Digital Rectal Examination


Digital Rectal Examination

Fundamental part of Urological assessment in males
it is an examination for detecting problems related to the prostate in Men.
The prostate lies immediately beneath the bladder and completely surrounds the urethra and lies immediately in front of the rectum (back passage).
Age-related enlargement is not a particular concern but if the gland feels abnormally firm or hard, it may sometimes be an indication of abnormal growth in the prostate gland.
During a Digital Rectal Examination, your doctor inserts a gloved finger into the rectum to feel the surface of the prostate that lies close to the rectal wall. If your doctor feels something suspicious such as a lump or bump, further tests will be carried out.
Your doctor will discuss the test results with you. If he or she detects a suspicious lump or area during the exam, or if your PSA level is elevated, an ultrasound-guided biopsy may be recommended.
After the test, you may continue your normal activities..

PSA Test

Prostate Specific Antigen testing
Your doctor may ask for an Ultrasound examination of Kidney Ureter & Bladder region. This is a good screening tool for many Urinary tract problems ranging from Infection to stones and even Tumors.
Ureteric stones are not well visualized sometimes due to gas in Intestines.
You will be asked to drink some water to make urine bladder full for examination.
You do not need to be empty stomach for KUB Ultrasound. 
2782267 color 5baa944e4cedfd00252b40ca 1
Diagram showing a transperineal prostate biopsy CRUK 473.svg

TRUS Guided Prostate Biopsy

Most Important test for Prostate cancer confirmation
The most common reason this test is performed is that either a blood test called PSA is abnormally high or the findings on examining the prostate through the back passage is abnormal.
Ultrasound scans use sound waves to build up a picture of the inside of the body. To scan the prostate gland a small probe is passed into the back passage and the image of the prostate appears on a screen. This type of scan is used to measure the size and density of the prostate. A sample of cells (biopsy) can be taken at the same time for examination under the microscope by a pathologist. The scan may be uncomfortable but it only takes a few minutes.
What actually happens?
A probe like an instrument about 2.5 cm in diameter is gently inserted into the back passage. This is in fact an ultrasound probe that allows visualisation of the prostate beyond what can be felt by the finger alone. More importantly, it allows for the placement of a special biopsy needle that collects samples of your prostate. At the time of biopsy, you will hear a loud clicking noise that may startle you momentarily. You will feel a slight sting as the needle passes but it literally happens in a split second. A total of 12 biopsy specimens are usually collected. The procedure takes about 10 minutes and you are able to drive home if you desire but it is often a good idea to have somebody with you due to the natural anxiety you may have over the anticipation of the results.
What risks are associated with the procedure?
Following a prostate biopsy, you can expect to see some blood in the urine, bowel motions and in the semen. Any blood in the urine or bowel motions usually settles by a week although brownish discolouration of the semen can last for up to a month. Uncommonly, you may develop an infection but this risk is minimised by the antibiotic administered. If you develop fevers and begin to shake you should go to the nearest Emergency Department to be assessed. You may have trouble passing urine after the procedure. Present to the closest Emergency Department if you are not able to pass urine and becomes uncomfortable with a full bladder.
Obtaining results
It generally takes up to a week to obtain the results of your biopsy. It is important that you have a follow-up appointment to follow up on the results of the pathology.