Robert, a 68-year-old man, has trouble urinating and is given a rectal exam. What is Robert’s most probable condition, and what is the purpose of the rectal exam?
Robert's most probable condition is an enlarged prostate gland which can put pressure on the urinary tract leading from the bladder. The rectal example is simple and commonplace. It is intended to feel the prostate gland and determine whether it is enlarged and how much it is enlarged beyond its normal size. If the prostate gland is simply enlarged, it is usually diagnosed as BPH (benign prostate hyperplasia). However, the urologist will be concerned about prostate cancer. This can be suggested by a significant increase in antigens found in blood samples, but the usual follow-up to the rectal exam, if cancer is suspected, is a biopsy, in which little pieces are cut from the prostate gland and examined for signs of cancer cells. The reference links below give information about BPH and PSA (prostate specific antigens) testing. Fortunately, BPH is far more common than prostate cancer. It can be treated with medications and minor surgery.