Digital rectal examination (DRE)
Digital rectal examination (DRE) The immediate anterior relationship of the rectum in the male is the prostate. The DRE is the mainstay of examination of the prostate. Explain the need for the examination. Ensure the examination is done in privacy. DRE is usually done in the left lateral position with the patient lying on their left side and with the hips and knees flexed to 90 degrees or more. Examine the anal region for fistulae and fissures. Apply plenty of lubricating gel to the gloved finger. Lift the tight buttock upwards with your other hand to expose the anus and gently and slowly insert your index finger into the anal canal and then into the rectum. Palpate anteriorly with the pulp of your finger, and feel the surface of the prostate. Note its consistency (normal or firm), its surface (smooth or irregular), and estimate its size. (It can be helpful to relate its size to common objects (e.g. fruit or nuts!) A normal prostate is the size of a walnut, a moderatel