So just what is a proper Digital Rectal Exam, and how to perform one.

[BBC3]

This Question primarily directed at anyone with real medical experience round here...

*** HOWEVER and ALSO, Anyone with their own experience from having a DRE please chime in and describe your experience in this exam...

I recently saw "The FINGER" in the last month or so. He's a good man and been in the game a long time. He diagnosed my dad at 50 with his midas touch, got it out clean and early. PSA would have never detected or caught it.

So what is a DRE. / in men.??? Is a Urologist simply there to diagnose the urinary tract, junk, and prostate in men.? Do women ever even see Uro's I wonder?. Seems like every time my wife had a urinary tract infection, it stopped at the OB with a cheap round of antibiotics. Of course there was the time no one picked it up with the exception of her internal who caught it in her kidneys and on the verge of death.. She was young and YES, cold as ice and could not even feel kidney pain.

BACK ON TRACK. Focusing on a Rectal Exam in men as primarily pertaining to examining the prostate. I have heard guys describe it as everything from..:
1. "Damn! He stuck his hand in there",
2. "I could feel him HOOK something and pull down",
3. "No big deal".

So last time I was in there I was pretty nervous about the prospect of bad newz. I'm getting mid forties and with a family history of dad and grand dad both having PC - that's enough to rack yer nerves for this appt. I had not seen him in 8 years which was the first time ever before back in my mid 30's.. I told him, "Look! And I'm not messing with you so don't take offense". I advised him that it had been a playground in there for MANY years now and that I was nervous about considering the family history, and he knows me from treating dad... So I say, "Don't be shy! You can't hurt it!, BE DAMN THOROUGH.. I'm dead serious.!!!".

Still, just a quick lube and poke and out. None of this pushing, pulling, poking, blasting, or whatever crap some any of my acquaintances (or even random polls when guys bring it up) / but I don't seem to experience the same crazy agony others have described. Are these guys claiming all this horseshit just trying to win the 'hey I'm a man - you can't get a tack up my tight ass'? It seems to me if I had to guess, that he just goes in with a pointer finger, and does a quick swipe from one side to the other, and out. I can say for sure that clearly he's not stressing the rectum trying to get down low on either side or top- at least I think. It would appear to me that he is just sampling the anterior rear side of it and a single swipe across and out. But I estimate he can feel and sample no more than maybe 15-20% of the entire prostate all told.!!! Of course there is some 35-40% of it which I anticipate there would be no way in hell a uro could get to by digit alone and EVEN if he was REALLY GOING AFTER IT...! So does this sound textbook?

SO WHAT'S THE DEAL...?
1. I think someone qualified posted here once that some 65% of Prostate Cancers occur on the ANTERIOR SIDE. I interpreted that as NOT THE FRONT, NOT EVEN THE SIDES, but the rear back side.? Thoughts there? True or False.

2. Is the Uro just calculating that if the back side of the area protruding closest to the rectum is going to be the most likely to have a problem.? If so, is that because the back side is the one contacted the most, whether is be a turd passing or an unnatural "Man Jammer"

3. Can he feel a "pressure imbalance is say there is a growth on the front side/inaccessible, which transfers a change in the way it feels all over?

4. I think I read that any "Course or hard" feeling is a bad indication for the patient's prostate.

5. About central type and the rarer neurological type PC's, can he pretty much determine a "core type cancer" from rear access alone?

6. Does my interpretation of my experience with DRE sound NORMAL or ABNORMAL. Is it a "lazy job" or all he needs to do"? Is is possible that knowing Family history and age, the he just figures I'm clear till at least 50? (I think he handled grand dad too..)

7. Perhaps he had just seen his share of STINKIN ASS that week, and just didn't give a shit, or could barely stand another poke without freaking out?

SOMEONE PLEASE DESCRIBE THE PROCESS OF A NORMAL D.R.E. ...!


*** On a side note I found interesting his seeming change in perspective on testosterone supping and TRT. I advised him I had been on TRT for 8+ years and his first response was - "I can help you with that once we get blood work back"... He said he would get blood and asked me how much I had been taking. I told him I had dosed 200mgs about 5 of the last 6 weeks. He appeared unshaken by that. It kinda surprised me cause last time (the first time I was in there) I had advised him that I was experimenting with testosterone in doses above 1000mgs/wk, at which time his brow raised real high as he exclaimed he hoped I was done having kids. My goal that time was to get some clomid prescribed, and he exclaimed his agenda was that he was thinking Durastride.!! I did not appear that androgenic at the time and he had just got thru complaining about my high body fat just 5 minutes before.! It was at then that I advised him that "I was convinced estrogen was the devil and my biggest concern / In my ignorant Experience". We disagreed at that time, and now its 8 years later. So I am getting ready to take him up on his offer to help with TRT. We'll see what the bloodz reveal and how he approaches soon.

Side note and appearing as due to Obama Care, the medical establishments appear to be spreading the wealth around as a combatant. Its like Fuckit - they want to tell us how to treat our patients, then we wont do it. Here, lets generate 4x's the BC/BS billing and well just churn em out every 5 fuking minutes... That shit is getting hot and interesting now. But the days of the one-stop shop internal are over / for now it appears. Worse, the internal medicine docs are so fucked in their heads over this shift, they are performing poorly in my opinion - Everything is FUCKED..

