title: Patients' perceptions of pain and discomfort during digital rectal exam for prostate cancer screening.
abstract: OBJECTIVE
  To evaluate patients' perception of pain and discomfort during DRE, the impact of discomfort on potential future screening compliance, and if emptying the bladder immediately before DRE reduces patient discomfort.
  
  
  METHODS
  One-hundred patients undergoing DRE for prostate cancer screening answered an anonymous questionnaire regarding pain, urinary urgency and bowel urgency during DRE and its potential impact on future examination. Another group with 100 patients was randomized in two subgroups to analyze if urinating immediately before DRE reduces patient discomfort.
  
  
  RESULTS
  Seventy-three (73%) patients reported moderate or higher discomfort for at least one of the domains evaluated: 61% complained of pain; 22% of urinary urgency; and 22% of bowel urgency. Emptying the bladder immediately before examination did not reduce pain (58% vs. 50%, p = 0.115), urinary urgency (22% vs. 16%, p = 0.151), or bowel urgency intensity (16% vs. 14%, p = 0.264). There was no difference in the number of patients that answered they will repeat the prostate exam next year (96% vs. 90%, p = 0.211) or in those that would encourage a friend that needs the prostate exam to do it (96% vs. 98%, p = 0.378).
  
  
  CONCLUSIONS
  Pain and discomfort during DRE are not negligible but they do not affect intention to have a prostate exam in the future. Urinating immediately before examination does not significantly reduce the incidence of pain, urinary urgency, or bowel urgency during DRE.
authors.affiliation: Instituto Curitiba de Saúde (ICS), Curitiba, PR, Brazil. frederico.romero@gmail.com
authors.forename: Frederico Ramalho
authors.initials: FR
authors.lastname: Romero
authors.forename: Anônio Wilson
authors.initials: AW
authors.lastname: Romero
authors.forename: Thadeu
authors.initials: T
authors.lastname: Brenny Filho
authors.forename: Nageib Mamedio
authors.initials: NM
authors.lastname: Bark
authors.forename: David Shinobu
authors.initials: DS
authors.lastname: Yamazaki
authors.forename: Fernando César Júnior
authors.initials: FC
authors.lastname: de Oliveira
mesh_terms: D051517:Digital Rectal Examination / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008403:Mass Screening; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D014554:Urination