scholarly journals Documentation of Rectal Examination Performance in the Clinical Teaching Unit of a University Hospital

2000 ◽  
Vol 14 (4) ◽  
pp. 272-276 ◽  
Author(s):  
Hugh James Freeman
Keyword(s):  
Blood Loss ◽  
Clinical Teaching ◽  
Prostate Gland ◽  
Digital Rectal Examination ◽  
Occult Blood ◽  
House Staff ◽  
University Hospital ◽  
Medical Resident ◽  
Rectal Examination ◽  
Teaching Unit

Digital rectal examination is used to evaluate the distal rectum and other organs, including the prostate gland. It may be combined with fecal screening for occult blood loss, and annual performance has been recommended for asymptomatic individuals over age 40 years for cancer screening. In this study, documentation of digital rectal examinations was assessed through a review of hospital medical records of a randomly selected group of 100 patient discharges (55 females and 45 males) from a total of 896 patients admitted through a hospital emergency room to a medical clinical teaching inpatient unit of a university hospital during a six-month period. In this group, 26% were admitted for a gastrointestinal disorder, but only 17% of all hospitalized patients had rectal examinations done by the medical resident house staff and/or attending medical staff directly responsible for the care of these patients. Occult blood testing was done in 15 patients. Pelvic and breast examinations were rarely documented. The majority of rectal examinations (ie, 13 of 17) were ’same sex’ examinations, appeared to be used largely for testing or confirmation of grossly visible blood loss and were never confirmed by attending staff. The presence or absence of nursing staff during examinations was not documented. The prostate examination was normal in one patient but not documented in the other 44 males (ie, 26 patients over age 60 years). In conclusion, rectal examinations (as well as breast and pelvic examinations) were rarely documented in the medical teaching unit by medical resident house staff or their attending staff.

INVOLVEMENT OF THE PROSTATE BY CHRONIC LYMPHOCYTIC LYMPHOMA, CLINICAL AND PATHOLOGICAL CHARACTERIZATION

2016 ◽  
Vol 11 (3-4) ◽  
Author(s):  
RAMI ALAZAB
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Prostate Volume ◽  
Prostate Gland ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Lymphocytic Leukemia ◽  
Rectal Examination ◽  
Treatment Paradigm ◽  
Male Patients ◽  
Prostate Diseases

Introduction: Few reports have described the involvement of the prostate by hematolymphoid infiltrate; the usual presentation is that of benign prostatic hyperplasia, because of the rarity of the condition; there is no specific diagnostic or treatment paradigm. We set out to study the clinicopathological features for this occurrence. Material and Method: This is a retrospective review to describe the clinical and pathological characters of secondary involvement of the prostate by chronic lymphocytic leukemia/lymphoma. Cohort included male patients above the age of 40 years who were diagnosed to have CLL with secondary infiltration of the prostate gland.Results: Among 1512 pathologies reviewed; nine patients were found to have involvement of the prostate gland by CLL. The discovery of the prostate involvement was proved either by pathology examination of prostate chips obtained by Tran Urethral Resection of the prostate or Tranrectal Ultrasound guided prostate biopsy. The average age 57.6 years, prostate specific antigen 2.52 ng/ml   AUA-score 23/35, abnormal Digital Rectal Examination 2/9, prostate volume 64 gm. Cohort was contrasted with our institutional prostate diseases database.Conclusion: Prostate gland might be an overlooked site of Chronic Lymphocytic leukemia infiltrate; patients usually present with severe obstructive symptoms and/or abnormal PSA/Digital Rectal Examination. Urologists and pathologists and should be oriented to the mode of presentation, diagnostic and treatment approaches of this population of patients.

A systematic review of the accuracy of the digital rectal examination as a method of measuring prostate gland volume

2019 ◽  
Vol 12 (5) ◽  
pp. 361-370 ◽  
Author(s):  
David RH Christie ◽  
Jane Windsor ◽  
Christopher F Sharpley
Keyword(s):  
Systematic Review ◽  
Statistical Tests ◽  
Prostate Gland ◽  
Transrectal Ultrasound ◽  
Digital Rectal Examination ◽  
Volume Estimation ◽  
Level Of Evidence ◽  
Rectal Examination ◽  
Gland Volume ◽  
Clinical Scenarios

Objective: There are many important clinical scenarios in which estimates of the volume of the prostate gland can have an influence on clinical decisions. The digital rectal examination is the simplest and most readily available method for measuring it. It is commonly performed numerous times every day by practising urologists and radiation oncologists. The prostate gland volume is the most studied parameter arising from it. Although reported in many heterogeneous studies, the accuracy of the digital rectal examination in measuring the volume has never been reviewed. Our aim was to conduct the world’s first systematic review. Methods: Articles from the literature were included if they compared the digital rectal examination with more accurate measures including fluid displacement after radical prostatectomy and transrectal ultrasound measurements. Results: Nineteen articles describing 7891 patients were reviewed and summarised. Wide variations were noted but most studies provided correlation coefficients that lay between 0.3 and 0.7. For those studies that did not involve special training in volume estimation or were not conducted by a urologist with a special interest in the correlation, the coefficients were below 0.6. For eight studies that analysed the estimated volume as a categorical variable, concordance was described using a variety of statistical tests but was generally high. Conclusions: The reported correlations were weak to moderate strength indicating that the digital rectal examination may not be accurate enough when quantitative measurements are required. However, enlargement of the prostate was detectable with high levels of concordance, indicating that the digital rectal examination is effective for that purpose. Level of evidence: Not applicable for this multicentre audit.

scholarly journals Do Patients Undergo Prostate Examination while Having a Colonoscopy?

2009 ◽  
Vol 23 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Tess Hammett ◽  
Lawrence C Hookey ◽  
Jun Kawakami
Keyword(s):  
Prostate Cancer ◽  
Detection Rate ◽  
Chart Review ◽  
Prostate Gland ◽  
Digital Rectal Examination ◽  
Retrospective Chart Review ◽  
Rectal Examination ◽  
Novel Concept ◽  
Direct Referral

OBJECTIVES: To determine the rate at which physicians report performing a digital rectal examination and comment on the prostate gland before performing colonoscopy in men 50 to 70 years of age.METHODS: A retrospective chart review of all men 50 to 70 years of age who had a colonoscopy in Kingston, Ontario, in 2005 was completed. It was noted whether each physician described performing a digital rectal examination before the colonoscopy, and if so, whether he or she commented on the prostate.RESULTS: In 2005, 846 eligible colonoscopies were performed by 17 physicians in Kingston, Ontario. In 29.2% of cases, the physician made no comment about having performed a digital rectal examination; in 55.8% of cases, the physician commented on having completed a digital rectal examination but said nothing about the prostate; and in 15.0% of cases, the physician made a comment regarding the prostate. No physician consistently commented on the prostate for all patients, and in no circumstances was direct referral to another physician or follow-up suggested.DISCUSSION: A colonoscopy presents an ideal opportunity for physicians to use a digital rectal examination to assess for prostate cancer. Physicians performing colonoscopies in men 50 to 70 years of age should pay special attention to the prostate while performing a digital rectal examination before colonoscopy. This novel concept may help maximize resources for cancer screening and could potentially increase the detection rate of clinically palpable prostate cancer.

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