Rectal examination. Digital rectal examination of the rectum. Digital rectal examination: indications for carrying out

To detect various diseases of the rectum and organs located nearby, a digital rectal examination is indicated. Often it becomes the only way to identify pathological processes in areas where visualization is difficult with instrumental methods.

Meaning

The digital rectum is recognized as the easiest technique in diagnosis. At the same time, this method is quite informative.

After an external examination and anamnesis, the doctor develops a certain hypothesis regarding the presence of a particular pathology. In this case, digital rectal examination is indicative. During palpation, the specialist analyzes the condition of the anus, mucous membrane and surrounding organs. In addition, the presence of a pathological process is detected and the possibility of subsequent colonoscopy is determined.

Also, a digital rectal examination is extremely important for an already diagnosed disease. In this case, its purpose is to collect detailed information about the local signs of the disease.

Capabilities

Using this method, doctors can detect the presence of:

malfunctions in the intestines;
hemorrhoids;
neoplasms;
anal fissures;
foreign objects;
inflammatory processes in the internal genital organs.

If a patient is diagnosed with rectal cancer, a digital examination decides whether to conduct an endoscopic examination. This is due to the fact that the lumen or can be significantly narrowed by the tumor.

Indications

From a psychological point of view, the procedure is unpleasant for most people. But there are situations in which a digital examination of the rectum cannot be avoided:

pain during bowel movements;
the appearance of bloody or mucous discharge;
frequent pain in the anus, lower abdomen, perineum or tailbone;
fecal incontinence;
haemorrhoids;
malfunctions of the digestive organs: diarrhea, constipation (if food poisoning and an infectious disease are excluded);
difficulty urinating in men;
the presence of neoplasms of a benign or malignant nature;
failure of the menstrual cycle in women;
intestinal obstruction;
bleeding.

In addition, a digital examination of the rectum is necessary before instrumental diagnosis. It is also indicated for people over 40 years of age for the timely detection of pathologies.

Contraindications

Rectal palpation is not performed in a situation where the patient's anus has narrowed sharply. With a pronounced pain syndrome, the procedure is carried out after its elimination.

Ways

To date, the following methods of digital examination of the rectum are used in medical practice:

One-finger begins with the introduction of the index finger into the lumen of the rectum. In the process of palpation, the doctor analyzes the condition of the mucous membrane, the walls of the anal canal, and the internal genital organs. It is also possible to identify neoplasms and exclude damage to the sacrum and coccyx (they often cause pain).
Double examination. Its essence is as follows: the doctor inserts the finger of one hand into the rectum. At the same time, the pubic area is probed with another finger. With the help of this technique, pathologies of distant zones of the rectum are revealed, and the degree of mobility of its wall in relation to the vagina in women is also determined.
The technique is similar to the previous one. The difference lies in the fact that the finger of the second hand is palpated through the vagina in women. In the process, infiltrates and malignant neoplasms are detected, the mobility of the tumor relative to the genitals and the degree of its spread are determined.

Proctologists, urologists, gynecologists own the techniques of digital examination of the rectum.

How is it carried out

The primary task is to choose the patient's posture. As a rule, it is knee-elbow. If the patient's condition is severe, it is more convenient to conduct a digital examination of the rectum when he lies on his side, while the legs are bent and maximally drawn to the stomach. Another option is for the patient to lie on his back and spread his legs to the sides, slightly raising them at the knees. Examination is carried out after a bowel movement or a cleansing enema (which is preferable).

The algorithm for digital examination of the rectum includes the following steps:

The patient takes the most appropriate posture, corresponding to his general condition.
The doctor washes his hands and puts on disposable rubber gloves.
An external examination of the anus and perineum is preliminarily performed. This is important for detecting cracks, fistulas, hemorrhoids, papillomas and various tumors.
With a pronounced pain syndrome, the anus is treated with an anesthetic, and the turunda impregnated with it is introduced inside.
The doctor generously lubricates the index finger with petroleum jelly and carefully, in a circular motion, introduces it into the rectum. At this time, the tone of the sphincter is determined. It is considered normal if it fits snugly to the finger. After the introduction, the mucous membrane and adjacent organs are diagnosed - the uterus in women and the prostate gland in men. If any neoplasms are found, their exact localization, shape, size, density, nature of the surface, etc. are determined. To palpate the zones located above, the doctor asks the patient to squat down and strain (as with the urge to defecate).
The finger is removed from the intestine. The doctor carefully examines the glove, studying traces of feces. Impurities (if any) are carefully examined: mucous and purulent discharge, blood.

