Your First Prostate Exam

Knowing what to expect when it's time for your first prostate exam can help you prepare, reduce your stress and make the examination easier. Lean the specifics of how a prostate exam is done.

Your doctor mentions a prostate exam. You tense up at the thought. You know where the prostate is and you fear the exam won't be comfortable and could be embarrassing.

The prostate exam is also called digital rectal exam (DRE) or rectal exam. It's one of those tests that most men will face at some point in their lives. This may be part of a routine exam or done because of trouble with urination or for other symptoms. Knowing what to expect can help you prepare.

The drill
You'll take off your pants and underwear and wear a paper gown or wrap around your waist, with the opening to the back.

The prostate lies in front of the rectum. Access to it requires you to bend over. You can stand up and bend over with your arms resting on the table. Or you may lie on the table on your side with your knees pulled up to your chest.

Your doctor will probably explain what he or she is doing as it's happening to let you know what to expect and put you at ease.

Your doctor may put his or her hand on your lower abdomen to help steady you. The doctor will separate your buttocks and examine the anal area.

Next, your doctor will slowly insert a gloved, lubricated finger into the rectum, pausing to allow your sphincter muscle to fully relax before inserting it further.

It's natural to want to tense up during the exam, but if you can relax, you'll be more comfortable. To help relax the sphincter muscle at the entrance to the rectum, your doctor may ask you to "bear down" like you are straining to have a bowel movement. Breathe out slowly through your mouth.

Next, the doctor will feel the rectal wall for any abnormalities and press on the prostate gland to check its size and for lumps or areas of hardness. You'll probably feel pressure and an urge to urinate when your prostate gland is pressed. Some men get nauseous or feel faint during a rectal exam. This is a normal reaction, so don't feel embarrassed. If you start to feel lightheaded, tell your doctor right away.

The exam usually takes only a minute or so.

When the exam is over, the doctor may run a test to check for blood on any stool that remains on the glove. This can be a sign of hemorrhoids, polyps or colon cancer.

While it can be uncomfortable, a rectal exam shouldn't hurt. If it does hurt, say so. If you have tenderness, it could indicate a problem, such as prostatitis (inflammation of the prostate).

Four tips to survive your prostate exam

  • Tell your doctor if you have hemorrhoids.
  • Breathe slowly in and out through your mouth. Don't hold your breath.
  • Detach and try to relax. Think about your favorite vacation spot or something else pleasant.
  • Tell your doctor if it hurts.

After the exam, you'll get some tissue to clean up with and some privacy to get dressed before the doctor tells you the results.