What Every Man Needs to Know About Prostate Examination and Diagnosis

Prostate cancer is a fairly serious blip on the male health radar as the third most common cancer in men over 70. Prostate cancer - and other prostate issues - can cause considerable discomfort, pain and even death, if they are left undiagnosed and untreated.

I'll be honest with you: a prostate exam is no fun. No guy looks forward dropping trou for the annual check-up; but if you're smart, you'll bite the bullet and go anyway. Regular screenings can not only save you a lot of pain and discomfort - they may just save your life.

What is the prostate - and why does it need to be examined?

The prostate gland is a doughnut-shaped organ that is part of the male reproductive system. A healthy prostate in a younger man is only about the size of a walnut. The prostate sits just under the bladder and is wrapped around the beginning of the urethra. It is surrounded by nerves that control erections and its primary function is to produce a liquid that enriches and protects sperm.

Unfortunately, as guys get older this little organ tends to act up. At times, some of the symptoms are simply a sign of aging, however, in many cases prostate trouble is an indication of a more serious problem. Prostate cancer is a primary concern, but other prostate disorders can be just as uncomfortable and a serious concern for male health.

So if you are experiencing symptoms like difficulty or discomfort while urinating, reduced ability to get an erection, blood in your urine or semen, or painful ejaculation, it's important to have your prostate checked out. Even if you aren't experiencing any symptoms, it's still wise to be screened from time to time, as you can pre-empt and prevent problems before they crop up.

What should I expect during a prostate exam?

A prostate exam can be done fairly quickly and easily by your doctor. It might be a little awkward and uncomfortable, but it should be pain-free and over in just a few minutes.

Many guys who go in for their first prostate exam don't realize that it involves the doctor inserting a finger into the anus to examine the prostate gland, so your doctor will likely discuss the procedure with you before getting started. He will answer any questions you might have and he'll make sure you understand what's going to happen

Next, you'll be asked to remove your pants and bend over a counter or examination table. Wearing sterile gloves, the doctor will lubricate both his finger and your anal opening. As uncomfortable as you might be, the very best thing to do at this point is to relax completely. Go to your "happy place" and relax your sphincter muscles as the doctor inserts his finger.

Once his finger is inserted, the doctor will examine the rectal walls, feeling for the pelvic structure along the left, right, and posterior sides. Finally, he will examine the prostate gland, which is located on the anterior rectal wall. He will examine the surface of the gland, taking note of its size, consistency and shape. He will check the lobes as well as the gap that separates the two lobes. He will ask if you feel any tenderness or pain when he touches various parts of the gland.

Finally, the doctor will remove his finger, and congrats! Your DRE (digital-rectal examination) is complete. Once he has removed his hand, he may examine the fecal matter on the glove, possibly transferring some to a lab slide for further examination if necessary.

At this point, sometimes your doctor will also do a PSA test. He may choose to do this if he notices any irregularities, or simply for a more thorough screening. This is a simple blood test that measures your levels of PSA (or Prostate Specific Antigen), which is a protein made by the prostate gland.
What should I do to prepare for a prostate exam?

Well, you're off to a good start. Simply knowing what to expect can help speed the process along, minimizing any potential awkwardness or discomfort for you. Remember, as uncomfortable as you might be, the doctor is a professional and he very likely does prostate exams on a daily basis. Relaxing and discussing the process openly with your doctor can take a lot of the discomfort out of the procedure.

Other than that, there's not much else you need to do to prepare. If you have hemorrhoids, however, you may want to let your doctor know so that he can try not to bother them. Just be prepared that there may be a little discomfort if hemorrhoids or anal fissures are present, and there may be a little bleeding after your exam. This is not a cause for alarm, however, and will clear up fairly quickly.
What happens if the doctor finds problems?

Once your examination is complete, your doctor will explain his findings. If your DRE (Digital-Rectal Examination) findings are normal, that means all's well, and you won't need any further tests until your next scheduled prostate exam (usually an annual procedure).

If the doctor does find some abnormalities, however, he might suggest a PSA test at this point. Otherwise, he might schedule a follow-up visit a few months down the line. At your next exam he will check to see if anything has changed or if the concerns have cleared up on their own.

If your PSA levels are high and the doctor finds abnormalities on your prostate, the doctor will then recommend further testing, including a prostate ultrasound and/or biopsy. This will give him a better idea of where the problem lies and how to remedy it.

Remember though, even if the doctor does find that some things are a bit abnormal, that doesn't immediately mean you have prostate cancer. There are other conditions - completely benign ones - that can cause similar results.

Whatever your results though, regular screenings ensure that problems are caught quickly. Catching a prostate problem right at the start, means that it can be treated and cleared up with far less difficulty.
So men, don't wait around till you run into trouble. A little momentary discomfort is a worthwhile trade for a long, happy, healthy life surrounded by your family and friends. Do yourself a favor and get your prostate checked out.