The conversation before the prostate examination
Most urologists are aware of the shyness of their patients
and therefore try to take away the fear of the preventive medical examination.
For this reason, many experts have switched to always having an intensive
conversation with the patient before a prostate examination. The examination
therefore usually begins in the specialist's waiting room.
The questionnaire
A general questionnaire is often the first step before
entering the medical treatment room. This must be completed in full before
treatment and collects numerous data that are of crucial importance, especially
for the risk of prostate disease. In some cases, however, these questions are
also clarified in a personal conversation with the doctor in order to alleviate
the fear of the examination. Mainly it is about the current general state of
health.
Urination and ejaculation
The doctor will ask in detail how you are feeling during
urination and ejaculation. The urologist attaches particular importance to the
descriptions of the amount of urine when urinating, as well as the consistency
of the ejaculate, since these two liquids provide information about many
diseases of the prostate. Any previous illnesses and family burdens are also
asked about. Frequent bladder infections or the occurrence of kidney stones
favor the occurrence of prostate diseases. Furthermore, genetic factors favor
many diseases, so that relatives can also provide information about their
personal risk.
The libido
The sexual drive (libido) can also play a decisive role. The
attending physician therefore often asks about the frequency of the
ejaculations within a certain period of time and the general desire for sex.
However, this data can only be evaluated if a clear trend can be identified.
That is why the urologist also asks about sexual desire and behavior at a young
age.
The prostate examination
1. The rectal introduction
After completing the personal interview, the doctor begins
the first of three preventive examinations. This is the rectal introduction.
Before doing this, however, the doctor will also thoroughly palpate the
testicles, penis and abdomen to make sure that all internal organs are healthy.
It is necessary for the doctor to push back the foreskin of the penis and check
the entire genital area for hardening and lumps. The patient's erections are
completely normal.
Then the patient lies on his side and takes an embryonic
position. This makes it particularly easy for the doctor to reach the prostate.
A rubber glove that encloses the finger or the entire hand is usually used for
the prostate examination. The finger to be inserted is covered with plenty of
lubricant so that the procedure is as painless as possible for the patient.
However, it is important that the patient relaxes, as tension can lead to pain.
During the exam, the doctor will determine the size of the prostate and check
whether it is hardened. Do not be alarmed, as putting pressure on the prostate
can result in a spontaneous orgasm with ejaculation. Overall, this examination
usually only takes 30 seconds.
2. The transrectal ultrasound examination
After the rectal insertion is complete, the transrectal
ultrasound may follow. This is always necessary if the doctor has the feeling
that he can feel a hardening. A probe is inserted through the anus, which
examines the prostate with the help of ultrasound waves. This examination is
usually a little more uncomfortable and takes over a minute. If the suspicion
cannot be completely eliminated, some tissue is removed from the prostate with
a thin needle.
3. The PSA test
The so-called PSA test is an alternative to conventional
prostate examinations. Blood is taken from the patient and examined for
prostate-specific antigen (PSA). If the concentrations of the antigen is above
average, there is a risk of prostate cancer . The only disadvantage of this
method is that, due to a lack of data, it is currently not possible to state an
exact limit value.
Why is the prostate examination useful as a preventive
measure?
Many men shy away from a prostate examination, mostly for
spongy reasons. However, a postponed prostate examination can have fatal
consequences. Prostate cancer is the most common type of cancer in men. If it
is detected too late, the urinary bladder and urethra must be completely
removed in addition to the prostate . For this reasons, it is always necessary
to insert an artificial urinary tract afterwards. Prostate prevention is
currently the only medically recognized method for effective prevention and
early detection.
This is mainly because this method has the highest accuracy
to date. In almost 80% of all cases, this examination comes to a correct
result. Only in 20% of all cases is a wrong diagnosis made, so that healthy men
are treated or sick men are warned.
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