title: Is there a role for digital rectal examination in the followup of patients after radical prostatectomy?
abstract: OBJECTIVE
  We determine the role of digital rectal examination in the followup of patients after radical prostatectomy.
  
  
  METHODS
  We retrospectively analyzed data on 501 consecutive patients who underwent radical retropubic prostatectomy between 1992 and 1998, and were followed at the University of Miami. Patients were evaluated at 3 to 6-month intervals after surgery with serum prostate specific antigen (PSA) and digital rectal examination. Biochemical recurrence was defined as PSA greater than 0.2 ng./ml. and increasing on at least 2 consecutive measurements. Local recurrence, detected by an abnormal digital rectal examination, was defined as an induration or nodularity in the prostatic fossa.
  
  
  RESULTS
  Mean followup plus or minus standard deviation was 25.4+/-20.8 months. Disease recurred in 72 patients (14.4%) and was biochemical in all. An abnormal digital rectal examination was noted in 4 patients, none of whom had an undetectable PSA at the time of a palpable abnormality.
  
  
  CONCLUSIONS
  Our results suggest that an abnormal digital rectal examination after radical prostatectomy is always associated with a detectable PSA, which implies that performing a digital rectal examination in the absence of a detectable PSA may not be necessary.
authors.affiliation: Department of Urology, University of Miami School of Medicine, Florida, USA.
authors.forename: C
authors.initials: C
authors.lastname: Obek
authors.forename: E
authors.initials: E
authors.lastname: Neulander
authors.forename: S
authors.initials: S
authors.lastname: Sadek
authors.forename: M S
authors.initials: MS
authors.lastname: Soloway
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D010173:Palpation; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D012007:Rectum; D012189:Retrospective Studies