A digital examination of the rectum is absolutely safe and does not cause complications. After the procedure is completed, the patient calmly goes about his business.

Digital rectal examination is recognized by physicians as the simplest and most reliable method of diagnosis. With its help, many pathological processes are revealed, and the possibility of conducting an examination using instrumental methods is also assessed.

In adhesive (adhesive) bags, remove the wrapping paper, position the center of the opening over the stoma and press evenly, making sure the plate is smooth and free of wrinkles. Check the correct location (opening down) of the drainage hole of the bag and the position of the latch in the closed position (Fig. 5.10).

Fig.5.10. Fixation of the drainage hole of the colostomy bag.

At a used closed colostomy bag, cut off the bottom of the bag with scissors and empty the contents into the toilet. Next, the colostomy bag should be rinsed under running water and thrown into the trash.

5.7. Digital examination of the rectum

Digital rectal examination is a mandatory method for diagnosing diseases of the rectum, pelvis and abdominal organs. Any instrumental, endoscopic, x-ray examinations of the rectum can be carried out only after a digital examination.

Indications for digital rectal examination:

It is performed in all cases when the patient complains of abdominal pain, dysfunction of the pelvic organs, and intestinal activity. It always precedes an instrumental rectal examination (anoscopy, sigmoidoscopy, colonoscopy) and allows you to decide whether the latter is possible, to avoid serious complications with a sharp narrowing of the anal canal or rectal lumen by a tumor, inflammatory infiltrate. Digital rectal examination makes it possible to assess the functional state of the muscles of the anus, to identify diseases, pathological changes in the anal canal and rectum (cracks, fistulas, hemorrhoids, cicatricial changes and narrowing of the intestinal lumen, benign and malignant neoplasms, foreign bodies), inflammatory infiltrates, cystic and tumor formations of pararectal tissue, sacrum and coccyx, changes in the prostate gland in men and internal genital organs in women, the condition of the pelvic peritoneum, recto-uterine or recto-vesical depression. Sometimes a digital rectal examination is

the only method for detecting a pathological process localized on the posterior semicircle of the rectal wall above the anal canal, in an area that is difficult to access for inspection with any type of instrumental rectal examination.

Contraindications:

A digital rectal examination is contraindicated in case of a sharp narrowing of the anus, as well as in case of severe pain until the pain syndrome is relieved with the help of an ointment with dicaine, analgesics or narcotic drugs.

Execution technique

Rectal examination is carried out in various positions of the patient: lying on the side with legs bent at the hip and knee joints, in the knee-elbow position, in the supine position (on the gynecological chair) with the legs bent at the knee joints and brought to the stomach. Sometimes, to assess the condition of the hard-to-reach upper rectum during a digital rectal examination, the patient is given a squatting position. If peritonitis or Douglas pouch abscess is suspected, a digital rectal examination should be performed with the patient in the supine position, because only under this condition can a symptom of overhanging and soreness of the anterior semicircle of the rectal wall be detected.

A digital rectal examination should always be preceded by a thorough examination of the anus, which often reveals signs of the disease (external fistulas, thrombosis of external hemorrhoids, insufficient closure of the edges of the anus, growths of tumor-like tissue, maceration of the skin, etc.), after which the index finger of the right hand , which is wearing a rubber glove, richly lubricated with petroleum jelly, is carefully inserted into the anus. The patient is recommended to "strain", as during a bowel movement, and during the study to relax as much as possible.

Consistently feeling the walls of the anal canal, evaluate the elasticity, tone and extensibility of the sphincter of the anus, the condition of the mucous membrane, the presence and degree of pain of the study. Then the finger is passed into the ampoule of the rectum, determining the state of its lumen (gaping, narrowing), the intestinal wall is sequentially examined over the entire surface and throughout the available extent, attention is paid to the condition of the prostate gland (in men) and the rectovaginal septum, cervix ( in women), pararectal tissue of the inner surface of the sacrum and coccyx. After removing the finger from the rectum, the nature of the discharge is assessed (mucous, bloody, purulent).

