Digital rectal examination. Digital examination of the rectum: description of the technique. Finger examination technique

In adhesive (adhesive) colostomy bags, remove the wrapping paper, position the center of the opening over the stoma and press evenly, making sure that 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 dikain, analgesics or narcotic drugs.

Execution technique

Rectal examination is carried out in various positions of the patient: lying on his 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), sequentially examining the intestinal wall over the entire surface and throughout the available extent, paying attention 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 the right hand, displaces the skin with the left and, placing the trocar perpendicular to the surface of the abdomen, pierces the abdominal wall, removes the stylet and directs the fluid stream 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 apply manual and instrumental R. and. Finger R. and. 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 instrumental R. and., allows you to decide on the possibility of the latter, to avoid serious complications with a sharp narrowing of the anal canal or rectal lumen 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, 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 finger R. and. 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 R. and. 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.

and. 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 R. and. a thorough examination of the anus should always be preceded, which often makes it possible to identify signs of the disease (external and 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 worn a rubber glove heavily lubricated with petroleum jelly is 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).

To diagnose diseases of the upper ampullar portion of the rectum, fiber of the pelviorectal or posterior rectal space (paraproctitis, presacral), 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 the rectum, and the fingers of the other hand press on the anterior abdominal wall above the pubic symphysis ( rice. 2 ).

Instrumental R. and. carried out with the help of a rectal mirror, anoscope (see. Rectum ) or sigmoidoscope (see

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Among the diagnostic methods in proctology, the digital examination of the rectum is considered basic. It is carried out during the initial visit of the patient to the doctor with complaints of pain, burning, cramps and other unpleasant sensations in the anus. Only after a digital examination can be assigned, and other instrumental examinations used in proctology. Finger research, despite the simplicity of the procedure, allows you to detect many diseases of the rectum. How and why it is carried out, what preparation is required for it, the article will tell.

Features of the diagnostic procedure

The name of the examination contains its essence: during a digital examination, a specialist (proctologist or urologist) inserts a finger into the patient's anus. By probing the surface of the rectum, he can suspect or detect various diseases, assess the condition and functionality of the muscles of the anus. The procedure is mandatory for suspected hemorrhoids.

Rectal digital examination does not require any additional devices and instruments. Diagnosis requires some preparation to minimize the discomfort and discomfort of the patient during the procedure.

When is the diagnosis carried out?

A rectal digital examination of the rectum is performed in cases where a patient contacts a proctologist with complaints of pain in the anus, lower abdomen, intestinal disorders, and discomfort in the pelvic area. The reason for the examination may be complaints of pain during defecation, discharge of mucus, pus, and blood from the rectum.

The examination allows to detect cracks in the anal passage, fistulas in the rectum, scars, neoplasms of benign and malignant nature (cysts, tumors), foreign objects, to diagnose narrowing of the intestinal lumen. In addition, during the procedure, it is possible to assess the condition of the prostate gland in men and the organs of the reproductive system in women.

Note: for preventive purposes, an annual examination is recommended for men and women over 40 years of age, even in the absence of complaints. It allows you to detect diseases of the prostate (in men) and the cervix (in women) in the early stages of development and start timely therapy.

In some cases, a rectal examination allows you to notice the occurrence of a pathological process in the area of the posterior semicircle of the rectum, located above the anal canal. This area is not visible when using instrumental techniques.

How is a finger test done?

Before proceeding to a digital examination, the doctor interrogates the patient, listens to his complaints. After that, a visual examination of the anal area is carried out, during which it is often possible to detect additional symptoms of the disease: loose closure of the anus, the formation of external hemorrhoids, fistulas, skin irritation and its maceration, tissue growth.

To perform a rectal examination, the doctor asks the patient to take a special position in which access to the rectum will be best provided. It could be a pose:

lying on your side with your knees pulled up to your stomach;
knee-elbow position;
lying on your back with your knees pulled up to your stomach;
lying in a gynecological chair;
squatting down.

