Digital Rectal Exam (DRE)

July 1, 2024

This page was reviewed under our medical and editorial policy by Wesley Yip, M.D., assistant professor, Division of Urology and Urologic Oncology, Department of Surgery, City of Hope^® Cancer Center Duarte

A digital rectal exam (DRE) is a test that examines the lower rectum (where waste collects before a bowel movement), the prostate gland (the small, round muscular tissue near the rectum that helps to supply fluid to semen), the pelvis and the lower belly. Also called a prostate exam, a DRE checks the prostate for signs of cancer and other conditions, such as abnormal masses.

What Is a Digital Rectal Exam?

The DRE is a standard examination used to check the health of the prostate. It may be performed in addition to a prostate-specific antigen (PSA) blood test to screen for prostate cancer. Screening tests help identify cancer before symptoms begin and before cancer spreads.

Doctors may perform a DRE as part of a regular checkup or if the patient has symptoms of prostate cancer or other health conditions. These symptoms may include:

• A change in bowel habits
• Blood from the rectum or in the stool
• Blood or discharge from the urethra, the tube from which urine leaves the body
• A change in urine flow

To perform the DRE, the doctor will feel the prostate by reaching through the anus into the rectum with a gloved and lubricated finger. The doctor will then feel the back wall of the prostate gland to see whether it is enlarged or tender. They will also feel for lumps or hard spots.

Primary care doctors, gastroenterologists (specialists who treat diseases of the digestive system), surgeons, oncologists (doctors who diagnose and treat cancer) and other types of doctors may perform DREs.

Preparing for a DRE

Patients often ask whether they should have a bowel movement to prepare for a DRE. This is not necessary. Patients do not have to do anything to prepare for a DRE. They should, however, let the health care team know if they have hemorrhoids or anal fissures, since the exam could make them worse.

What Happens During a Prostate Exam?

DRE tests are quick, taking only a few minutes to complete. During the appointment, the health care team will bring the patient to a private exam room where he will be given a gown to wear or a cloth to wrap around himself. Patients will be asked to remove their clothing from the waist down and put on the gown or wrap.

Once the patient is ready, the doctor will have him get into position — either bending forward at the waist or lying on one side. To start the DRE, the doctor may ask the patient to try to relax and take a deep breath. Then the doctor will reach into the rectum with a gloved and lubricated finger to:

• Feel whether the prostate gland is enlarged or firm
• Feel whether the prostate gland has any lumps or soft or hard spots
• Determine whether the patient feels pain when the doctor touches or presses the prostate

Does a Prostate Exam Hurt?

A DRE is not usually painful, but it may be uncomfortable. If the patient has an enlarged prostate or hemorrhoids, a DRE may cause some mild discomfort.

DRE Results

The results of a DRE are typically available right away, because they don’t have to be sent out for analysis. If the prostate feels normal, the patient and doctor may discuss whether the patient should have another screening and, if so, when.

If the prostate feels enlarged or has irregularities, the doctor may recommend repeating the test soon to see how the prostate has changed, if at all. The doctor may also recommend additional tests, such as a PSA blood test, imaging and/or a biopsy (a procedure to remove a small sample of the prostate for testing).

If the DRE was done along with a PSA blood test as a prostate cancer screening, the doctor and the patient can use the PSA results to decide whether another test may be needed and how soon to do it.