Male rectal exam - other hand?

The other hand is always on my buttocks

The doctors other hand is alway seperating my buttocks.

Mostly parting my bottom cheeks I noticed

I use my free hand to spread the guy's cheeks. When you tell them to spread their cheeks most have a hard time following instructions.

Personally, I would repeat the command and add a bit more detail. "What you are doing with your hands is not adequate. I need you to spread the cheeks apart so that I can see your anus." If that still proves to get an inadequate separation of the cheeks to provide exposure for you, try demonstrating what you want by spreading the cheeks for the patient and then asking him to reproduce your retraction maneuver. You could say something like "this is what I am wanting you to do. Spread them for me." If you have a scolding tone in your voice it could add a lot to putting the patient in his place and letting him know you are in charge. Very humbling.

I don't think I've ever paid attention to where the other hand was.

Sometimes, they put their other hand on your back, to keep you immobilized during the uncomfortable procedure. During a recent prostate exam, the urologist told me to bend over the table with my legs spread and knees bent. I was responding to a question about my recent symptoms when, midsentence, I felt a hand firmly placed on my back followed immediately by the sensation of anal penetration and pressure on my prostate. I emitted a groan before regaining the composure to finish talking. Unpleasant, but I was impressed by the accuracy. In one swift motion, without even needing to part my cheeks, he was knuckles deep in my rectum and ready to probe and massage my prostate.

I would have liked some warning before the finger went in, although a patient receiving his first rectal exam might appreciate his effort to spare him the dread of the impending insertion.

When I do rectals at work I usually try to keep my hand on the table. When the patient is standing I don't need to part the buttocks. When they are lying down I may use the other hand to lift the upper buttock. When doing a gyne rectal I usually try to keep my other hand to myself. I DO NOT want to convey any overfamiliarity or sexual overtones to the patient. When I've had rectals I've never noticed where the other hand is.

The procedure I teach is to position the patient facing the table, feet shoulder distance apart with elbows (and arms) on the table. The examiner places lube on the back of their nondominant hand and sits behind the patient. Always tell the patient what's coming next. First the examiner places one hand on each buttock and spreads the cheeks to observe the area. The examiner then takes the dominant index finger and lubes it from the back of the other hand, the other hand doesn't move. The lubed index finger is placed on the external anus and inserted. The other hand never leaves the buttock during the exam.

Good question. Thinking back to my one and only rectal exam, I don't remember at all where the other hand was. I remember walking over to the table, standing where he told me to and pulling down my pants and underwear. During this second big reveal of my physical, I became aware of him taking a seat on his stool behind me. As I leaned over and placed my elbows on the table, I had never felt as exposed and vulnerable as I did at that moment. I do remember very clearly him placing a hand on each cheek spreading them apart. To me, this was the worst part of the rectal exam. Me with my pants around my knees and bent over, with the doctor sitting right behind me spreading my cheeks apart and inspecting my butt hole. Just staring at my butt. That was the worst. I remember the insertion was very... ehh. It didn't hurt, didn't feel good, didn't feel bad. Just kind of weird. Even though I don't remember feeling his other hand, I do remember feeling his knuckles on the back of my scrotum when he was all the way in.

I would have liked some warning before the finger went in, although a patient receiving his first rectal exam might appreciate his effort to spare him the dread of the impending insertion.

Trust me, that first time patient is going to be full of dread no matter how much warning the doctor gives!

I've had rectal examinations twice (though not DRE; I'm not old enough yet, sadly), and both times, funny enough, the doctor started to examine my anus with both hands, and I could tell he was having a bit of trouble seeing everything (I'm fit and have a pretty muscular backside), so I said "how's this?" and spread my cheeks apart for him. With both doctors, right away he said, "Great! Yeah, that's perfect." One did mention, "Yes, I know this is a little awkward, but yes, this is perfect." It was incredibly nerve-wracking and exciting for me, spreading my own ass wide open for the doctor to see, and they both spent quite a bit of time down there. So I guess I'm the exception where the doctor was using both hands to do the examination! I can't wait for the day when I get a prostate exam and the other hand will go in the crease of my hip, or on my other butt cheek. Great question!