The prostate gland to the touch. Digital rectal examination of the prostate: what is it and how is it performed? The role of the prostate in the male body
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What to expect during a visit to the urologist?
At the consultation, the doctor will find out the history of the disease. The urologist must first of all make sure that the urination disorders that have arisen in you are really caused by prostate adenoma.
- Check the size of the prostate with a finger through the rectum. This examination is mandatory. At the same time, a smooth, elastic, enlarged prostate gland is found, which is evenly compacted (nodules in the prostate gland are suspicious for cancer!). This is a simple examination method and you should not be afraid of it, usually it does not cause serious inconvenience to the patient.
- Ultrasound examination (ultrasound) allows you to evaluate the size and structure of the prostate, the condition of the urinary tract and the amount of residual urine in the bladder. Often, to confirm the diagnosis, an ultrasound examination of the prostate gland is possible using a special rectal sensor (TRUS) - they determine the size of the gland, the presence of seals in it.
- If you are over 50, the urologist will definitely prescribe a blood test for prostatitis specific antigen. Blood test for PSA? a substance secreted by the prostate and is an important indicator for the diagnosis of prostate cancer. Kidney dysfunction is clarified with the help of biochemical blood tests (residual nitrogen, creatinine, urea).
- In the study of urine, the presence of blood, glucose, infections is determined. Filling out questionnaires and urination diaries is a very simple and at the same time mandatory procedure, provided for by international guidelines for examining patients with diseases of the prostate and bladder. Their filling allows you to identify the severity of symptoms of adenoma. The patient can significantly help the doctor if he fills them out before the consultation.
- The International System for the Total Assessment of Symptoms of Prostate Diseases (IPSS) conditionally divides the course of BPH: up to 7 points - mild degree, 8-19 points - moderate degree, 20-35 points - severe degree.
Finger examination of the prostate
Finger examination through the rectum of the prostate gland should not be neglected in any case. One must be produced. A digital rectal examination of the prostate gland is performed as follows:
* The essence of the upcoming study is explained to the patient.
* It is best to conduct the study in the knee-elbow position of the patient.
* Put on a rubber glove, lubricate the index finger with gel (vaseline) and gently insert the finger into the anus with a smooth movement towards the spine. In the presence of rectal fissures and hemorrhoids, the study can be painful.
* At a distance of 5-7 cm from the anus, on the anterior wall of the rectum, a dense body of the prostate gland is felt, in the middle part of which there is a slight depression.
* The size, nature of the surface, consistency and sensitivity of the prostate gland is estimated.
Normally, the prostate gland has a diameter of about 3 cm (when the bladder is full, the prostate gland seems larger), the surface is smooth, densely elastic, painless, two lobes separated by a groove are well felt.
For cancer the prostate gland is enlarged, has an uneven surface, to the touch - hard (stony) consistency.
With adenoma the prostate gland is enlarged, smooth, tight elastic consistency (like a rubber expander).
In chronic prostatitis, the prostate is swollen and painful. Pain on pressure radiates to the penis. The surface is uneven, in consistency looks like a baby rubber ball. Often after research purulent discharge from the urethra, which is one of the diagnostic criteria for prostatitis.
Laboratory diagnosis of prostatitis
Methods for laboratory diagnosis of prostatitis include:
* Counting leukocytes in the secretion of the prostate gland to assess the inflammatory component (normally up to 3-5 leukocytes per field of view).
* The predominance of leukocytes in the first portion of urine in a triple test (three-cup test).
* Counting leukocytes in urine after prostate massage.
* Bacteriological examination of urine after prostate massage.
* Prostatitis, especially infectious prostatitis, can cause an increase in the concentration of prostate antigen (PSA). If PSA is more than 4.0 ng / ml, a prostate biopsy is indicated to exclude prostate cancer.
Instrumental diagnosis of prostatitis
Imaging methods in the diagnosis of prostatitis are not used due to their low information content, but are used for the purpose of differential diagnosis:
* Computed tomography of the pelvis and transrectal ultrasound are important for the detection of stones and abscesses of the prostate gland, tumor formations.
* Cystoscopy is indicated if there was a history of invasive manipulations (diagnostic, surgical) on the organs of the genitourinary system.
Prostatitis cannot be cured with medication alone. It is necessary to have a regular sexual life, urinate immediately after the urge occurs, increase physical activity, limit alcohol consumption, avoid hypothermia and sexually transmitted diseases.
Prostatitis is quite “extensive” not only in terms of symptoms, but also in terms of tests. For proper treatment, it is necessary to know both the level of hormones and the presence (absence) of infections, of which there are quite a lot. Sexually transmitted infections may be involved in the basis of prostatitis or in the course of the disease. Therefore, it is important in the treatment of prostatitis to have a complete and comprehensive examination, which allows you to make the correct diagnosis and, accordingly, to treat it correctly.
A few words about the most unpleasant
The most terrible, unpleasant, painful and humiliating, according to the vast majority of men, what awaits them in the treatment of prostatitis is prostate massage. It is these impressions that make it possible for many enterprising gentlemen who are not too clean at hand to talk about the latest methods of treating prostatitis without prostate massage. It is not surprising that a man agrees to pay any money to get rid of this disease, avoiding such unpleasant moments. Unfortunately, these methods of treating prostatitis appear and disappear every day, only proving again and again that prostate massage has been and remains the cornerstone of prostatitis treatment for many decades.
Massage action on the prostate gland consists in squeezing out the inflammatory secret accumulated in it with a finger, into the ducts and, ultimately, into the urethra. On the other hand, when massaging the prostate gland, its blood supply improves (and congestion in the pelvis is one of the important factors in the development of prostatitis, as mentioned above), which enhances the effect of antibiotic therapy. The effectiveness of prostate massage for prostatitis is due to the uniqueness of its structure and location, the special structure of its ducts. It should be noted that the prostate gland is the only organ whose massage effectively helps to cure acute inflammation. Massage of any other tissue or organ of the human body can only lead to the spread of inflammation and the progression of the disease.
A very common disease among men is. At the same time, the diagnosis of prostatitis is often carried out too late, already in the acute or chronic period. This is because the representatives of the stronger sex simply ignore the disease. And most men have never been to a urologist at all, believing that problems with the prostate arise already in old age. This is absolutely not true. Prostatitis can occur between the ages of 20-50. The risk of diseases of the genitourinary system increases from the moment an active sexual life begins. Therefore, it is so important to regularly undergo elementary examinations from specialists.
Prostatitis is an inflammation of the prostate gland. The prostate gland plays an important role in the male reproductive system. The vas deferens and the urethra pass through the prostate. The ejaculate passes through the prostate before ejaculation. If there is inflammation of the gland, both channels are compressed, urination and ejaculation are difficult. Speaking about the endocrine properties of the organ, the prostate converts the male sex hormone testosterone into its active form. And it is prostatitis that often causes erectile dysfunction, male infertility.
The danger of the disease lies in the fact that there is a risk of prostate cancer, prostate adenoma. Such diagnoses are usually made in adulthood. Also, those men who ignored all the doctor's prescriptions and did not carry out proper therapy are at risk. What leads to this disease? The main cause of inflammation of the prostate gland is a violation of blood circulation in the organ. Stagnation begins to form, the ducts clog. This is what causes inflammation. The blood flow is disturbed due to excess weight, sedentary work, a sedentary lifestyle.
Often, infectious and sexually transmitted diseases lead to prostatitis:
- Gonorrhea;
- Chlamydia;
- Tuberculosis;
- Flu;
- Frequent complicated angina.
The presence of infection in the body is always accompanied by an inflammatory process of some organs. Could be bacterial prostatitis. At the same time, bacteria enter the body through the biological fluids of the body (during sexual intercourse, through the blood, lymph). There are also such causes of prostatitis: hypothermia, injuries of the pelvic organs, low physical activity, prolonged abstinence from sex, interruption of sexual intercourse, frequent constipation, immune system dysfunction, urological diseases, hormonal failure, diabetes mellitus.
Finger diagnosis of prostatitis
Diagnosis of prostatitis in men, as a rule, begins with the collection of anamnesis. The patient is interviewed and examined. The doctor finds out what symptoms bother men, when they become more acute, under what circumstances they disappear and reappear. Also, it is important for the doctor to know if among the blood relatives there are patients with prostatitis, prostate cancer, adenoma. After all, the factor of heredity is important.
A reliable method of diagnosis is a digital examination of the prostate through the rectum. It is not worth neglecting this diagnostic option. Most physicians start with this research. The digital rectal examination procedure is as follows:
- The essence of the procedure, preparation is explained to the patient;
- The patient takes a knee-elbow position near the couch;
- The doctor puts on disposable sterile gloves, lubricates his finger with gel;
- Gently inserts a finger into the anus towards the spine;
- At a distance of 5 centimeters from the passage, the doctor will feel the prostate gland, and will be able to assess its size, structure, consistency, and sensitivity.
If during the examination a man has hemorrhoids, cracks in the rectum, he may feel pain. The normal size of the prostate gland is 3 cm in diameter. If the bladder is full, the prostate may be slightly larger. Necessarily, in the normal state of the organ, a flat and smooth surface will be diagnosed. The consistency is quite dense, but at the same time elastic. It is very important that during the diagnosis, the doctor can well feel two different lobes, which are separated by a furrow. This will indicate the absence of an inflammatory process.
If a man is diagnosed with prostate cancer, the organ increases in size, has a bumpy, uneven surface. To the touch, the prostate is very hard, practically does not have elasticity. And only finger diagnostics will help to evaluate all the qualities of the prostate gland. Therefore, such a diagnosis cannot be avoided, it is considered one of the most reliable and fastest.
The ultrasound probe is inserted rectally. This diagnostic is used in such cases:
- Acute bacterial disease of the prostate;
- Pathological abnormal processes in the gland;
- Monitoring the effectiveness of prostatitis treatment;
- Suspicion of an oncological disease during a digital examination of the gland;
- Pain during ejaculation;
- Bacterial cystitis, .
Myography is prescribed to determine the level of pressure in the urethra. If there is a risk of an abscess or cancer, the doctor will refer the patient to an MRI or CT scan. An additional diagnostic method is cytoscopy. It is carried out according to strict indications: injuries of the genital organs, preparation for surgery, with hematuria, pain in the scrotum, in case of obstructive urination.
It is very important to recognize the first symptoms of the disease in a timely manner. That is why self-diagnosis of prostatitis at home plays an important role. Every man can suspect a problem by listening and looking more closely at his body. So, for the initial stage of prostatitis, the following symptoms will be characteristic:
- Pain when urinating;
- Pain during ejaculation;
- premature ejaculation;
- intermittent urination;
- secret allocation;
- Increase in body temperature;
- Pain in the perineum, scrotum, testicles.
Often, it spreads to the back, lower back, legs, anal passage. The process of defecation can be difficult. The presence of at least one of the signs indicates an inflammatory process in the body. Also, you can carry out another diagnostic method in the house. To do this, a man must urinate in three different containers. In case of prostatitis, urine in jars 1 and 3 will be cloudy. If the liquid is cloudy in only 1 of the vessels, there is some kind of inflammatory process. In any case, it is very important to immediately seek help from a doctor. After all, timely treatment guarantees a complete recovery, and a full sexual life.
The prostate gland is an organ of the male reproductive system, which takes part in spermatogenesis, by producing special hormones, they produce a secret that dilutes the seminal fluid and improves its patency. So how to find the prostate and examine it?
Manual or how to call it correctly rectal finger examination of the prostate gland is the first examination method that does not require the use of expensive equipment and is quite informative. Starting such a procedure, the doctor, first, examines the anus, as there may be changes that can provoke diseases ( areas of infiltration of an inflammatory nature, hemorrhoidal fissures and nodes).
In the diagnosis of diseases of the prostate, this research method plays an important role. The procedure is carried out: when the patient lies on his right side, or kneels and elbows, or standing, bending forward while leaning on his elbows and spreading his legs.
The doctor inserts the index finger of the right hand into the rectum and directly examines the gland. Normally, the prostate gland is located at a distance of 4 cm from the anus in front of the rectum. It determines: what size of iron (normally it is no more than 3 cm wide, no more than 4 cm long), what consistency (normally it should be elastic). Checks for the presence of a groove that divides the gland into two lobes, normally it should be well palpable.
If there are any changes in the gland (inflammatory or tumoral in nature), then the boundaries of the gland are smoothed, its size may decrease or increase, the consistency may vary from testy to dense cartilaginous, the presence of various foci in the form of compaction or softening of tissues, crepitus, fluctuation . It is also checked whether the mucous layer of the rectum is displaced.
During the examination, a massage is performed for diagnostic and therapeutic purposes. The doctor performs this manipulation by lightly stroking the lobes of the gland from the sides to the center. If it is necessary to get the secret of the prostate gland, then the massage is finished by sliding along the interlobar groove, thereby the doctor, as it were, squeezes the secret from the prostatic glands into the urethra.
With this type of examination, seminal vesicles, if they are not changed, cannot be felt. They can be palpated if there is a pathological increase in them, while they are determined on both sides of the center line directly above the prostate. To the touch, these are oblong formations. The best position for examining the seminal vesicles is when the patient is squatting, that is, putting himself on the doctor's finger. At the same time, he evaluates the density, uniform consistency, the size of the seminal vesicles, whether there is a pain symptom.
Also doing research cooper (bulbourethral) glands. These are two small glands of the so-called external secretion. To the touch, they are dense in consistency, no more than 1 cm in size. They are located in the thickness of the perineum, directly at the base of the penis. These glands perform a protective function, they secrete a secret that protects the urethra from the effects of the acidic environment of urine. They also improve the permeability of spermatozoa through the urethra. They are probed during inflammatory processes with the index finger, which is inserted into the rectum, and the thumb, which is placed on the skin in the perineum.
Rectal digital examination of the prostate gland does not require any special preparation of the patient. And does not cause any harm to his health.
This method of diagnosing prostate ailments was used by the ancient healers of the time of Hippocrates, who did not have the opportunity to examine patients using any laboratory and instrumental methods.
Today, doctors say that all men over the age of 40 should have a rectal prostate exam every year. Examination is also necessary for patients who suffer from urinary dysfunction or have problems with erection.
A digital examination of the prostate gland is a diagnostic procedure that is performed by a physician instructed through the patient's rectum.
During the manipulation, a person must take a special pose.
It is better if the man lies on his side with his legs brought to his stomach and bent at the knees or takes a knee-elbow position. An experienced doctor will easily detect the prostate through the rectum.
It is located about 3-4 cm above the anus and has a pronounced median groove that divides the organ into two lobes. The size of a healthy prostate is 2.5-4.5 cm in diameter. On palpation, it has a tight elastic consistency and a certain mobility.
Indications for digital examination of the prostate
- men over the age of 50;
- males who have had inflammatory diseases in the past or had tumors of the prostate gland;
- patients with a genetic predisposition to the development of prostate ailments;
- men with complaints of urination and erection disorders, as well as those experiencing in the pelvic area.
Doctors constantly remind about the importance of preventive examinations for men of any age. Since it is the timely determination of diseases of the organs of the male genital area that allows you to prescribe effective treatment and avoid the serious consequences of pathological conditions.
Preparation of palpation of the pancreas through the rectum
In order for the picture of the state of the prostate to be really clear and informative during the examination, the patient must refrain from:
- a few hours before a rectal examination;
- ride on;
- physical labor and
On the eve of the digital examination, it is imperative to empty the intestines by a natural method or make an enema.
Particular attention should be paid to psychological preparation. During the examination, a man should not worry or be nervous. Anxiety can provoke false diagnostic results and, accordingly, an incorrect diagnosis.
How is the check going?
Before the procedure, the doctor must talk with the patient, ask him about complaints and determine the presence of a genetic predisposition to prostate pathologies.
The specialist should definitely explain to the person the technique of manipulation and warn him about the possible risks of consequences.
If the rectal examination is performed correctly, then after it there should not be any side effects or.
A digital examination of the prostate should be performed in positions such as knee-elbow or lying on the right side with legs tucked under.
Before inserting a finger into the rectum, the doctor puts on sterile gloves and lubricates the index finger to facilitate its penetration into the organ cavity (vaseline, glycerin).
By palpation, the doctor can evaluate a number of characteristics of the prostate, including:
- the shape and size of the organ;
- elasticity and consistency;
- symmetry of the structural components of the prostate gland;
- mobility relative to adjacent organs;
- clarity of contours and longitudinal furrows;
- the presence of pain during the examination, tumors or stones.
What should a man's prostate feel like?
The prostate gland is normally palpated at a distance of 3-4 cm from the anus towards the pubic symphysis. By consistency, it resembles an elastic ball with clear contours, which is freely displaced relative to the rectal mucosa.
Normal and enlarged prostate
An experienced specialist will always be able to assess the size of the organ, find the frontal groove and judge their normality. The transverse size of the gland should be in the range from 25 to 35 m, while its lengthwise is 25-30 mm.
Normally, palpation of the prostate should not cause pain, discomfort, or the appearance of blood in the secret.
What does it mean if the prostate is hard?
A hard prostate gland on digital examination indicates pathological changes in the organ.
Among the reasons for the development of pathological changes in the body can be:
- inflammatory process or (and);
- benign tumors;
- malignant neoplasms.
When determining a hard prostate, the patient is invited to undergo additional laboratory and instrumental examinations in order to understand the nature of the change in the consistency of the organ.
As a rule, hardening of the prostate is not asymptomatic and is almost always accompanied by the appearance, disruption of normal urination, problems with erectile function.
Examination of the prostatic secretion
An analysis of the prostatic secretion makes it possible to judge the presence of an inflammatory process in the organ, the nature of the pathogen, and even the stage of the pathological condition or the degree of its chronicity.
The study of the secret is a microscopy of the physiological fluid that is produced in the prostate and is an important component of sperm. To take a secret for analysis, it is necessary to conduct a rectal massage of the organ, during which it occurs.
Manipulation can be carried out at any time of the day and without prior preparation of the patient. On the eve of the test, it is recommended to refrain from sexual intercourse. The secret of the prostate is examined under a microscope and the number of leukocyte cells, epithelium, lecithin grains, amyloid inclusions is determined in it. The examination allows you to diagnose the presence of pathogenic microorganisms in the prostate fluid.
After they are identified, the laboratory assistant makes a mandatory sowing of biological material to identify the nature of infectious agents, their activity and sensitivity to.
Normally, the secret is a viscous white liquid, which has a characteristic odor reminiscent of the aroma of chestnut flowers.
A healthy prostatic secret contains single leukocytes, 0-1 erythrocytes in the field of view and a small amount of epithelium. It does not detect amyloid inclusions and bacteria, the appearance of which indicates the development of a pathological process.
Related videos
About the technique of conducting a rectal examination of the prostate gland in the video:
Rectal examination of the prostate gland is an important diagnostic procedure that makes it possible to identify diseases of the organ even at the initial stages of development. With its help, it is possible to suspect in time the appearance of structural changes in the prostate in a man, the occurrence of tumor processes and inflammation.
The prostate of each man has individual dimensions that change throughout life. In most cases, the size of the prostate in sexually mature men is from 40 to 50 mm. And at the same time, the back of the prostate gland is tightly adjacent to the rectum of a man, which makes it possible to examine it in a rectal way.
How to find the prostate yourself
In fact, finding the prostate on your own is not as difficult as it might seem at first glance. As mentioned above, the prostate gland is tightly adjacent to the rectum, therefore, in order to find it, you need to insert your index finger into the anus. Approximately 5 cm from the beginning of the entrance, you can feel a rounded formation of a small size. This is the prostate gland. In healthy men, it has an elastic, but rather dense structure.
If you put a little pressure on the prostate gland, the man will feel discomfort or even pain. Such symptoms indicate that inflammatory processes have begun in the prostate.
Important! With progressive inflammation in men, the pain will be throbbing, sharp and severe. This pain is difficult to confuse with pain in the rectum. This may be the first.
During self-examination, which is carried out to find the prostate gland, you can also perform a special therapeutic massage that will allow a man to improve the functionality of the prostate gland, as well as significantly increase the level of a man's sexual activity.
How to find a prostate for massage yourself - preparation for the procedure
The rectal finger massage method for detecting the prostate gland has been used in medical practice for a long time. In order for the procedure to be as effective and painless as possible, especially if it is performed at home, a man should prepare. There are several general recommendations that must be followed both before an appointment with a proctologist and before an independent procedure to find the prostate:
To massage the prostate gland, and also, before finding the prostate on their own, a man should undergo special antibacterial therapy.
It should be borne in mind that in order to find the prostate, it will be necessary to perform a rectal examination, therefore, before starting the procedure, it is imperative to clean the rectum (empty the intestines). If this procedure cannot be performed naturally, then it is worth putting a small cleansing enema (to thoroughly clean the rectum). For an enema, warm boiled water is used, to which a few drops of vegetable oil are added (you can take the most common sunflower or olive oil).
The prostate is located behind the bladder, so during the procedure it should be as full as possible. It is thanks to the filled bladder that the prostate gland will be located as close as possible to the rectum of a man, so it will be easier to find it. And if the prostate gland is sought for the purpose of performing therapeutic massage at home, then a filled bladder will significantly improve the quality and effect of performing massage procedures. As practice and numerous recommendations of proctologists show, approximately 40-60 minutes before the actual rectal examination procedure, you should drink at least 1 liter of liquid.
Immediately before performing the rectal examination procedure, it is necessary to perform standard hygiene procedures (take a shower, treat the anal entrance with a damp warm towel or hygienic wet wipes). But during the procedure itself, the skin around the anus should be not only clean, but also dry.
A few hours before the rectal examination procedure (at least 1.5 hours), you should refuse to eat and limit yourself to water.
Attention! The presence of anal fissures or hemorrhoids will make the rectal examination more painful in the early stages. However, these pains will pass very soon and will not be reflected in the quality of the examination aimed at determining the location of the prostate gland.
Advice! To perform an independent rectal examination, you can take any other comfortable position. For example, standing with one leg raised, or sitting. When choosing the optimal position, you should focus on your individual feelings, because this procedure should not bring a feeling of discomfort.
- Immediately before the start of the examination procedure, the man must take the correct posture. As practice shows, the most optimal position, which allows you to most relax the muscles of the anus and in the rectum, is lying on your side, your knees are tightly pressed to your stomach.
- Independent rectal examination is performed only in specially prepared medical gloves (the index finger should be generously lubricated with petroleum jelly to ensure the most comfortable entry into the rectum).
- The index finger is inserted into the rectum no more than 5 cm. If a man followed the recommendations before performing the procedure and drank a large amount of liquid to fill the bladder, then the finger can be inserted less than 5 cm. But he must reach the borders of the prostate gland. The finger is inserted into the rectum slowly, even slowly, and not too deep. These measures are necessary so that men do not experience any discomfort or pain during the examination.
- The procedure for the first examination of the prostate lasts no more than 30 seconds. This time is quite enough to feel the prostate gland with light massage movements, to determine its actual state (soft or hard structure, actual size, etc.).
About the frequency of self-massage
If the prostate gland needs to be found in order to perform an independent therapeutic massage, then the first examination is performed according to the sequence described above. And the next day, the procedure is repeated. Only here during the execution of massage procedures, stroking of the prostate is performed. And each subsequent procedure of therapeutic and prophylactic massage is no more than 40 seconds. This time is enough to stimulate the functionality of the prostate gland in men.
About massage pain
If during the determination of the location of the prostate gland, a man feels pain, then this indicates the presence of inflammatory processes in this gland. In addition, pain in the prostate may indicate an exacerbation. In the presence of chronic prostatitis, the consistency of the prostate becomes softer.
About scars and indurations
If scars are felt under the finger, or small areas with seals, then this indicates the presence of inflammatory processes, or this, as well as the possible presence of stones in this gland.
The prostate gland is enlarged
If both lobes of the prostate gland are symmetrically enlarged, but its consistency remains homogeneous, these are the first signs of such a disease as prostate adenoma.
Important! Rough contours of the gland, or increased texture density may indicate the development of prostate cancer.
Conclusion
If, during an independent rectal examination, at least one of the above symptoms was found, you should immediately consult a specialist. After all, each of the possible diagnoses requires mandatory additional confirmation by laboratory tests.