Understanding Your Digital Rectal Exam Results

What Do Your Digital Rectal Exam Results Mean?

Mature male patient sitting on exam table in discussion with doctor in exam room
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The digital rectal exam (DRE) is an important part of the early detection and diagnosis of prostate conditions such as prostate cancer and BPH (enlarged prostate). Your digital rectal exam results can give you and your doctor a great deal of information in a short amount of time. It is important to know what the results of your exam could mean.

What Is "Normal" and "Abnormal" on a Digital Rectal Exam?

If the prostate is "normal" on a digital rectal exam, it will feel smooth and will not have any areas of increased hardness or bumpiness.

Additionally, the prostate should not feel enlarged on the exam.

The prostate may be "abnormal" on the digital rectal exam for any number of reasons including:

  • the presence of an area of increased hardness
  • the presence of a nodule or bump
  • overall increase in size
  • feelings of being tender to the touch

What Happens If Your Digital Rectal Exam Is Abnormal?

The digital rectal exam is most helpful when it is coupled with the PSA test. If your PSA is high or increasing quickly, then your doctor will likely choose to test you for prostate cancer regardless of what the digital rectal exam shows. This is because, unfortunately, some men develop prostate cancer without any detectable abnormality on their digital rectal exam.

If your PSA is normal, but your doctor detects an area of increased hardness or a nodule, then he will likely choose to do a biopsy at a later date to determine whether or not this area is the result of prostate cancer.

Only a biopsy can definitively determine if a man has prostate cancer.

If you PSA is normal or elevated and your prostate is simply enlarged without an area of hardness or a nodule, then your doctor may simply attribute this to BPH (a benign enlarged prostate). He may, however, want to do a biopsy to rule out prostate cancer.

Prostatitis, a temporary inflammation of the prostate that is not cancer, can also cause the prostate to swell and become tender on the examination.

What's the Bottom Line?

The digital rectal exam provides considerable information to your doctor about the health of your prostate, but it is not a perfect test. When combined with the PSA test and other information about your health, it can help to guide your doctor to order more testing (such as a biopsy) so that prostate cancer or other important prostate conditions can be diagnosed early.


Tanagho EA, McAninch JW. Smith's General Urology, 17th Edition.

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