The prostate exam

Abstract

Objective: To help students, residents, and general practitioners to improve the technique, skills, and reproducibility of their prostate examination. Methods: We developed a comprehensive guideline outlining prostate anatomy, indications, patient preparation, positioning, technique, findings, and limitations of this ancient art of urological evaluation. Results: The prostate exam was the first diagnostic test used for prostate cancer screening and other urological conditions. Although several alternative procedures have been developed in the past century, the prostate exam is still an important part of genital-pelvic evaluation because of its simplicity, cost and time effectiveness, and relatively minimal patient discomfort experienced. Conclusion: With an aging population and increasing incidence of prostate diseases, it is imperative that healthcare professionals possess the knowledge, skills, and attitudes to make the prostate exam a routine part of a complete physical examination.

Estimation of prostate size by trans-rectal ultrasound and its correlation with DRE and endoscopic grading

“…Thus for 4 fingertip impressions on the posterior surface of the prostate was inferred as 40 cc volume [18]. Romero et al, [3] documented a volume of 20 g for Grade I, 30 g for Grade I/II, 40 g for Grade II, 50 g for Grade II/III, 60 g for Grade III and 80 g or greater for Grade IV in their study. In their study Lodh, et al concluded that estimation of prostate size may be overestimated or underestimated by DRE but it gives a rough idea of prostate volume estimation [2].…”

“…International Journal of Medical Research and Review Available online at: www.medresearch.in 67 | P a g e current study used DRE grading mentioned by Lodh et al which is a modification of DRE grading described by Romero et al due to its simplistic nature [2,3]. The size of prostate lobes on DRE is not a criterion as to the size of their protrusion into the bladder.…”

“…An effective DRE requires a meticulous, thorough, and skilful examination technique that is usually acquired only after a fairly long learning curve. There have been various attempts to standardize the DRE grading in the past of which the work of Romero et al and recently Lodh et al has been most widely accepted [2,3]. Estimation of prostate size is important to guide the most appropriate pharmacological or surgical approach.…”

One-year urinary and sexual outcome trajectories among prostate cancer patients treated by radical prostatectomy: a prospective study

“…Multinomial logistic regression was used to explore BPH- and ED-related factors associated with short- and long-term improvement beyond baseline and maintenance in urinary and sexual outcomes (in sub-scales with at least 10 men for stable estimation). Factors considered were individual measures of BPH (pre-surgical prostate size, IPSS score, and reported use of BPH medications, overall and separately by type), as well as a composite BPH outcome (prostate size ≥ 40 g [ 19 ], IPSS score ≥ 8 [ 20 ], or medication use), and measures of sexual dysfunction (pre- and post- surgical ED medication and device use). Sensitivity analyses were performed by: (1) adjusting for factors significantly associated with improvement or maintenance in at least one urinary or sexual outcome; (2) using the lower bounds of the EPIC-50 sub-scale-specific MCID ranges to classify participants; (3) excluding men with pre-surgical EPIC-50 scores too high to experience improvement (i.e., higher than the value obtained by subtracting the sub-scale specific MCID from 100); (4) restricting to men with complete data on specific urinary and sexual outcomes at baseline, 5 weeks and 12 months; and (5) repeating the analyses using the 6 month follow-up data.…”

Electromyography needle breaks within the perineum: a rare complication of urodynamics not reported earlier and lesson learnt

“…Digital rectal examination showed clinical grade I prostate,2 irregular, non-nodular, with decreased anal tone. The patient was non-diabetic and non-hypertensive.…”