Generality
Digital rectal exploration of the prostate consists in palpation of the prostatic surface by introducing the gloved index finger into the patient's anus.
This operation is carried out by a doctor specialized in urology and is essential for the diagnostic assessment of prostate cancer.
Why It Executes
Together with the blood assay of the prostate specific antigen (PSA), the digital rectal examination of the prostate represents a first level investigation to identify subjects who presumably, although not necessarily, have developed prostate cancer. confirmation or diagnostic denial can only come from the results of a further examination, the prostate biopsy, during which small samples of prostate tissue are taken to be examined in the laboratory.
Sensitivity and Specificity
Digital rectal examination of the prostate is not a particularly pleasant experience, but neither is it a burdensome or embarrassing one. It is performed in a few minutes and concretely increases the chances of discovering prostate cancer at an early stage, even if to tell the truth it is a far from foolproof test.
The purpose of the procedure is the tactile perception of enlargements, irregularities, lumps and increases in consistency (hardness) of the gland, which allow to distinguish a healthy prostate, from a "benign prostatic hypertrophy and prostate cancer. Unfortunately, however, the" digital rectal prostate exploration remains an imprecise examination, although still very useful. Despite the good specificity, due to the often contained tumor size or to a localization not reachable with digital rectal exploration, the ability to identify sick subjects is reduced; on average, in fact, out of 100 prostate cancers only 20 are found on palpation.
When to run it
If you are over 45/50 years old, especially in the presence of close relatives (children, fathers, brothers) suffering from prostate cancer, contact your doctor to evaluate the opportunity to undergo an annual urological examination for digital prostate rectal exploration. combined with serum PSA assay.
Not all doctors agree that this screening approach (PSA + digital exploration) is useful in asymptomatic subjects or without important risk factors; in fact, this procedure involves some non-negligible risks:
- the risk of having to undergo an "invasive investigation such as biopsy for a false alarm (subjects who, based on PSA values or suspicions emerged from" digital rectal exploration of the prostate, appear to be ill, when in reality the biopsy examination reveals healthy);
- having to undergo, in the event of a positive biopsy, a therapeutic intervention for a "latent" form that would remain inert for the rest of life, with all the psychophysical repercussions (risk of erectile dysfunction and incontinence) related to the intervention.