But knowing the standard classic Uro thoughts on testosterone supping back in the 1990's and before. Seems like they were all convinced testosterone caused PC, and the usual protocol from them was (1) 200mg injection once a month. I did advise him I was of the Supplement to prevent philosophy, and what were his thoughts. He stated testosterone supping would NOT cause cancer. He also stated he did not think it would prevent either. Finally caveat - if cancer is there, it could mean trouble. I pretty much agreed, with the exception that perhaps it might prevent. Still I am also focusing on NOT having a vasectomy, as i suspect this contributes to PC. But how could you even run a case study when everyone alive over 50 today pretty much has had a vasectomy.? I wonder did they ever even used to encourage it. This uro has never uttered the word. Makes you wonder. But DID URO's used to solicit vasectomies - wonder? Guys SPEAK UP HERE. I want to know did you have to go out of your way to get one.? or if it was ever suggested by any docs and which ones?? "And how would ya like a nice fast vasectomy with that DRE.?" LOL

Back to the question in RED. Answer please. Anyone..?

 

[dyna5]

I had so many DRE exams the past 4 years i cant even count tem. First off, they dont hurt at all and i had them performed by different doctors.
They check for smoothness and roundness. They should be very adept at feeling for anything suspicious since most Uro's perform about 10 DRE's per day.
One guy i went to spend what felt like an hour in there while most others spent about 20 seconds tops.
I do know the prostate should'nt feel " too firm" / very hard either, mine was soft due to inflammation.
They also check the size in order to detect BPH but size means nothing if you have no symptoms. If your prostate is huge but your urine stream is strong, the size means nothing. If its rekatively small but your urine stream is weak, its still bph and needs to be addressed. You can have a smaller sized prostate and still have bph symptoms although its more common when its larger.
One quick note regqrding psa tests especially while on T. You should get tested every 6 months especially when over 40 or with a family history of PC. They look more at how stable your psa is opposed to the actual number unless its high. Example, if your psa is 1.0 and after 6 months of T it goes to a 1.1 and then stays that way for a year its fine. However, if its a 1.0 and suddenly jumps to 1.6 , they may be concerned due to the " velocity " of change even know the number is still considered normal.
By the way, my GP's always said my prostate seemed perfect, it was i who initiated the URO visit due to prostate issues along with a bout of eppidimytis.

 

[Oregongearhead]

I had a PSA of .75 last exam . Which is pretty low considering I have a small tangerine up my butt (prostate) . Still waiting to see if ObamaCare will pay for "Greenlight Surgery" ....still peeing 4-5 times a night.

 

[BBC3]

Thank you for the reply. You got me wondering. Cause this guy is faster than a chimp. I mean we are talking in and out and I am thinking DAMN, no time to even ask for a reach around... LOL I wonder.. I suspect he is going on family history is what I am thinking.

STill looking for a uro to input. Make no mistake. I think this Uro is a fine man. I am just wondering if he's been in the biz too long. He was definitely open to talk. And asked the right questions. It just does seem like it should be a little more thorough. May get a second. My new internal is HOT AS SHIT... LOL

Still, and you have to wonder with mine's experience. Is he just like "fuk it, they are all gonna get it, and even if I feel something it will take 20 years to manifest. I know because of all the ones I let slide that felt funny. LOL And hey, I'm only going to reduce the quality of his life by cutting on him. And shit BC/BS will hate me..."

FYI - If one spent 20 minutes in ME. I think I would start moaning and tell him HARDER. And hit the right side more.... LOL


"Death comes when it comes I guess... Childhood MUST END once we realize this. This is the day we KNOW we are growing OLD..."
Author Unknown...

I had so many DRE exams the past 4 years i cant even count tem. First off, they dont hurt at all and i had them performed by different doctors.
They check for smoothness and roundness. They should be very adept at feeling for anything suspicious since most Uro's perform about 10 DRE's per day.
One guy i went to spend what felt like an hour in there while most others spent about 20 seconds tops.
I do know the prostate should'nt feel " too firm" / very hard either, mine was soft due to inflammation.
They also check the size in order to detect BPH but size means nothing if you have no symptoms. If your prostate is huge but your urine stream is strong, the size means nothing. If its rekatively small but your urine stream is weak, its still bph and needs to be addressed. You can have a smaller sized prostate and still have bph symptoms although its more common when its larger.
One quick note regqrding psa tests especially while on T. You should get tested every 6 months especially when over 40 or with a family history of PC. They look more at how stable your psa is opposed to the actual number unless its high. Example, if your psa is 1.0 and after 6 months of T it goes to a 1.1 and then stays that way for a year its fine. However, if its a 1.0 and suddenly jumps to 1.6 , they may be concerned due to the " velocity " of change even know the number is still considered normal.
By the way, my GP's always said my prostate seemed perfect, it was i who initiated the URO visit due to prostate issues along with a bout of eppidimytis.