Patient's reactions to digital rectal examination of the prostate.
OBJECTIVE
In recent years, there has been a rise in the incidence of prostate cancer (PCa), and routine screening for the disease has become a well accepted clinical practice. Even with the recognized benefit of this approach, some men are still reluctant to undergo digital rectal examination (DRE). For this reason, we designed the present study in order to better understand men's reactions about this method of screening. The aim was to identify possible drawbacks that could be overcome to increase DRE.


METHODS
We randomly selected 269 patients that were enrolled in an institutional PCa screening program. They were first asked to answer a question regarding their preferred position to undergo the examination. Following this step, they answered a questionnaire in which physical and psychological reactions regarding the DRE were presented. Finally, we used a visual analogical scale (VAS) to analyze the perception of pain during DRE.


RESULTS
The supine position was preferred for most patients (53.9%). Before DRE, about 59.4% of patients felt that the exam would be acceptable. After DRE, this figure increased to 91.5% (p < 0.001). Mean VAS score during DRE was 1.69 on a scale with a range between 0 and 10 (0 = no pain; 10 = extreme pain).


CONCLUSIONS
Patient expectations about DRE were negative before examination and changed significantly following the exam. Pain during examination was negligible, contrary to the prevalent belief. These two findings must be clearly presented to patients in order to improve PCa screening acceptance.
Furlan
Andre B
AB
Division of Urology, University of Sao Paulo, USP, Sao Paulo, SP, Brazil.
Kato
Rafael
R
Vicentini
Fabio
F
Cury
Jose
J
Antunes
Alberto A
AA
Srougi
Miguel
M
D000368:Aged; D000369:Aged, 80 and over; D051517:Digital Rectal Examination / Q000009:adverse effects / Q000379:methods / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology; D011187:Posture; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D011795:Surveys and Questionnaires