The choice of posture depends on the complaints that the patient has addressed. For example, if it is necessary to examine the upper rectum, the doctor will ask the patient to take a pose, squatting down.

The study is carried out as follows:

the doctor puts on disposable rubber gloves;
the index finger of the right hand is smeared with petroleum jelly and injected into the anus;
the patient must relax;
if necessary, the doctor asks the patient to strain slightly, as during a bowel movement.

First, the anal canal is palpated, then the ampulla of the rectum. The doctor slowly feels the surface of the intestine, assesses the tone, the degree of elasticity of the tissues, paying attention to the patient's sensations (whether pain occurs, how pronounced it is).

At the end of the examination, the finger is taken out, the nature of the discharge in the intestine is assessed (they can be mucous, bloody, purulent).

Attention! The duration of the procedure is 5-10 minutes.

In addition to the above process, a two-finger and two-handed (bimanual) examination can be performed. The two-finger method is used in the diagnosis of diseases of the anterior wall of the rectum in women. In this case, the doctor inserts one finger into the anus, and the second - into the woman's vagina. During a bimanual examination, after inserting the finger of one hand into the anus, with the free hand, the doctor presses on the lower abdomen in the pubic area.

Contraindications to the diagnostic procedure

The diagnostic procedure is not possible if the patient has the following contraindications:

sharp narrowing of the anus;
thrombosis of hemorrhoids;
severe pain.

The last contraindication is relative, since it can be eliminated and examined. To do this, the area around the anus is treated with drugs with anesthetics in the composition, painkillers are taken orally or in the form of injections.

Preparation for the examination

Preparation for the study of the rectum is to follow the recommendations for nutrition and bowel cleansing before diagnostic manipulation. Simple preparatory actions will allow the patient to feel more comfortable during the examination and relieve embarrassing moments.

For a few days (in the absence of the possibility of long-term preparation - on the day before the study), it is recommended to eat exclusively light food that is quickly absorbed in the body. Flatulence should also be excluded from the diet. You need to refuse:

carbonated drinks;
strong tea, coffee;
chocolate, sugar-containing products;
muffins, fresh bread;
beans, beans, lentils, peas;
fresh vegetables and fruits;
bran;
products with yeast (baking, kvass).

Note: protein foods such as cottage cheese, egg whites, meat, fish, when consumed in large quantities, can also cause increased gas formation. They linger in the intestines for a long time and cause fermentation processes in it.

It is better to drink clean water without gas, jelly, herbal tea, compote. You need to drink enough liquid so as not to provoke constipation.

On the day of the procedure, it is important that the bowel is cleansed. If natural emptying does not occur, an enema should be given. A quick and mild effect can be obtained from Microlax microclysters. It is placed in the morning on the day of the examination. It is also acceptable to use a cleansing enema with a decoction of chamomile.

If a person anticipates possible difficulties with defecation (constipation is chronic), on the evening before the day of the examination, he should take a laxative. These can be products with senna leaves in the composition, lactulose syrup.

Psychological preparation is equally important. The patient should not worry, be nervous, feel false shame in front of the doctor. Yes, the study cannot be called pleasant and ordinary, but it is extremely necessary for the correct diagnosis.

Rectal examination is part of the mandatory annual preventive examinations. Most patients are afraid of this manipulation and make them move the time of visiting specialists further away, 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.

Rectal examination is the main procedure that is necessary for urological examination and detection of pathological processes in the prostate gland. The prostate is a glandular organ of the male body, which is very susceptible to negative factors.

Fundamentals of digital examination

A digital rectal examination is performed by probing the prostate with your fingers. To do this, a finger is inserted into the rectum of a man who turned to a urologist with complaints of pain and discomfort in the posterior canal and perineum. Rectal examination allows diagnosing for the appointment of effective treatment.

The considered method of diagnosis allows you to perform an examination without instrumental examinations, which prevents the risk of injury and pain when testing the prostate in other ways.