To diagnose diseases of the upper ampulla of the rectum, tissue of the pelviorectal or posterior rectal space (paraproctitis, presacral cyst), pelvic peritoneum (inflammatory process or tumor lesion), a bimanual digital examination is used. For this purpose, the index finger of one hand is inserted into a straight

intestine, and with the fingers of the other hand they press on the anterior abdominal wall above the pubic symphysis.

The condition of the rectovaginal septum, the mobility of the rectal wall in relation to the posterior wall of the vagina and the body of the uterus can be assessed by conducting a bimanual digital rectal and vaginal examination.

CHAPTER 6. PUNCTION OF SEROUS CAVITIES

6.1. Abdominal puncture

The purpose of the operation: the evacuation of ascitic fluid in dropsy of the abdominal cavity.

Methodology: a puncture is made along the midline of the abdomen. The puncture point is chosen in the middle of the distance between the navel and the pubis. The bladder must first be emptied. The patient is seated on the operating or dressing table. The operating field is treated with alcohol and iodine. The skin and deep layers of the abdominal wall are anesthetized with a 0.5% novocaine solution. The skin at the puncture site is incised with the tip of a scalpel. The puncture is made with a trocar. The surgeon takes the instrument in his right hand, displaces the skin with his left hand and, placing the trocar perpendicular to the surface of the abdomen, pierces the abdominal wall, removes the stylet and directs a stream of fluid into the pelvis. To avoid a rapid drop in intraperitoneal pressure during fluid extraction, which can lead to collapse, the external opening of the trocar is periodically closed. In addition, the assistant pulls the stomach with a towel as the ascitic fluid flows out.

6.2. Laparocentesis

Laparocentesis is a puncture of the peritoneum with the introduction of a drainage tube into the cavity. The puncture is performed by a doctor (Fig. 6.1).

Indications: ascites, peritonitis, intra-abdominal bleeding, pneumoperitoneum.

Contraindications: coagulopathy, thrombocytopenia, intestinal obstruction, pregnancy, inflammation of the skin and soft tissues of the abdominal wall.

Equipment and tools: trocar for puncturing the abdominal wall with a diameter of 3-4 mm with a pointed mandrin, a drainage rubber tube up to 1 m long, a clamp, a syringe with a volume of 5-10 ml, 0.25% novocaine solution, a container for collecting ascitic fluid, sterile test tubes, dressing material, sterile cotton swabs, sterile tweezers, skin needles with sterile suture material, scalpel, adhesive plaster.

Methodology: the doctor and the nurse assisting him put on hats, masks. Hands are treated as before a surgical operation, put on sterile rubber gloves. It is necessary to ensure the complete sterility of the trocar, tube and all instruments in contact with the skin. The puncture is performed in the morning, on an empty stomach, in the treatment room or dressing room. The patient empties the intestines, bladder. The position of the patient is sitting, in a serious condition lying on the right side. As a premedication for 30 minutes. before the study, 1 ml of a 2% solution of promedol and 1 ml of a 0.1% solution of atropine are administered subcutaneously. The puncture of the abdominal wall is carried out along the midline of the abdomen in the middle of the distance between

