same happens when the man develops an infection in their prostate. 

An enlargement of the prostate gland is also known to elevate the protein levels in the man’s body. This is an indication of benign prostatic hyperplasia, a prevalent condition in men. When left untreated, an enlarged prostate can cause problems. This includes a risk of infections – bladder infection and urinary tract infections can occur. 

A PSA test can also help in the diagnosis of prostate cancer. When cancerous cells develop in the prostate gland, the PSA levels in the man’s body will also rise. 

A PSA test cannot definitively diagnose prostate cancer on its own. Further tests and evaluations are needed to confirm the diagnosis. It can, however, help the doctor determine if their suspicions are correct. If the PSA levels are significantly high, the doctor will generally request imaging tests. 

These imaging tests will provide a view of the prostate gland. It can be used to determine if there is abnormal growth affecting the prostate. This may be an indication of cancer. The doctor can also use imaging tests to see if there is an enlargement of the patient’s prostate gland. 

How Should I Prepare For The Exam?

Men need to understand how they should prepare for a prostate exam. The first thing to know is how the process works. Men should know exactly what to expect. This will help them to remain relaxed during the procedure. The man will also be able to breathe normally if they know how the procedure works. 

Men do need to ensure that they tell the doctor if they have any problems with their anus or rectum. This includes telling the doctor about hemorrhoids. The man should also tell the doctor if they have an anal tear. 

When the man needs to undergo a PSA test, there are a few things they should tell their doctor too.

A list of medications and supplements taken by the man should be noted to the doctor. There are a few products that can interfere with the results of a PSA test. The doctor will be able to determine if any drugs the patient takes may alter the PSA test results

The man also needs to understand that ejaculation can affect their PSA levels. If the man had recently ejaculated, they should note this to the doctor too. Men should also ensure they do not ejaculate too closely to a PSA test. A doctor will be able to tell the patient if they need to avoid having sexual intercourse prior to the test. 

What Do The Results Mean?

If the doctor identifies an abnormality with the prostate, they will discuss the findings with the patient. The doctor may be able to tell the patient what the abnormality may mean. This could include cancer, prostatitis, and an enlarged prostate

Men need to understand what PSA levels mean too. If a PSA test is done, the doctor will be able to tell the patient how much prostate-specific antigen is in their blood. 

The PSA test provides a measurement in ng/ml. 

Here is an indication of what the measurements mean:

  • If the PSA levels are under 4ng/mL, then the test is normal. This means the man’s prostate should be healthy and not have serious abnormalities. 

  • If the PSA levels are between 4ng/mL and 10ng/mL, then it means there might be a problem with a man’s prostate. In these cases, it might mean there is inflammation or infection in the prostate gland. 

  • When the PSA level is higher than 10ng/mL, then it is considered to be too high. In this case, the doctor may order further tests. The doctor may have concerns about prostate cancer based on elevated PSA levels, but a confirmed diagnosis requires additional testing and evaluation.

In some cases, a urologist may monitor the rate of change in PSA levels over time, which could involve multiple PSA tests. This is done to assess any significant fluctuations and guide further evaluation

It’s important to note that PSA levels can be influenced by various factors, including medication and other health conditions. A final diagnosis is typically made after considering PSA levels in combination with other tests and clinical assessments.

What Happens After The Exam?

When abnormalities are found with the rectal exam, the doctor will order a PSA test. After the results for PSA testing are returned, the doctor will analyze the measurements of prostate-specific antigen in the patient’s blood. 

The findings of the PSA test determine what the doctor will do next. 

If the doctor suspects prostate cancer, other tests may be requested. A transrectal ultrasound is often requested. This gives the doctor a visual view of the patient’s prostate gland.

Cancerous growths can be observed through this type of ultrasound test. The test is also relatively quick to perform. Men may experience discomfort when an ultrasound is performed. The discomfort should not last long, however. 

A prostate biopsy is sometimes done. This helps to provide a more accurate test for cancer. A colonoscopy is sometimes needed too. This is especially the case when prostatic carcinoma is suspected.


The prostate gland is important in the male body. It is essential for reproductive health. A prostate examination can help a doctor identify abnormalities with a man’s prostate. In such a case, additional tests may be ordered. This can help to detect BPH, prostate cancer, and other conditions early on. We shared some essential information on how a prostate exam is done in this post. 

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  1. (2011) How does prostate work? [online] Available at:
  2. MedlinePlus. Health screenings for men ages 40 to 64. [online] Available at:
  3. National Institute on Aging. Prostate Problems. [online] Available at:
  4. (2020) Localized prostate cancer: PSA tests for prostate cancer screening. [online] Available at:

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