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Advances in Urology
Volume 2013 (2013), Article ID 797096, 5 pages
http://dx.doi.org/10.1155/2013/797096
Clinical Study

Digital Rectal Examination Standardization for Inexperienced Hands: Teaching Medical Students

1Faculty of Medical Sciences, University of Campinas, Unicamp, Rua Tessália Vieira de Camargo 126, Cidade Universitária “Zeferino Vaz”, 13083-887 Campinas, SP, Brazil
2Faculty of Medicine, Center for Life Sciences, Pontifical Catholic University of Campinas, PUC-Campinas, 13060-904 Campinas, SP, Brazil

Received 14 July 2013; Accepted 22 August 2013

Academic Editor: William K. Oh

Copyright © 2013 Leonardo Oliveira Reis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. To standardize digital rectal examination (DRE) and set how it correlates with the comprehensive evaluation of lower urinary tract symptoms (LUTS). Methods. After scaled standardization of DRE based on fingertips graphical schema: 10 cubic centimeters—cc for each fingertip prostate surface area on DRE, four randomly selected senior medical students examined 48 male patients presenting with LUTS in an outpatient clinical setting, totaling 12 DRE each. Standardized DRE, international prostate symptom score (IPSS), serum PSA, transabdominal ultrasound (US), urodynamic evaluation, and postvoid residue were compared. Results. The mean and median PVs were US—45 and 34.7 cc (5.5 to 155) and DRE—39 and 37.5 cc (15 to 80). Comparing DRE and US by simple linear regression: US PV = 11.93 + 0.85 × (DRE PV); . Among patients classified as nonobstructed, inconclusive, and obstructed, the US PVs were 29.8, 43.2, and 53.6 cc ( ), and DRE PVs were 20, 35, and 60 cc ( ), respectively. Conclusion. This is the first attempt to DRE standardization focusing on teaching-learning process, establishing a linear correlation of DRE and US PVs with only 12 examinations by inexperienced hands, satisfactorily validated in an outpatient clinical setting.