Digital Rectal Examination

Question 1

Indications for DRE?

Answer 1

• Anorectal symptoms (bleeding, pain, tenesmus, incontinence, perianal masses, discharge)
• Lower urinary tract symptoms (HITS/FUND/haematuria/FHx)
• Post-partum
• Intra-abdominal pathology
• Pelvic pathology
• Ectopic pregnancies

Question 2

Outline how to perform a DRE

Answer 2

1. Introduction, explanation
2. Organise a stop signal
3. Position patient
4. Left lateral, knees to chest
5. Gloves, lubricant, get patient to breathe in and warn them you’ll insert a gloved finger when they breathe out
6. Use sweeping motions to palpate rectal wall
7. Take special note of the anterior wall, where the prostate resides. Try and determine consistency, extent