navel and pubic bone or along the edge of the rectus abdominis muscle (before puncture it is necessary to make sure that there is free fluid in the abdominal cavity). After disinfection of the puncture site, infiltration anesthesia of the anterior abdominal wall, parietal peritoneum is performed. To prevent damage to the abdominal organs, it is advisable to flash the aponeurosis of the abdominal wall with a thick ligature, through which to stretch the soft tissues and create a free space between the abdominal wall and the underlying organs. The skin at the puncture site is displaced with the left hand, and the trocar is inserted with the right hand. In some cases, before the introduction of the trocar, a small skin incision is made with a scalpel. After the penetration of the trocar into the abdominal cavity, the manner is removed and the liquid begins to flow freely. They take a few ml of liquid for analysis and make smears, then a rubber tube is put on the trocar and the liquid flows into the pelvis. The liquid should be released slowly (1 liter for 5 minutes), for this purpose, a clamp is periodically applied to the rubber tube. When the liquid begins to flow out slowly, the patient is slightly moved to the left side. If the release of fluid has stopped due to the closure of the internal opening of the trocar with a loop of the intestine, you should carefully press on the abdominal wall, while the intestine is displaced and the fluid flow is restored. collapse. To prevent this complication, during the removal of fluid, the assistant tightly tightens the stomach with a wide towel. After removing the liquid, the trocar is removed, sutures are applied to the skin at the puncture site (or tightly sealed with a sterile swab with cleol), a pressure aseptic bandage is applied, an ice pack is placed on the abdomen, and a strict pastel regimen is prescribed. It is necessary to continue monitoring the patient after the puncture in order to detect possible complications early.

Complications:

Phlegmon of the abdominal wall due to violation of the rules of asepsis and antisepsis.

Damage to the vessels of the abdominal wall with the formation of hematomas of the abdominal wall or bleeding of the abdominal cavity.

Subcutaneous emphysema of the abdominal wall due to the penetration of air into the wall through a puncture.

Damage to the abdominal organs.

The release of fluid from the abdominal cavity through the puncture hole, which is associated with the risk of infiltration of the wound and the abdominal cavity.

Rectal examination(lat. rectum rectum) - special examination techniques to assess the condition of the rectum and its surrounding organs and tissues, performed through the lumen of the rectum.

In clinical practice, finger and instrumental rectal examination. Finger rectal examination is a mandatory method for diagnosing diseases of the rectum, pelvis and abdominal organs. It must be performed in all cases when the patient complains of abdominal pain, dysfunction of the pelvic organs, and intestinal activity. It always precedes the instrumental rectal examination, allows you to resolve the issue of the possibility of carrying out the latter, to avoid serious complications with a sharp narrowing of the anal canal or the lumen of the rectum by a tumor, inflammatory infiltrate. Finger R. and makes it possible to assess the functional state of the muscles of the anus, to identify diseases, pathological changes in the anal canal and rectum (cracks, fistulas, hemorrhoids, cicatricial changes and narrowing of the intestinal lumen, benign and malignant neoplasms, foreign bodies); inflammatory infiltrates, cystic and tumor formations of pararectal tissue, sacrum and coccyx; changes in the prostate gland in men and internal genital organs in women; condition of the pelvic peritoneum, recto-uterine or recto-vesical depression. Sometimes digital rectal examination is the only method for detecting a pathological process localized on the posterior semicircle of the rectal wall above the anal canal, in an area that is difficult to access for inspection with any type of instrumental rectal examination.

Finger rectal examination it is contraindicated in case of a sharp narrowing of the anus, as well as in case of severe soreness until the pain syndrome is relieved with the help of an ointment with dikain, analgesics or narcotic drugs.

Rectal examination is carried out in various positions of the patient: lying on the side with legs bent at the hip and knee joints, in the knee-elbow position, in the supine position (on the gynecological chair) with the legs bent at the knee joints and brought to the stomach. Sometimes to assess the condition of the hard-to-reach upper rectum with digital rectal examination the patient is given a squatting position. If peritonitis or Douglas pouch abscess is suspected, the digital rectal examination it is necessary to carry out in the position of the patient on the back, because. only under this condition can a symptom of overhanging and soreness of the anterior semicircle of the rectal wall be detected.

Finger rectal examination a thorough examination of the anus should always be preceded, which often reveals signs of the disease (external fistulas, thrombosis of external hemorrhoids, insufficient closure of the edges of the anus, growths of tumor-like tissue, maceration of the skin, etc.), after which the index finger of the right hand, on which put on a rubber glove, richly lubricated with petroleum jelly, carefully inserted into the anus ( rice. one ). Consistently feeling the walls of the anal canal, evaluate the elasticity, tone and extensibility of the sphincter of the anus, the condition of the mucous membrane, the presence and degree of pain of the study. Then the finger is passed into the ampoule of the rectum, determining the state of its lumen (gaping, narrowing), the intestinal wall is sequentially examined over the entire surface and throughout the available extent, attention is paid to the condition of the prostate gland (in men) and the rectovaginal septum, cervix ( in women), pararectal tissue of the inner surface of the sacrum and coccyx. After removing the finger from the rectum, the nature of the discharge is assessed (mucous, bloody, purulent).

instrumental rectal examination carried out with the help of a rectal mirror, anoscope (see. Rectum) or sigmoidoscope (see Sigmoidoscopy).

