Digital rectal exam: which fingers?

I used to assume a digital rectal exam involved only one finger (index or medium?). However I've seen on a web site "1 or 2 fingers". Does 2 fingers really happen? And which finger is used?

(My only experiences with DREs happened nearly 40 years ago, as a kid, one finger I'd say, but in no position to see if index or medium.)

@Jacana Not to say a DRE is never done with two fingers. Do you recall the reference to the website mentioning “one or two fingers”? From what I could find searching the internet for DRE procedures, two articles referenced a two finger DRE (TF-DRE). Both stated they used it to assess anal fistulas, (it wasn’t clear to me if both fingers were inserted internally or one internal and one external on the perinium). The only mention of using the middle finger was for a female recto vaginal check, but I don’t know why they couldn’t for a prostate exam as well

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331745/

https://jgo.amegroups.org/article/view/76450/html

Pretty sure all my DREs were performed with the index finger as I’ve observed a well lubricated gloved index finger either before or after the exam.

Laura and I always ask our NP for a DRE during our annual gyn exams and it always happens with just her index finger. We're both quite petite there, so two fingers would be quite uncomfortable for us.

I have had them done by few different doctors and a couple of nurse practitioners. For all but a couple of the exams I have been able to see them lubricate their finger right before the exam. And it's always been their index finger that they have used.

I had an ex that worked at a urologist office.

She said if a patient wanted a second opinion they would insert 2 fingers!

I was trained in my physical diagnosis class to use one finger: the index. In the thousands of DREs I've done I've never done it any other way.

The index finger is the most logical, but am sure some play doctors could experiment using others, or multiple. Two fingers (index and middle) can definitely help assess any unusual findings, giving a second dimension to the sensation/sizing etc or be used to palpate each side of the prostate at the same time rather than brushing the index finger over the prostate from side to side, but rare in practice.

If you wiggle each finger on your dominant hand you’ll quickly find why the index finger is preferred, it has the most movement, and usually is more sensitive than other fingers. Plus it more easily allows the other fingers to be rotated out of the way in between the buttocks during an exam, and puts the wrist under less strain in the common exam positions.

I have never had a doctor do a digital rectal exam so I do not really know what finger is best for that, but with that being said anytime I have been fingered they have used their middle finger to stimulate the prostate but they have also been able to get there pointer finger and middle finger in at the same time. If they are trying to stretch me out a bit the two fingers are best but if they are just playing with my prostate the middle finger works great.

I have never had a doctor use two fingers at the same time but I have had a doctor with really small hands switch fingers and try again. She started with her index finger but it was too short to locate the prostate so she switched to her slightly longer middle.

I don't think she performed them often and she was apologetic about needing to switch. That was no big deal but if a physician wanted to use two at once they would need to explain to me some pretty sound rational for doing so beforehand.

It’s always been one finger, the index finger for every rectal exam I’ve had performed by a doctor.

In the real exam, the urologist uses only one finger to check the prostate. However, in the medfet exams, the prostate exam is done with several fingers, up to the insertion of two fingers.

I've only had a DRE once by a urologist. He did use the index finger. I made sure to watch. He had big hands.

Had my fair share of digital rectal exams from both male and female providers. I believe exams have mainly been index finger, but one male doctor I saw used his middle finger - he was really rough too!

I can recall two different female doctors who used two fingers, index and middle finger together to do the exam. One of the doctors would even stand in front of me holding a a 3x3 gause pad with a large squeeze of lubricant on it with her two fingers in the lube while she was telling me to turn around, bend over and rest my chest on the exam table.

Had this happen in play exams a number of times.

Ergonomically- the thumb. It's best situated to go in without stress on the joints, which allows for longer exams and milking.

All of them!

Solo or quintet.

I’m a retired emergency doc. Medical rectal exams are only done with a single finger. The index finger of one’s dominant hand. It becomes trained to feel pathology—rectal tumors, foreign bodies and prostatic nodules. Two fingers are used only in a bimanual pelvic exam where one uses two fingers—the index and long finger (the middle finger) of the dominant hand.