Position for digital rectal exam

Just had my annual physical today. The Doc. (Very attractive female) explained the two options and gave me my choice.

And what was the second option that she gave you?

Laying on my side.

The conventional position in most clnics is Sims (as described) but that's the real world. In a play doc situation the relationship you've established will determine the most stimulating position eg facing downwards on the floor with both elbows/forearms flat to ground, bum raised, legs drawn up and toes inward and touching. Very exposing but not seen in most hospital settings!!

Army doctor had me from a standing position bend over and spread my cheeks, two different Urologists in different offices both did it the same, standing, no bending over, one female Nurse Practitioner had me lay on my side and bring top knee toward chest, and my current female Nurse Practitioner has me stand on the foot stool at the end of the table and lay my chest on the table. This is my favorite, because the gown drops off, I'm completely exposed, and can't see what she's doing. Plus she's hot.

I have had a few all by military docs or va docs always bent over a table

With all the male doctors I have been examined by, it has been while standing and leaning over the exam table. This includes a urologist. In the last four years I have had two exams by female doctors where they had me lay on my side. I prefer the standing method, but would not object to being on all fours.

I can't say it enough, I just love to have a man up on the exam table on all 4's completely naked so I can play with and in his ass. Mmmm

Mashie

As I've mentioned before, I've had three DREs in my lifetime; all in the past couple of years. One was on my side and the other two leaning over a table. But for my last DRE, about a year ago) the doctor did something a little different to get me into position to accept his finger. After the abdominal palpation and genital exam, he instructed me to hop down off the table and so he could check my prostate. I figured he would just want me to lean over the table with my pants around my ankles so I got into what I thought would be a suitable position. But as I was doing so, he stopped me and told me exactly how he wanted me to stand. In fact, with my pants and underpants around my ankles, he faced the table and demonstrated the position.

Basically, I was to lean over and support my upper body with my forearms like normal. But he was insistent that I point my toes together. I didn't ask him why, I just obeyed his wishes. In fact, after telling me to take a deep breath, he asked me to confirm that my toes were pointed together. Has anyone else been told to assume this position? I don't know what pointing my toes together accomplished. Maybe it helps to relax the sphincter and/or other muscles in the buttocks? Would it maybe prevent a less willing patient from clenching up? (Trust me when I say I am more than willing to accept a doctor's finger in my anus.)

My understanding for the patient being asked to point their toes together prior to a digital rectal examination is that it helps to prevent the patient clenching their buttocks.

I have had five rectal exams, two in Sims position and three bent over the table. I like Sims better because it is awkward and I find that it enhances the embarrassment of the exam. Getting into Sims requires that the patient lie on his side and bend the top knee and pull it toward his chest. The examiner then has to lift the top cheek up to expose the anus. It is also awkward if the patient his lowered his shorts for the genital and hernia exams before the rectal and then has to remount the exam table with the shorts still down. When the patient bends over the table, it is a much smoother transition from genital to rectal by just having the patient leave his shorts down and turn toward the table and bend over. Also, when the patient is bent over, the anus is exposed so that little of the cheek spreading is required. Sims is a more fulfilling experience.

I have had probably 15-20 DREs over the years, and every single one involved bending over with my chest on the exam table.

Diaper position is the best...the helplessness ...the vulnerability

Standing on my head! Okay just kidding! I have had them most often while on my back and in stirrups or while lying on my side. Sometimes both ways during a physical. On rare occasions, its has been leaning onto the table and checked while standing. One thing is for sure, no one has ever missed the target so to speak. Each time my anus puckers either before or upon removal of the doctor's finger. I have to say that feeling of lube between my cheeks is such a unique feeling if only for a few seconds! So anyone had it done standing on their head?

Have a great day...off to run with my dogs.

At the Pediatrician the rectal was done with me laying on my side. Whe I switched to a regular doctor, he had me bend over the table. These days they are always done bent over. At my PCP I'm in a gown with everything exposed. At the urologist, I drop my pants and underwear to my ankles and spread my legs apart so she can examine the front then I turn around and bend over the table. She is seated for all of this.

Has any one ever gotten a rectal exam rectal temp, suppository or enema lying totally naked on their stomachs flat on an exam table? Seems not many did but I did and its a sensation that's never been repeated anytime else. If so how old were you , what were you there for and what kind of doctor was it?

Maybe eight years old at doctor for checkup. Nurse (then in the white uniform and cap) made me lie face down on my tummy... she pulled my briefs down and then despite my protests that I was too old for this, dipped a rectal thermometer in Vaseline, spread my cheeks and slipped it in.