Bibliography: Aminev A.M. Guide to proctology, vol. 1-4, Kuibyshev, 1965-1978; Henry M.N. and Swash M. Coloproctology and the pelvic floor, p. 89, M., 1988; Fedorov V.D. Cancer of the rectum, p. 79, M., 1987; Fedorov V.D. and Dultsev Yu.V. Proctology, p. 24, M., 1984.

In medicine, there are a huge number of various studies that allow you to carry out diseases in a patient, as well as prescribe further treatment.

But despite the development of technological progress, everyone independently with the help of their own hands.

So, digital rectal examination has acquired particular significance, which allows, at the first examination, to preliminarily determine the diagnosis of the patient.

Finger research method: basics

From the name itself it becomes clear the principle of the presented study.

Thus, a specialist, with the help of a finger inserted into the rectum of a patient who has applied for help and complaints of pain in the anus, can diagnose and, based on the results, prescribe treatment.

The presented study makes it possible not to resort to any instrumental examination, which can often become painful for the patient.

The goals of a digital rectal examination are as follows:

The specialist, after listening to the patient's complaints, is already forming an assumption about the unpleasant situation that has arisen and the disease as a whole. As a rule, treatment is not prescribed on one assumption, so he needs to confirm his guesses. For this, a digital examination is carried out immediately upon examination in the doctor's office.
Also, on the basis of the presented study, a specialist can prescribe an additional instrumental examination and diagnostics to the patient to accurately determine the nature of the disease.

Based on the foregoing, it follows that the digital method of research is very informative and the patient should not refuse it.

Indications for examination

Finger examination is not carried out for everyone and not always.

Here there are indications for carrying out, where there are:

patient complaints of pain in the lower abdomen;
if the patient has a violation of the functions of the genitourinary organs and intestines;
complaints of pain in the anal region, during defecation;
in the presence of already diagnosed and, to determine the effectiveness of treatment;
preventive examination of men after 40 years in order to prevent the development of prostate diseases;
examination of women over 40 years of age to detect and prevent diseases of the genital organs (if it is not possible to conduct a digital examination directly).

A digital rectal examination reveals the development of pathology, which contributes to the start of timely treatment.

Also, a specialist with the help of such an examination can determine the need for additional instrumental research in the form, colonoscopy or.

Research Opportunities

With the help of the type of survey under consideration, a number of parameters can be determined, which include:

condition of tissues and intestinal mucosa;
determination of the tone of the anal canal;
the possibility of further research and its nature;
the general condition of the membrane of the intestinal sections that are involved in humans during defecation;
the rate of functioning of tissues located near the above areas;
color and structure, as well as with the help of additional studies, the bacteriological composition of the secretions.

At first glance, a digital examination of the intestine does not seem informative.

However, it can be used to identify such dangerous neoplasms as internal hemorrhoids, various tumors and polyps (here you can also determine the shape), prostate enlargement, foreign bodies, inflammatory infiltrates.

With the help of a digital examination, it is possible to diagnose insufficiency of the anal sphincter and even changes in the internal genital organs in women.

How the study is done

Rectal examination is carried out in a certain position of the patient's body, which directly depends on complaints and pain, that is, if a particular disease is suspected.

