A prostate exam looks for early signs of prostate cancer. The average age that most males get their first prostate exam is 50. But you may need one earlier. It can’t diagnose prostate cancer. But abnormal results mean you need more testing.
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A prostate exam is a screening method healthcare providers use to look for early signs of prostate cancer. In general, a prostate exam includes a:
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A prostate exam is usually quick. In many cases, a primary care provider (PCP) may recommend a prostate exam during an annual physical exam.
A provider may perform a PSA blood test, a digital rectal exam or both. A PSA blood test can more accurately detect prostate cancer. But a DRE can still detect prostate cancer in males with normal PSA levels. For this reason, many healthcare providers recommend both.
Healthcare providers recommend that males get their first prostate exam by age 50. But it’s a good idea to get it at 45 or younger if you’re at a higher risk of prostate cancer. Prostate cancer risks include:
You don’t need to do much before a prostate exam. But you should let healthcare providers know if you have any conditions that may cause discomfort, like:
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Providers may ask you to avoid all sexual activity for 48 hours before your exam. This includes masturbation. Ejaculation can cause your PSA levels to temporarily increase. This could affect your test results.
No, you don’t need to poop before your exam. If you feel like you need to poop before your appointment, then it’s fine to do so. But don’t worry if you don’t have the urge.
Some people worry about poop appearing during the exam. There’s no need to be embarrassed. Your healthcare provider has lots of experience doing this exam. They’ll do everything they can to make you comfortable.
A prostate exam may include a PSA blood test, a digital rectal exam or both.
During a PSA blood test, a healthcare provider takes a blood sample, usually from a vein in your arm. They send your sample to a lab and look for high PSA levels.
If you have high PSA levels, providers may recommend more tests to confirm prostate cancer. Other tests may include:
During a DRE, you undress from the waist down. You lie on your side or stand and lean forward slightly. A provider puts on a medical glove and applies lubrication (lube) to a finger. They insert their finger into your rectum and feel for any lumps or bumps on the back portion of your prostate. The back portion of the gland is where many cancers start.
A PSA test can hurt — most people describe it like a small pinch. But it should only last a short time until a healthcare provider can gather a large enough sample.
A digital rectal exam usually isn’t painful. But it may be uncomfortable. Let your provider know if you have hemorrhoids or fissures that may cause pain. A DRE only takes a few seconds to complete.
If your healthcare provider takes a blood sample, they’ll put a bandage over the area where the needle went in. You may need to avoid heavy lifting or physical activity for the rest of the day.
After a digital rectal exam, your provider will give you tissues or wipes, so you can clean off any remaining lube. You can put your clothes back on and return to normal activities immediately.
Prostate exams are generally safe. Potential risks include:
A healthcare provider will let you know if they notice anything abnormal during your digital rectal exam. Abnormal findings may include:
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Your provider will discuss their findings with you, explain what they may mean and recommend what to do next. This may include additional testing.
Once your PSA blood test results come back, your provider will let you know if they recommend any additional testing. PSA levels can change over time for several reasons that don’t relate to prostate cancer. Examples include ejaculation, certain medications, infection and an enlarged prostate.
If your PSA levels are borderline, your provider may recommend another PSA test in a few months. If your PSA is still high, they may refer you to a urologist for further evaluation and testing.
A healthcare provider can tell you the results of your digital rectal exam immediately.
It takes at least a day or two to receive the results of your PSA test.
Healthcare providers recommend that you should get a prostate exam every two to four years. Most males should get their first prostate exam at 50.
If you’re 50 or older and haven’t had a prostate exam, call a healthcare provider to set up an appointment. If you’re at a higher risk, you should have your first prostate exam by age 45 or younger.
It’s also a good idea to schedule a visit if you have symptoms of a blockage in your urinary system, like:
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These can be signs of an enlarged prostate or urinary tract infection (UTI). Prostate cancer doesn’t usually exhibit symptoms until advanced stages.
It’s natural to think that a colonoscopy is similar to a prostate exam — they both involve your rectal area. But a prostate exam typically involves a PSA test and a digital rectal exam. A colonoscopy uses a camera to examine the walls of your colon. Healthcare providers don’t typically examine your prostate during a colonoscopy.
A prostate exam is a typically quick procedure that a provider can perform in an office setting. A colonoscopy is an outpatient procedure that a provider performs in a hospital, and it involves sedation.
Most people are nervous or wary about their first prostate exam. This is totally normal — blood tests are never fun, and an examination of your nether region can be uncomfortable. But they both go by quickly with a very low risk of complications. A prostate exam is also the first step in the early detection of prostate cancer — and early detection is key to successful treatment.
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