Digital rectal examination

Buckle examination
Digital rectal exam: side view of the male reproductive and urinary anatomy, including the prostate, rectum, and bladder.
ICD-9-CM	89.34
MeSH	D051517
MedlinePlus	007069
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A rectal examination, commonly called prostate exam, is an internal examination of the rectum performed by a physician or other healthcare professional.

The digital rectal examination (DRE; Latin: palpatio per anum, PPA) is a relatively simple procedure. The patient undresses, then is placed in a position where the anus is accessible (lying on the side, squatting on the examination table, bent over the examination table, or lying down with feet in stirrups). During this procedure, areas which can be palpated are: the bulb of the penis, the urogenital diaphragm, the anorectal ring, and other nearby anatomical landmarks. However, structures like the ureter (the two tubes that run from each kidney to the urinary bladder), and the urethra (which, in a male, is divided into three parts, and is inside the penis) cannot be palpated.

If the patient is lying on his side, the physician will usually have him bring one or both legs up to his chest. If the patient bends over the examination table or the back of a chair, the physician will have him place his elbows on the table and squat down slightly, generally a man having his prostate examined can expect it to be examined in the bending position as it is easier to conduct the examination with a man standing. If the patient uses the supine position, the physician will ask the patient to slide down to the end of the examination table until his buttocks are positioned just beyond the end. The patient then places his feet in the stirrups.

The physician spreads the buttocks apart and will usually examine the external area (anus and perineum) for any abnormalities such as hemorrhoids, lumps, or rashes. Then, as the patient relaxes, the physician slips a lubricated finger into the rectum through the anus and palpates the insides for a short time (from about 5 to 60 seconds).

This examination may be used: