How is the Prostate Examined?

The prostate is felt or "palpated" via digital rectal exam or "DRE". 

See figure below:

Source: Wikimedia Commons and NCI

In this cutaway side view, the doctor's finger is in the rectum and digitally examining the prostate gland.

When your doctor does a DRE he or she is assessing several attributes regarding your prostate:

• Size - How big is the gland?
• Symmetry - Is one side or "lobe" different in size compared to the other one?
• Contour - Are there any lumps or "nodules" within the gland?
• Consistency - Are there any firm areas within the prostate?

A well trained clinician can detect all these factors pretty quickly from the exam.  If an abnormality is found the patient may be offered a prostate biopsy to determine whether or not the prostate harbors cancer.

As a urologist, I believe that when a patient elects to be screened for prostate cancer a digital rectal exam should be part of the process.  Though screening for prostate cancer is a controversial issue, much of the attention has been around PSA testing alone with little acknowledgement of the utility of the DRE.

The DRE is also helpful in assessing the prostate for other conditions such as benign enlargement of the gland or "BPH" or prostatitis.