Prostate Examination
Step 1: Explain the procedure
Step 2: Position the patient
Position the patient either standing and bending at the waist or while lying on their side with their knees bent towards the chest.
The buttocks are spread apart, and the anus, posterior perineum, and gluteal folds are visually inspected to identify pathologic conditions.
Step 3: Insert index finger
The nondominant hand is placed on the patient’s anterior pelvic bone to provide countertraction while the dominant hand slowly advances only the index finger through the sphincter and into the rectum.
After a few seconds, the sphincter should relax slightly, at which point your finger should advance further. Note should be made of sphincter tone, which can be lax or absent in neurologic diseases.
Palpation of the internal structures then proceeds in a systematic fashion.
Step 4: Palpate internal structures
Begin palpating at the apex of the prostate and progress toward the base. Determine the size of the gland and assess its consistency, which, when normal, resembles that of the thenar eminence when the thumb and little finger are opposed.
Prostate cancer typically feels like a harder nodule, and an abscess is typically fluctuant. In acute prostatitis, the gland can be quite tender, which can be a diagnostic finding; however, do not manipulate the prostate vigorously, because of the risk of bloodstream infection.
Step 5: Palpate the rectum
Circumferential palpation of the rectum is performed to identify any internal hemorrhoids that may be present and to detect any stool present and assess its consistency.
Step 6: Remove index finger
Upon removal of the finger, the stool on the finger is evaluated for blood and can be sent for studies, including occult blood, if found.
Supply the client with tissues for cleansing.