Prostate exam

You may get a prostate exam at your age 40 exam but I wouldn't be surprised if you don't. May depend on the age and medical training and practices of the doctor. There are other reasons to do a rectal exam than just checking the prostate so it is the better practice to do one than not do one. But some doctors believe that doing a rectal exam on male patients makes many of those patients less likely to have regular physical exams, which may be right. So the docs skip the rectal and rely more on the PSA because patients accept having their blood drawn for a physical but are scared off of having physicals by the possibility of a rectal exam. I had my first rectal exam in my 20s as part of my first adult physical and have continued to get them regularly for years. Not every doctor did one when I was in my 30s and I didn't see a doctor every year during that period but by the time I hit 40, I got one every time I had a physical exam, except maybe once or twice. It became such a normal part of the exam that there was no reason to dread it. The type of doctor makes a difference too. An internist is more likely to be more thorough than a family practice doc because internist aren't as rushed and set more time for physicals than just the usual 10 minute appointment slots.

I used to get a private medical most years paid for by my employers, and from around age 45 they started to do a DRE to check the prostate. I had to lay on my side and bring my knees up to my chest and it was always done with one finger and some lube. It wasn't a big deal as long as you stayed relaxed and didn't tense up, and was over in less than 30 seconds. It's not a perfect test as they can only feel part of the prostate but neither is the PSA blood test apparently. I was talking to one of my NHS GPs a couple of weeks ago about this, and she said the PSA test is not considered very reliable nowadays as a number of factors can influence a too high or too low reading. So you could either get a false sense of security or end up being sent for painful invasive biopsies unnecessarily. Under pressure from me she reluctantly agreed to include that as part of some routine blood tests for me and I'll probably get those done in the Spring. Actually the same GP did automatically include a PSA for me in some routine blood tests a couple of years ago, so I guess the thinking around this test has change since then. I don't know what else men are suppose to do, be aware of symptoms I guess.

My doctors office I go to is part of a medical college and he of course is a teacher. I've learned a lot from going to him. My last visit he had a NP shadowin him to get her continued education in or something.

So who knows. I'll share the experience next week. Thank you all for your awesome feedback on my question.

Adding to my previous post re DRE checks of the prostate, I actually experienced my first rectal exam in my early 20s. I had on-going problems with my appendix that flared up every 6 months or so, and at the last appointment with my GP before he sent me into hospital to have it out he did a rectal exam. He told me to pull my pants down below my knees, and to lay on the couch on my left side with my knees brought up to my chest. I had no idea what was going to happen and assumed he was going to give me an injection. He told me to take a big deep breath and let it out slowly. As I was exhaling he slide 2 fingers into my rectum and pressed on my lower abdomen in several places with his other hand and asked me if anything hurt. I don’t think he used a glove as such, but more some sort of latex cover over his index and middle fingers, perhaps similar to a condom and pre-lubricated as it happened too quickly for him to be fiddling with a tube of KY. The examination was very comfortable to be honest, and I have had worse in more recent years with just the one finger. I guess his relaxation instructions helped, in more recent DREs I find they just do it without saying anything.

Men can be complete babies though...A couple few years back I was in the sauna at my gym and two guys were sitting across the way in the darkness and chatting. I gathered from their conversation that one of the men had recently been for a routine medical and had his first DRE. He was obviously at that age when they start doing these things but he was in pieces about it, completely aghast like he’d been violated or something. ‘They didn’t tell me that was going to happen, it was awful totally out of order’, he said. Goodness me perhaps he would prefer to be a woman and experience what they do !

I had my first prostate exam during my teens. I visited urology because of urinating problems. at the end of the exam female doctor instructed me to lay on my left side and bend my knees, than she put on gloves spread my buttocks and said "I'll put my finger in to your anus". She lubricated her finger and inserted one in to my rectum a pressed my prostate. it was just for few seconds 😃 .

My doctor is female. She said the DRE and PSA test is still advisable since I am 55 . She told me to move feet shoulder width apart and bend over the table as far as I could to bring the prostate into position for her. She swept around my rectum 360* then pushed down on my prostate asking if I felt any pain. Having none, she slowly pulled her finger out.

She said I should have a PSA blood test every year as well to keep a baseline and velocity( amount of change)

She told me to wait 48 hours for the blood test since she had pressed on the prostate which could raise the PSA score. Also said NOT to ejaculate for 48 hours prior to the test for the same reason.

Anyone else get this experience and advice?

I've read that you should wait 48 hours after a prostate exam and ejaculating before having your blood drawn for a psa test but my doctor did not mention it to me at all.

I've heard/read that ejaculating prior to a PSA test can raise the numbers. Never heard about the DRE doing the same.

Typically - I ignore the warnings and either have sex or masturbate well within the 48 hour window. My PSA is low and hasn't changed much in years.

Riding a bicycle, motorcycle or a horse can raise your PSA.

Riding a bicycle, motorcycle or a horse can raise your PSA.

Mine should be in the negative numbers then.

Since I lost my family doctor a few years ago I have to ask to get a DRE and even then I get the feeling she doesn't want to do it.

Mine should be in the negative numbers then.

Since I lost my family doctor a few years ago I have to ask to get a DRE and even then I get the feeling she doesn't want to do it.

Can you imagine how dull and boring she must be in bed??????

Can you imagine how dull and boring she must be in bed??????

Oh I hope not. She's a very pretty young woman and her husband sounds like a great guy on the phone. At my first appointment with her she was interested in my railcar adventures and wanted to go for a ride. I called her the next 2 or 3 times our group was going but she always had some excuse.

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Anyone else get this experience and advice?