My much older sister was their (she had driven me) and she just laughed and laughed. Total humiliation.

The sensation and that event is still a defining moment for me.

I hope everyone realizes that

1) Rectal temperatures are not rectal exams, and

2) in the absence of some suspected pathology, rectal exams are not part of pediatric care.

Keep reality threads real and have fun on the fantasy threads.

Interesting that taking the temperature recally appears to have been much more common in the US than here in the UK.

From UK here, never had a rectal temperature taken. It used to be a glass thermometer in the mouth, but now an electronic instrument in the ear. But rarely done during a GP appointment nowadays.

Like my other UK people, I have never ever heard of anyone having a rectal temperature taken in the UK, goes back to what I keep saying the US is obsessed with rear ends, DRE's before 20? never had one at any time and I am 53 now, its been proven a pointless procedure. Injections in the bottom? not once ever. You're getting the ass end of the deal America!

Like my other UK people, I have never ever heard of anyone having a rectal temperature taken in the UK, goes back to what I keep saying the US is obsessed with rear ends, DRE's before 20? never had one at any time and I am 53 now, its been proven a pointless procedure. Injections in the bottom? not once ever. You're getting the ass end of the deal America!

DRE has not been proven pointless. It's been proven to be the most effective inexpensive and minimally invasive method of evaluating the prostate. I had my first in my 20s as part of a physical for a job that included a public pension that might have provided 100% disability on day 1 of employment. After that, not until I was over 40 and it became an annual routine.

Rectal temperatures? Not after I was able to hold the glass thermometer under my tongue.

To Jds4MEd

I think you should do the reading, all modern physicians state it has really no value. In comparison with PSA testing and subsequent questioning by your physician about history and symptoms.

Jds4med: I'm over 40 and I've not been proposed a rectal exam so far (except the two ones I got as a kid for appendicitis, and then they were more imposed than proposed)... I guess I'm not considered at risk or old enough.

Other folks: Why are we discussing rectal temperatures?!

all modern physicians state it has really no value

All modern physicians? Hardly. There a numerous recent studies that still underscore the importance of the DRE for prostate cancer detection.

Here's one from 2012: https://www.ncbi.nlm.nih.gov/pubmed/23228289

From the study: "CONCLUSION: Almost 50% of men in our cohort diagnosed with prostate cancer had an abnormal DRE. While only 14% of all patients with prostate cancer had an isolated DRE abnormality, 31% of these men had normal age-specific PSA values. Such observations underscore the importance of the DRE for prostate cancer screening."

Please get your facts straight before you make sweeping statements that use the word "ALL".

The reliance on technology is a detriment to good medical care. The number of false positive and false negative PSA results is startling. I've personally been the victim of a false positive and only escaped an unnecessary biopsy by having an old school urologist. After a round of antibiotics and time, my level dropped into a normal range.

Bottom line - all tools should be used and evaluated by an open mind. DRE isn't used as much because of insurance reimbursement - they won't pay for two tests for screening purposes. Sending the patient out for a blood test is much simpler and efficient for the doctor's schedule than taking the time for a DRE.

I think one reason they don't do them as much is because many patients don't love the idea of them. I was definitely in that camp, then I got my first one. I don't love them, but the worst part was definitely worrying about it. For 30 seconds to a minute of embarrassment and slight discomfort a doctor can assess whether the prostate is inflamed, get a very rough estimate of size, feel for unusual parts over about a third of the surface, and check out the condition of the anal canal and lower rectum and pelvic floor muscles. I'm not jumping up and down thinking "Oh goodie!" over the prospect of one (that's saved for play with my wife), but it complements the other tests and adds information that may be valuable, so I do it and don't worry too much.

@moliere Your characterization of the evaluation of the prostate via DRE is somewhat flawed. In the mere seconds that the doctor's finger is in your rectum, they feel about 1/2 of the surface, evaluate the texture and contour, evaluate consistency, feel for lumps and bumps and estimate the weight of the prostate rather accurately.

For the routine DRE, the examiner also feels for anomalies in the anus and rectum and evaluates anal sphincter tone.

For me, it's always done with me bent over the exam table.

Not every person posting here has a medical background, but I hope that when someone in no way invokes fantasy, but states a more than reasonable understanding, and certainly a much to be encouraged, honest, perspective, that we thank that person, and others, for bothering to express.him/herself.

Either leaning over exam table with elbows on table , or laying on left side with top leg bent.

I always spread my legs and lean over the exam table.,. However after reading some other posts I may ask the Dr. if he would get a better feel for things if I assumed the Sims position. I'll let you know what happens in the next few weeks when I have some exams coming up.