When the doctor does a digital exam of the prostate, what will the patient feel if the prostate is enlarged? Pressure? Pain? Something else?

— Carl, Mississippi

The pain of a digital examination of the prostate is mostly related to the discomfort of having the examiner's finger inserted into the anus. Most men will report a feeling of burning in the area or slight queasiness. The actual palpation of the prostate to assess it for enlargement is probably less painful. It is likely that a sensation of pressure would be experienced, which may be disconcerting. If the prostate is acutely inflamed by an infection, then it could be extremely painful. However, this is the rare exception and usually such patients will already have been experiencing a significant number of symptoms. Objective studies of the pain from a rectal examination document that the level of pain (on a scale of 1 to 10) is approximately 3.6. Thus, we would consider this to be mild discomfort. It is important to note that the digital rectal exam can detect prostate cancers and other abnormalities that are not picked up on other routine blood-screening tests for prostate cancer (prostate specific antigen, or PSA).