I commented in a different thread about getting the same advice, including refraining from heavy exercise....

https://en.zity.biz/index.php?mx=forum;ox=display;msg=656427

Since I lost my family doctor a few years ago I have to ask to get a DRE and even then I get the feeling she doesn't want to do it.

I had similar experience. I have seen two different female physician assistants. The first 10 years ago did the dre/prostate exam. She passed away and I went to another in the same practice 6 years later. When we discussed the prostate exam she sent me to a urologist. I heard later she was the only female in the practice so the women could have a female for their annual well woman exams. I felt discriminated. She'll stick her fingers in a vagina, but not my ass and I had to pay another copay!

Seems to me if you ride a horse, or a motorcycle, or a bike, or masturbate, or have sex before every PSA test - your PSA may be a little artificially high - but it should be consistently a little bit high over the long term. (Unless, of course something changed). Docs look for changes - especially accelerated change in PSA.

When we discussed the prostate exam she sent me to a urologist.

and I had to pay another copay!

I think you found the secret ------ another copay. That's how they make up for the reduced payments on patient meetings. When they were promoting the new healthcare system one question they were asked was how they were going to pay for free healthcare for all. The answer was the money would come out of Medicare. Instead of your new "family physician" providing the same care you used to get they send you to other doctors ie more copays and in my experience sometimes full pays because the specialist doesn't do Medicare. For me that means Nocare because not knowing how much I'm going to be expected to pay I simply don't go.

My experience with real medical prostate exams is that they were not fun like the play exams. The first medical exam I received at age 20, when I was being examined for a hernia. I was put on my side, and at least two maybe three fingers were shoved into me. Later years I have had less aggressive exams but they were not at all stimulating.

Fortunately the last PSA test I received was part of a standard blood test, no fingering involved.

I was once fingered and given a blow job at the same time from a girl friend, now that was exciting!

@SWspanking

I was once fingered and given a blow job at the same time from a girl friend, now that was exciting!

I've received that many times, and it was very Hot! 😜

@gwhap

I've heard/read that ejaculating prior to a PSA test can raise the numbers. Never heard about the DRE doing the same.

I was speaking to a doc about this last Spring and she said that ejaculating prior to the test can raise the numbers. Seems to me that they need to come up with a more reliable test or something...

@gwhapI was speaking to a doc about this last Spring and she said that ejaculating prior to the test can raise the numbers.

@Dr_Philip - I don't doubt that ejaculating can raise your PSA numbers. But how much?? Is it significant?? And if someone ejaculates before every PSA test - unless there has been a significant change wouldn't the results still be consistent - albeit a little higher than if they hadn't ejaculated? Or is the rise in the PSA number random after ejaculation??

Just curious...

When I get my annual blood work done at the VA they test for just about everything. PSA is included. They tell me not to eat before the test why can't they tell me not to jerk off? The ARNP I had for 20 years certainly would have if she felt it was important.

I have heard before that getting a rectal/prostate exam before having the blood drawn can raise the PSA levels enough to give a false positive but I have never had a doctor say anything about it. Most of the doctors that I have seen in the past have done the rectal exam first and then sent me to the lab or drawn blood in the exam room. I guess that if the PSA numbers turn out higher, then you either see the doctor again or get referred to a urologist for another exam and more blood work. That happened to me several years ago. I got my physical exam, including a rectal, and then was sent to the lab for a blood draw.

My PSA numbers were a little high because my internist then referred me to a urologist who ordered another blood draw first before seeing me. He had the new PSA numbers, which were still higher than he liked. He did an exam and pressed on my prostate to get some fluid on a slide. He took the slide out out of the exam room, checked it under a microscope, came back into the exam room and told me that I had a mild prostate infection. Prescribed antibiotics and had me come back about a month later. Had blood work done again and did another rectal. He was satisfied enough with the PSA numbers and what he saw on the slide this time that he told me that I was fine.

My urologist said many things can give a higher psa number. Riding a motorcycle, horse riding and sex prior to blood test.

@gwhap

@Dr_Philip - I don't doubt that ejaculating can raise your PSA numbers. But how much?? Is it significant?? And if someone ejaculates before every PSA test - unless there has been a significant change wouldn't the results still be consistent - albeit a little higher than if they hadn't ejaculated? Or is the rise in the PSA number random after ejaculation??

Just curious...

I've never been told not to ejaculate before a PSA test, or been asked if I have ejaculated recently before they do it, so it does all seem a bit random. I heard that the examination itself can also affect the PSA level, perhaps they take the bloods first but can't remember on that one myself. I was speaking to a friend last week who has just been given the all clear from prostate cancer, and his PSA was around 2 or 3 but went up to 13 when he got the cancer, so I guess the increase is significant.

For me its always been one finger...legs spread to shoulder width and chest across the exam table

On a serious note, my PSA has always been taken a week prior to my check-up with no ejaculation for 2 days prior. It was always between 1.25 and 1.75. A year ago, it rose to 2.25 so my family doctor had it retaken 6 months later and it rose to 3.25. She sent me to a urologist.

The urologist is a pleasant young woman three years out of residency at a prestigious medical school. First she redid the the DRE and genital checks which showed no issues. However, her recommendation was to do the needle biopsy and my own research said that was the prudent course of action.

The biopsy is brutal with the needle pricking your prostate 12 times, but you hardly feel that. The worst part is the insertion of the probe / needle gun into the rectum - it's about the size of a baseball bat handle. You will also bleed in your urine, semen and stools for about a month afterwards. Good news is there was no cancer found and I will now have a genetic test done to determine the frequency of retesting.

Guys, don't mess around - early detection is pertinent!