Here are the following possible positions for examination:

There are three methods of digital examination of the rectum:

One-finger examination- the doctor lubricates the index finger with petroleum jelly and introduces it into the rectum, starting the examination. Thus, a specialist can recognize the condition of the walls of the anal canal, identify any neoplasms, check the condition of the internal genital organs (cervix, vaginal septum, prostate condition in a man). Using the one-finger method, a specialist can feel the sacrum and coccyx, since sometimes pain in the groin and lower abdomen can be caused precisely by damage to the lower spine. After the doctor removes the finger, he examines the remaining mucus, where pus, blood, and other unpleasant and abnormal discharges can often be found.
Bidigital examination- the doctor uses the finger of one hand, introducing it into the rectum and the finger of the second hand, pressing it in the pubic area. In this way, diseases or tumors in the upper rectum or pelvic peritoneum can be examined and identified. Using the presented research methodology, the specialist also determines the mobility of the rectal wall to the vagina in a woman.
Two-hand examination- the method of carrying out the procedure practically does not differ from the two-finger method, with the exception of using the fingers of the second hand. In a man, the penetration of a finger in this case is carried out into the anus, and in women it can pass through the vagina if there are suspicions of the presence of malignant tumors on the anterior wall of the rectum.

How a digital rectal examination of the rectum is performed - a visual video:

A digital rectal examination of the rectum is an important examination, without which no one can do, often used by a gynecologist.

But the presented examination has contraindications in the form of a strong pain syndrome and a sharp narrowing of the anus. In this case, this method of examination is possible in case of elimination of contraindications.

Rectal examination is part of the mandatory annual preventive examinations. Most patients are afraid of this manipulation and make them postpone the time of visiting specialists, under the pretext that the absence of complaints indicates a good level of health. Rectal examination of the rectum is used in gynecology, proctology, urology, surgery and allows you to determine the presence of pathological conditions of neighboring organs.

Types of examination

They use the method of finger research, as well as instrumental, during which rectal mirrors and a sigmoidoscope are involved. The finger method allows you to assess the condition of the pelvic organs in women, the prostate gland in men and the abdominal organs.

A rectal examination with a digital method is carried out every time during a medical examination, the appearance of abdominal pain, disorders of the intestinal tract and organs of the reproductive system. This method is used before each instrumental examination to check the patency of the rectum, avoiding further complications.

Instrumental rectal examination is carried out in order to assess the condition of the intestinal tract, rectum itself. It allows you to determine the presence of inflammatory processes, polyps and neoplasms, obstruction, strictures.

Indications for carrying out

Such manipulation is carried out in the following cases:

pathology of the rectum (infiltration, the presence of ulceration, narrowing, compression of the walls by neoplasms);
paraproctitis - inflammation of the pelvic tissue;
peritonitis;
assessment of the performance of the sphincter;
determination of pathologies of the coccyx, Bartholin and Cooper glands;
diseases and neoplasms of the prostate gland;
inflammatory processes, the presence of tumors of the female reproductive organs;
for diagnostic purposes.

Rectal examination in proctology

Before the manipulation, the doctor examines the anus. The presence of hyperemia, maceration, inflammatory processes, pathological secretions, external hemorrhoids is determined. Next, the patient takes one of the postures:

on the side with the knees brought to the chest;
knee-elbow posture;
lying on and legs bent at the knees and pressed to the stomach.

How is the procedure carried out

Digital rectal examination does not require prior preparation of the patient. It is enough that after the last bowel movement the patient takes a shower and hygienic treatment of the genitals and the anus. The procedure algorithm is as follows:

The patient takes one of the positions (at the request of a specialist, she changes during the manipulation).
The doctor cleans his hands and puts on gloves.
Vaseline oil is applied to the index finger and the anus.
With a gentle slow movement, a finger is inserted along the posterior wall of the intestine to a depth of 5 cm.
During the examination, the doctor may ask you to tighten or relax the sphincter.
The finger is removed. No pathological secretions (mucus, blood streaks, pus) should remain on the glove.

Examination with rectal speculums

Consider how the examination of the rectum is carried out using medical instruments. After the digital method, the rectal mirrors in the area of the branches are lubricated with vaseline oil. The area is treated in the same way.

The patient takes a knee-elbow position. The branches are introduced into the rectum by 8-10 cm, moved apart and slowly removed, in parallel examining the intestinal mucosa. The same principle is used in the vaginal gynecological examination of women.

Sigmoidoscopy

This is an endoscopic condition of the sigmoid and rectum. The examination is carried out using a sigmoidoscope. The device is inserted into the rectum, the patient is in the knee-elbow position. With the help of the lighting device, which is part of the device, and the optical system, you can examine the mucous membrane for 30 cm.

