How do I get a prostate exam?

kato_boi

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I want my urologist to give me a prostate exam. I actually do have some relevant symptoms - straining to urinate and increased post-void dribbling, but he's never suggested a rectal exam, maybe given I'm in my 20s?

Anyway, how would I go about asking him for one? What kinds of symptoms would absolutely require one regardless of age?
 

paget54

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Just ask. Each of us needs to be our own advocates for our health. If you haven't done so, I'd recommend a PSA blood test.
 
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Dave NoCal

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State your symptoms and ask for a rectal exam and a PSA test. The rectal exam itself can raise the PSA level and you may be advised to wait a few days. If this doesn't result in the health care you believe you need, find a different urologist. Your rationale is valid. The possibility of cancer at your age is remote. The possibility of an infection, given your symptoms, is high. For many urologists, a DRE is a given at any appointment. This person's hesitance seems well worth noting.
 

kato_boi

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State your symptoms and ask for a rectal exam and a PSA test. The rectal exam itself can raise the PSA level and you may be advised to wait a few days. If this doesn't result in the health care you believe you need, find a different urologist. Your rationale is valid. The possibility of cancer at your age is remote. The possibility of an infection, given your symptoms, is high. For many urologists, a DRE is a given at any appointment. This person's hesitance seems well worth noting.
Yeah I'm not worried about prostate cancer at all, it's more so the infection/BPH possibility. I didn't always have post void dribbling and straining to urinate. So I think a DRE is perfectly reasonable at this point.
 
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deleted1025121

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I think at some point in your age they stop doing digital rectal exam and prostate exams. I think they rely more on just urine and blood tests. I remember as a younger guy having to bend over all the time at the doctors. But that hasn't happened in years. With either my PCP or my urologist. I dont know. Maybe times have changed and its considered too personal now?
 

Dave NoCal

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Many physicians I know talk about "probabilistic medicine." To me it seems to be a rationalization for doing less and less and kicking the can down the roads to the specialists. This seems to be particularly true in Family Practice, a "specialization" in doing nothing at all except reading lab results.
 

kato_boi

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Many physicians I know talk about "probabilistic medicine." To me it seems to be a rationalization for doing less and less and kicking the can down the roads to the specialists. This seems to be particularly true in Family Practice, a "specialization" in doing nothing at all except reading lab results.
Thing is, I'm seeing a urologist, who is supposed to be a specialist in all things regarding the male reproductive system. That includes doing DREs for possible prostate issues. So why the reluctance on his behalf?
 

Dave NoCal

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Thing is, I'm seeing a urologist, who is supposed to be a specialist in all things regarding the male reproductive system. That includes doing DREs for possible prostate issues. So why the reluctance on his behalf?
Obviously, I couldn't say. It seems like you need a second opinion. I'll add that a PSA test can also be elevated in the presence of infection. I know. Mine was 37! No cancer just infection. I do not believe your young age rules out the possible usefulness of that test, give you symptoms. Stop worrying about this guy. Find another doctor.
 
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palakaorion

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In my admittedly limited experience, DRE is no longer indicated for asymptomatic patients. PSA blood test seems to be the gold standard.

You, however, are not asymptomatic. DRE could be revealing. But as pointed out by another, you may need to find a urologist, as DRE seems to have fallen out of favor with family practice and internal medicine providers, possibly due to reimbursement issues with payers.
 
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kato_boi

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In my admittedly limited experience, DRE is no longer indicated for asymptomatic patients. PSA blood test seems to be the gold standard.

You, however, are not asymptomatic. DRE could be revealing. But as pointed out by another, you may need to find a urologist, as DRE seems to have fallen out of favor with family practice and internal medicine providers, possibly due to reimbursement issues with payers.
I did see a urologist, not an internist.
 

AllDixNeedLuv69

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when we go to doctor we think of the worst things that can be wrong with us---symptoms like yours can be just a urinary tract infection---men also need to learn to do a prostate exam on themselves--the doctor will put a glove on then lube-- so you can do same--as slide finger in about3/4 of your indesx finger rub against inner wall towardpenis see if there something feels swollen--if it feels smooth you are usually fine--if theres a lump there then get it checked--

also flushing yourkidneys out once a week with cranberry juicehelps flush out any bad stuff hanging around in kidneys