title: Patient positioning during digital rectal examination of the prostate: preferences, tolerability, and results.
abstract: OBJECTIVE
  To evaluate the preferred position used by Brazilian Urologists to perform DRE, the position that Brazilian patients prefer or think it is less embarrassing to have a DRE, and to evaluate the results of DRE with patients in left lateral decubitus, modified lithotomy, standing-up, or the physician will have them place their elbows on the table and squat down slightly.
  
  
  METHODS
  Brazilian Urologists were contacted by e-mail, and 200 patients answered a questionnaire while undergoing prostate cancer screening.
  
  
  RESULTS
  The preferred position was modified lithotomy position reported by 63.4% of Urologists, and left lateral position reported by 42.7% of the patients. Total DRE time was lower in the standing-up position. Pain and urinary urgency scores were similar regardless of the position used, and bowel urgency score was higher in patients squatting down. Patients were similar in terms of age and PSA level, but there was a significant difference between the standard deviations of estimated prostate weight in left lateral position. There were no differences in prostate asymmetry, positive DRE, or incomplete palpation of the prostate rates among different examination positions.
  
  
  CONCLUSIONS
  Despite individual subjective preferences, a faster examination time in the standing-up position, and higher bowel urgency scores in patients with their elbows placed on the table and squatting down slightly, there were similar rates of prostate asymmetry, positive DRE, and incomplete palpation of the prostate, and comparable patient tolerability among different examination techniques.
authors.affiliation: Hospital de Clinicas da Universidade Federal do Parana, PR, Brazil. frederico.romero@gmail.com
authors.forename: Frederico R
authors.initials: FR
authors.lastname: Romero
authors.forename: Antonio W
authors.initials: AW
authors.lastname: Romero
authors.forename: Renato
authors.initials: R
authors.lastname: Tambara Filho
authors.forename: Thadeu
authors.initials: T
authors.lastname: Brenny Filho
authors.forename: Fernando Cesar
authors.initials: FC
authors.lastname: de Oliveira Júnior
mesh_terms: D051517:Digital Rectal Examination / Q000009:adverse effects / Q000379:methods*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D056888:Patient Positioning / Q000379:methods*; D057240:Patient Preference / Q000706:statistics & numerical data*; D011467:Prostate; D014572:Urology / Q000706:statistics & numerical data