Name of the Procedure:

Common Name: Prostate Cancer Screening Medical Term: Digital Rectal Examination (HCPCS Code: G0102)

Summary

A digital rectal examination (DRE) is a simple and quick procedure where a healthcare professional checks the prostate gland for abnormalities. The doctor or nurse uses a lubricated, gloved finger to gently feel the prostate through the rectal wall.

Purpose

Medical Conditions/Problems Addressed:

• Prostate cancer
• Benign prostatic hyperplasia (BPH)
• Prostatitis (inflammation of the prostate)

Goals/Expected Outcomes:

• Detecting early signs of prostate cancer.
• Assessing the size and shape of the prostate.
• Identifying possible abnormalities requiring further investigation.

Indications

Symptoms/Conditions Warranting the Procedure:

• Elevated prostate-specific antigen (PSA) levels.
• Difficulty urinating or changes in urinary habits.
• Family history of prostate cancer.
• Men over the age of 50, or younger men with high risks factors.

Patient Criteria:

• Usually recommended for men above 50.
• Younger men with a family history of prostate cancer or other risk factors.

Preparation

Pre-Procedure Instructions:

• No special fasting or medication adjustments typically required.
• Patients may be asked to empty their bladder before the exam.

Diagnostic Tests/Assessments:

• A PSA blood test might be performed before or after the DRE.

Procedure Description

Step-by-Step Explanation:

1. The patient will be asked to undress from the waist down and may be provided a gown.
2. The patient will either stand and bend forward at the waist or lie on their side with knees pulled to the chest.
3. The healthcare provider will put on a lubricated glove.
4. The provider will gently insert a lubricated finger into the rectum and feel the prostate gland.
5. The provider will assess the size, shape, and texture of the prostate.
6. The finger is removed, and the area is cleaned if necessary.

Tools/Equipment Used:

• Lubricated glove.

Anesthesia/Sedation:

• Generally not required.

Duration

• Typically takes about 1 to 2 minutes.

Setting

• Performed in a doctor's office or outpatient clinic.

Personnel

• Examined by a healthcare provider such as a primary care physician, urologist, or qualified nurse.

Risks and Complications

Common Risks:

• Mild discomfort during the procedure.
• Minor rectal bleeding (extremely rare).

Rare Risks and Complications:

• Infection (extremely rare).

Possible Management:

• Address any notable discomfort with over-the-counter pain relievers.
• Report any unusual symptoms to the healthcare provider immediately.

Benefits

Expected Benefits:

• Early detection of prostate cancer, which can significantly improve treatment outcomes.
• Identifying other prostate issues that may require treatment.

Realization of Benefits:

• The benefits are generally immediate in terms of finding abnormalities that warrant further testing.

Recovery

Post-Procedure Care:

• No special care required; patients can resume normal activities immediately.

Expected Recovery Time:

• Immediate, as it is minimally invasive.

Restrictions/Follow-Up:

• Follow-up appointments may be scheduled if abnormalities are found.

Alternatives

Other Treatment Options:

• PSA blood test alone.
• MRI or ultrasound of the prostate.
• Prostate biopsy (if cancer is suspected).

Pros and Cons of Alternatives:

• PSA blood test: less invasive but can give false positives/negatives.
• MRI/Ultrasound: non-invasive but more expensive and less accessible.
• Biopsy: provides definitive diagnosis but more invasive and has higher risks.

Patient Experience

During the Procedure:

• Patients may feel slight pressure or discomfort.
• The exam is brief and usually well-tolerated.

After the Procedure:

• Mild, temporary discomfort may persist.
• Minimal or no recovery time needed.

Pain Management and Comfort Measures:

• Relaxation techniques during the exam can reduce discomfort.
• Lubrication helps minimize discomfort during the examination itself.