What is a Digital Rectal Exam (DRE)?

A Digital Rectal Exam, or DRE, is a quick and straightforward medical test used by doctors to check the prostate gland. The prostate is a small gland in men located just below the bladder and right in front of the rectum. “Digital” refers to the use of the doctor’s finger (digit), and “rectal” refers to the exam’s method—through the rectum.

During a DRE, your doctor will ask you to either bend forward over the exam table or lie on your side with your knees drawn toward your chest. They will wear gloves and use lubrication to carefully insert one finger into your rectum. This allows the doctor to feel the prostate gland through the rectum wall. They check for anything unusual, such as lumps, hardness, tenderness, or swelling that might signal prostate cancer or other prostate issues.

The exam is quick—usually lasting less than a minute—and while it may feel uncomfortable or a bit awkward, it’s typically not painful.

Common Myths About Digital Rectal Exams

Myth 1: The exam is extremely painful.
Truth: Most men experience mild discomfort or a feeling of pressure, but rarely significant pain. Any discomfort is usually brief and manageable.

Myth 2: Having a DRE can turn a heterosexual man gay.
Truth: A DRE is a medical exam. Sexual orientation is a deep and complex aspect of human identity. It cannot be changed by medical procedures or examinations. Many men wrongly fear this myth, but the reality is that having a medical exam involving the rectum has no impact whatsoever on sexual orientation.

Myth 3: A DRE is embarrassing and shameful.
Truth: Feeling embarrassed is understandable, but doctors regularly perform this exam as a normal part of medical care. They approach it professionally, ensuring your dignity is respected. Your health matters more than temporary embarrassment.

What a Digital Rectal Exam Might Catch

A DRE can help detect several potential prostate health issues:

  • Early signs of prostate cancer, such as a lump or hardness in the prostate gland.
  • Enlargement of the prostate (Benign Prostatic Hyperplasia or BPH).
  • Signs of infection or inflammation in the prostate (prostatitis).

What the Digital Rectal Exam Might Miss

While useful, the DRE isn’t perfect:

  • It might not detect very small or early-stage tumors.
  • The exam can only check part of the prostate, not areas farther away from where the finger can reach.
  • Some prostate cancers don’t change the shape or size of the prostate and might therefore feel normal during the exam.

Because the DRE can miss some cancers, doctors often combine it with other tests, such as the PSA blood test, for a more thorough screening.

Positives of Digital Rectal Exams

  • Early Detection: Can find prostate cancer at an earlier, more treatable stage.
  • Quick and Simple: Takes less than a minute and does not require any special preparation.
  • Other Prostate Issues: Helps identify conditions like prostate enlargement or inflammation.

Negatives of Digital Rectal Exams

  • Potential Discomfort: Some men feel uncomfortable or embarrassed during the exam.
  • Limited Accuracy: Can miss small cancers or abnormalities that might require additional tests for confirmation.

Making Your Decision

Talk openly with your doctor about your concerns. Understanding the facts about Digital Rectal Exams can help you make the best choice for your health.

If possible, the DRE should be done after a PSA test. Having a DRE straight before a PSA test may raise your PSA level. Your doctor may decide to do them at different appointments.

If the prostate gland feels larger than expected for your age this could be a sign of benign prostatic hyperplasia (BPH). A prostate gland with hard bumpy areas may suggest prostate cancer.
If your DRE result shows anything unusual, you may be referred to a hospital specialist. However it is not a completely accurate test. A man with prostate cancer may have a prostate that still feels normal.