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ISRN Urology
Volume 2012 (2012), Article ID 456821, 4 pages
Research Article

Why I Cannot Find the Prostate? Behind the Subjectivity of Rectal Exam

Department of Urology, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, School of Medicine, P.O. Box 3235, Jerusalem 91031, Israel

Received 5 November 2011; Accepted 4 December 2011

Academic Editors: T. J. Maatman, F. Staerman, and A. C. Thorpe

Copyright © 2012 Dmitry Koulikov 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.


Background. Most physicians use digital rectal examination (DRE) to help detect prostate cancer and to estimate the prostates’ size. The accuracy of DRE is known to be limited. We evaluate the ability of doctors to palpate the whole prostate with DRE. Methods. At time of transrectal ultrasound (TRUS) the distances from the anus to the apex and base of prostates were measured. The TRUS’s distances were compared to the mean index finger length of our clinic doctors. Results. The ability of the urologist to reach and examine the apex, half, three quarters and the whole prostate was in 93.7%, 66.3%, 23.2% and 3.2% of cases respectively. Conclusions. In most cases it was impossible to palpate the whole prostate. Anatomical location and volume of the examined prostate, as well as the length of his own index finger limit DRE and allow the examination of only a small portion of the prostate.