title: Does clarifyng the digital rectal examination to the elderly reduce the discomfort in its first execution?
abstract: OBJECTIVE
  To assess the degree of discomfort reported by elderly men when first submitted to digital rectal examination (DRE) in the prevention of prostate cancer and the effect of previous explanations on this complaint.
  
  
  METHODS
  A prospective, randomized study in 120 men aged 60 to 80 years, divided into two groups: group A (routine medical appointment) and group B (medical appointment with educational intervention). In group B, the information tools were informal talk with explanations of DRE and prostate cancer, visualization of model of the male pelvis and the anatomical relations with the prostate, DRE simulator and DVD with three-dimensional animation of the pelvic organs. The degree of discomfort was measured by visual scale of pain. We used the chi-square test, with significance at 0.05.
  
  
  RESULTS
  There were significant differences between the degree of discomfort mentioned in DRE between the two groups; 81% of group B reported it as mild, while 80% of group A referred it as moderate or intense, with significant p=0.01. The signs and symptoms were the main reason for consultation in 35% of patients; 78% went to be consulted alone and 81% commented on their own examination with their spouses. With no statistical difference, 94.2% in group A and 97.8% in group B repeated the examination the following year and 91.6% in group A and 96.6% in group B reported that the exam was not worse than imagined. All would recommend DRE for relatives or friends.
  
  
  CONCLUSIONS
  Patients who did the first DRE after urological consultation with prior educational clarification on the issue reported significantly less discomfort.
authors.affiliation: Urology Service of the Gama Regional Hospital, Federal District, Brazil. bruno.mestrinho@gmail.com
authors.forename: Bruno Vilalva
authors.initials: BV
authors.lastname: Mestrinho
authors.forename: Lucy
authors.initials: L
authors.lastname: Gomes
authors.forename: José Luiz Telles
authors.initials: JL
authors.lastname: de Almeida
authors.forename: José Carlos
authors.initials: JC
authors.lastname: de Almeida
authors.forename: Renata Verna Leal
authors.initials: RV
authors.lastname: de Oliveira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D051517:Digital Rectal Examination / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011446:Prospective Studies