DIGITAL RECTAL EXAMINATION OF PROSTATE: DOES EXAMINER’S EXPERIENCE INFLUENCE THE RESULTS?
Division of Urology, Institute of Nephro-Urology, Lourdes Hospital, Kochi, India 682 012
H.Krishna Moorthy, Biju S Pillai, Sony Bhaskar Mehta , “DIGITAL RECTAL EXAMINATION OF PROSTATE: DOES EXAMINER’S EXPERIENCE INFLUENCE THE RESULTS?”. American Research Journal of Urology, vol 4, no. 1, 2020, pp. 1-3.
Abstract
There is lack of uniformity in grading the size or assessing the consistency of prostate gland with Digital Rectal Examination (DRE) when done
by different clinicians during evaluation of prostate pathology. This study was to compare the results of DRE findings in prostate pathology
performed by Urologists at three different levels of clinical practice in the same set of patients and assess the accuracy of the findings with
respect to their clinical experience.
Materials and Methods: 200 patients with clinical features of prostatomegaly having no documented Urinary Tract Infection were subjected
to DRE separately by one Resident in his Final year of training, Junior Consultant (5 years post degree) and Senior Consultant with more than
10 years clinical experience. Their findings were correlated with USG Abdomen estimated volume. Patients with DRE detected hard area in the
prostate underwent Trans-rectal tru-cut biopsy of the hard area in the prostate and the biopsy reports were again correlated with the clinical
findings.
Results: DRE grades assessed by Final year Resident correlated with USG Abdomen estimated volume in 63%, while the same for Junior
Consultant was 69% and that for Senior Consultant was 71%. The percentage correlation was better with smaller clinical size of the prostate
when the overall DRE assessment of the prostate volume by the three sets of observers was compared to USG Abdomen prostate volume. There
was also error in diagnosing abnormal texture of the prostate by Final year Resident in a significant number of patients.
Conclusions: There were significant variations in DRE findings of prostate among clinicians, with the accuracy improving with increase in
clinician’s experience. DRE
by different clinicians during evaluation of prostate pathology. This study was to compare the results of DRE findings in prostate pathology
performed by Urologists at three different levels of clinical practice in the same set of patients and assess the accuracy of the findings with
respect to their clinical experience.
Materials and Methods: 200 patients with clinical features of prostatomegaly having no documented Urinary Tract Infection were subjected
to DRE separately by one Resident in his Final year of training, Junior Consultant (5 years post degree) and Senior Consultant with more than
10 years clinical experience. Their findings were correlated with USG Abdomen estimated volume. Patients with DRE detected hard area in the
prostate underwent Trans-rectal tru-cut biopsy of the hard area in the prostate and the biopsy reports were again correlated with the clinical
findings.
Results: DRE grades assessed by Final year Resident correlated with USG Abdomen estimated volume in 63%, while the same for Junior
Consultant was 69% and that for Senior Consultant was 71%. The percentage correlation was better with smaller clinical size of the prostate
when the overall DRE assessment of the prostate volume by the three sets of observers was compared to USG Abdomen prostate volume. There
was also error in diagnosing abnormal texture of the prostate by Final year Resident in a significant number of patients.
Conclusions: There were significant variations in DRE findings of prostate among clinicians, with the accuracy improving with increase in
clinician’s experience. DRE
Keywords
Prostate, Digital Rectal Examination, Volume, Ultrasound Scan Abdomen