A digital rectal examination is as follows:

doctor and patient

The doctor interrogates the patient for the presence of disturbing symptoms, which may indicate the occurrence of an inflammatory process of the prostate. One survey, as a rule, is not enough to establish a diagnosis, since it is impossible to prescribe therapy based on complaints alone.
To confirm his doubts, the doctor conducts a digital rectal examination. After that, the urologist can prescribe to the patient an additional, instrumental examination to diagnose a more accurate nature of the pathological process.
Rectal digital examination is considered the most informative method for diagnosing a glandular organ. Therefore, such a study is very important to conduct before the appointment of effective treatment.

Who is eligible for this examination?

Rectal examination is performed according to the testimony of a specialist with:

Anatomy of the genitourinary system

complaints of painful symptoms in the lower peritoneum;
impaired functionality of the intestines, urinary and genital organs;
pain syndrome in the anal canal;
discomfort during bowel movements;
to determine the method of therapy;
for prevention purposes (rectal massage);

Rectal massage is carried out not only for research, with the help of this procedure, you can take an analysis of prostatic juice.

After a digital examination, the specialist decides to prescribe other methods for diagnosing the prostate gland, among which are noted: anoscopy, rectoscopy, colonoscopy.

What can be determined after a rectal examination

During digital diagnostics, it is possible to recognize the texture of the tissue of the glandular organ and the mucous membrane of the rectum, determine the tone of the anus, the characteristic possibilities for further research, the condition of the rectum, the size of the prostate, the presence of nodular seals, and also take an analysis of the prostatic juice for bacteriological examination.

During the diagnosis, it is possible to identify the occurrence of benign and malignant neoplasms, polyps, anal fissures, foreign bodies, inflammatory infiltrates.

Inspection

Rectal diagnostics is carried out in several positions of the patient:

lying on your side with bent knees pressed tightly to the chest - such an examination allows you to identify the pathology of the rectum and the presence of formations;
knee-elbow posture is recommended to determine the degree and form of tumors with trauma to the mucous membranes of the intestine;
a posture lying on the back with bent legs is proposed for examinations for inflammatory processes in the urinary and genital areas of the female body to detect peritonitis, abscess.

Rectal examination is carried out in several ways:

Palpation of the prostate

One-finger examination - the urologist lubricates the finger (index), which easily penetrates the rectum for probing. With such an examination, it is possible to diagnose the condition of the anal canal, detect neoplasms, examine the internal genital organs and the prostate. Using the inspection method with one finger, the sacrum with the coccyx is probed, since in some cases pain in the groin, at the bottom of the peritoneum, can be triggered by injury to the lower spinal column. After removing the finger, the mucus remaining on it is examined. Sometimes there are traces of pus, blood, other pathological secretions.
Two-finger examination - one finger penetrates the rectum, with the other finger pressure is made in the pubic zone. In this way, it is possible to recognize the pathological process, tumors of the upper section in the rectum or in organs located in the small pelvis. A two-finger examination can tell about the mobility of the walls of the rectum in relation to the female vagina.
Two-hand examination - this method has no difference from the two-finger examination. When the health condition of the male body is diagnosed, a digital examination is performed through the anus. The female body can be diagnosed by penetration into the vagina. This method is used when there is a suspicion of an oncological process on the anterior wall of the rectum.

Rectal massaging of the prostate gland is carried out both for examination and for the purpose of effective treatment and prevention of the glandular organ. Of course, some patients do not want to seek the help of a specialist for massage sessions, and resort to the help of massagers. Such devices are sold in the pharmacy network, but their use is possible only if the specialist permits.

Digital rectal testing is a much needed procedure that should not be ignored. For every proctologist, such an examination is an important component for diagnosing diseases. Finger diagnostics may have contraindications, which include severe pain, a sharp narrowing of the anal canal, infectious prostatitis, and acute course. In infectious pathologies, antibiotic therapy is first performed, and then a rectal examination is prescribed for further effective therapy.

Patients with chronic prostatitis undergo prostate massage annually. This is essential for prevention.