The picture of the examined area is displayed on the monitor screen, where a doctor with an assistant can assess the presence of an inflammatory process, tumors, polyps, internal hemorrhoids, cracks.

Indications for carrying out:

the presence of pathological discharge;
false urge to defecate;
haemorrhoids;
discomfort in the rectal area;
suspicion of a neoplasm;
colitis.

Contraindications to sigmoidoscopy:

acute peritonitis;
acute inflammatory processes of the rectum;
the general serious condition of the subject.

Highly specialized institutions

The proctology center is one of the specialized medical and diagnostic institutions, where rectal examination is a mandatory procedure for examining patients. Any diagnostic and some therapeutic manipulations take place immediately after assessing the condition of the rectum.

The proctology center is an institution whose specialists are engaged in the differentiation of pathology, the development of complex programs for the treatment of patients using medical, surgical and physiotherapeutic methods of treatment.

Here they deal with conditions such as:

haemorrhoids;
inflammatory processes of the rectum and colon, fiber, anorectal region;
failure of the sphincters;
removal of foreign bodies;
helminthic invasions;
congenital pathologies of the anorectal region;
strictures and atresia of the rectum;
trauma;
fistulas;
tumor processes;

Rectal examination of the prostate

In the field of urology, examination through the rectum is a must for all men over 40 years of age. This method allows you to recognize the presence of pathologies at the initial stages. The finger method is used. Before it is carried out, it is necessary to explain to the patient the purpose of the diagnosis in order to avoid tension and a negative reaction.

Rectal examination of the prostate allows you to evaluate the following indicators:

size and shape;
density and elasticity;
clarity of contours;
symmetry of the gland lobules;
the presence or absence of pain;
the presence of scars, cysts, stones on the surface;
condition of the seminal vesicles;
gland mobility;
the state of the lymph nodes, their size, mobility, elasticity.

Normal indicators are as follows:

The gland has two symmetrical lobules separated by a groove.
Dimensions (in cm) - 2.5-3.5 x 2.5-3.
Rounded organ.
No pain on palpation.
Clear contours.
Dense-elastic consistency.
Smooth surface.
Seminal vesicles are not palpable.

Examination of the rectum in gynecology

In this area of medicine, a rectal examination is performed by a gynecologist, not a proctologist. How the examination is carried out in women and why it is carried out, we will consider in more detail.

Examination using the finger method is necessary in the following cases:

assessment of the state of the pelvic organs in girls who did not have a sexual life;
in the presence of atresia (fusion of the walls) or stenosis (narrowing) of the vagina;
as an additional examination of the prevalence of the tumor process, if it is established;
in the presence of inflammatory diseases, in order to assess the condition of the ligaments, fiber;
with parametritis;
as a stage

Since the proctologist does not participate in this manipulation, how the examination is carried out in women and in what cases it is necessary, the attending gynecologist decides. During the procedure, you can clearly assess the condition of the cervix, the presence of cicatricial changes, fluid accumulation. In addition, a specialist can determine the presence of pathological changes in the rectum itself, which have arisen against the background of gynecological diseases or tumor compression.

Examination of women in labor

Rectal examination can be used to re-monitor the condition of women in labor. You can determine the degree of cervical dilation, the presentation of the child, the condition of the amniotic sac and its integrity, the location of the sutures and fontanelles of the baby (this item is not in all cases).

Before the procedure, the woman must empty her bladder. Lie on your back, bend your legs at the knees and spread apart. The woman in labor should breathe absolutely calmly in order to relax the muscles as much as possible. Several diagnostic methods are used:

Finger - with one finger, thickly lubricated with vaseline oil, the necessary indicators are evaluated.
Rectovaginal - the index finger is inserted into the vagina, and the middle finger into the rectum. The second hand examines the reproductive organs of a woman through the abdominal wall.

Rectovaginal examination can also be performed in several ways. Sometimes it is necessary to insert the index fingers of both hands: one into the vagina, the other into the rectum. In order to study the state of the vesicouterine space, it is possible to insert the thumb into the vagina, and rectally - the index finger.

Conclusion

Rectal examination is a reliable and informative method for the initial assessment of the patient's condition. This method is affordable and allows you to obtain additional data on the level of health of the patient.