This topic continues to come up from time to time. I still see trauma programs that perform the good, old-fashioned digital rectal exam on nearly every trauma patient. But is it really necessary? In the not so distant past, it was standard operating procedure to perform a digital rectal exam in all major trauma patients. The belief had always been that valuable information about blood in the GI tract, the status of the urethra, and the neuro exam rectal tone could be gleaned from this exam. Unfortunately, a finger in the bum also serves to antagonize or even further traumatize some patients, especially those who may be intoxicated to some degree. On a number of occasions I have seen calm patients become so agitated by the rectal exam that they required intubation for control.
Male Exam Resources
The genitourinary and rectal exam is an essential part of the overall health assessment in the male. A complete and efficient exam will lead to the identification of current or potential health problems. For a variety of reasons, novice providers may meet barriers that interfere with adequately learning to perform this exam. This educational module is meant to provide an illustrated way to learn the basics, and to begin to overcome reluctance to perform the exam when given the opportunity. In addition, when you believe in the importance of the exam and know that you can carry it out successfully, you will find that the patients and your supervisors will be willing partners in your learning. While the discovery of abnormalities on exam is very important, the exam is a unique opportunity for the provider and the patient to communicate effectively about urinary and sexual function concerns, and how those concerns fit into the patient's overall health and well-being. When you and the patient work together during a well-executed exam, there is the development of mutual confidence and trust.
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Fellas: suck it up. So you get a digital rectal exam every few years. So you have to turn your head and cough. Ever seen a metal speculum?
It was the day: D-day, the day my soul died, and the day I had dreaded ever since my first day of medical school. It was the day my fingers were booked on a trip to the rectum in search of the elusive, possibly mythical, prostate gland. I thought that I would be ready. I thought that the repeated desensitization to otherwise grotesque topics would have saved me from my overly-sheltered, semi-stereotypical home-school graduated self. The medical school recruiters and academic advisers had conveniently forgotten this detail during my educational overview when I originally signed up to be a physician.