The prostate exam is a tool doctors use to screen for prostate cancer. It usually involves a digital rectal exam (DRE), where your doctor inserts a gloved, lubricated finger into your rectum to feel your prostate gland, and a prostate-specific antigen (PSA) blood test.
Understandably, many people wonder, “Should I poop before my prostate exam?” It’s a good question! You may feel anxious about having a bowel movement during the exam. It’s also reasonable to want to be as comfortable as possible.
Let’s take a closer look at what you need to know to prepare for a prostate exam, ease your anxiety, and take great care of your prostate health.
What Is a Prostate Exam?
To check the health of your prostate, your doctor will likely perform one or both of the following tests:
Digital Rectal Exam (DRE)
In this procedure, the doctor inserts a gloved, lubricated finger into your rectum to physically examine your prostate gland. The goal is to feel the size, shape, and texture of the prostate and identify any lumps, hard spots, or other anomalies.
You may experience some minor discomfort during this exam. Light rectal bleeding is a possible side effect, but it’s rare.
Prostate-Specific Antigen (PSA) Blood Test
This blood test measures the level of prostate-specific antigen (PSA) in your blood. PSA is a protein produced by the prostate gland. A higher-than-normal PSA level may be a sign of prostate cancer. However, elevated PSA levels can also be caused by other conditions, such as an enlarged prostate (benign prostatic hyperplasia, or BPH) or an infection.
Do I Need to Empty My Bowels Before a Prostate Exam?
Nope. You don’t need to do any special prep, like emptying your bowels, before a prostate exam.
A digital rectal exam (DRE) focuses on the prostate gland, which sits close to the rectum, but the presence of stool in your bowel doesn’t usually affect the exam. Your doctor can typically perform the exam without any problems, even if your rectum isn’t completely empty. Forcing a bowel movement when you don’t need to can cause discomfort, so don’t worry about it.
If you feel a strong urge to go during the exam, tell your doctor. They can adjust the exam or give you advice. Also, be sure to let your doctor know if you have any existing conditions like hemorrhoids or anal fissures beforehand.
Who Should Get a Prostate Exam and When?
It’s important to remember that prostate cancer screening isn’t one-size-fits-all. The decision about whether or not to get screened should be made individually, based on your personal risk factors and after a thorough discussion with your doctor.
The U.S. Preventive Services Task Force (USPSTF) provides recommendations on prostate cancer screening. For men aged 55 to 69, the USPSTF suggests that they should talk with their doctor about the potential benefits and risks of PSA (prostate-specific antigen) screening to make an informed decision. They recommend against routine PSA screening for men aged 70 and older.
Risk Factors
Certain risk factors may warrant earlier or more frequent screening. These include:
- A family history of prostate cancer
- Being African-American
- Having certain genetic mutations
Men with these risk factors should talk to their doctor about screening options starting at age 40 or 45. Your doctor can help you weigh the pros and cons of screening based on your individual situation.
What to Expect During and After the Exam
Okay, so what happens at the doctor’s office?
During the Exam
Remember, a digital rectal exam is usually quick. The doctor will insert a gloved, lubricated finger into your rectum to feel the prostate gland. The whole thing only takes a few seconds.
If you feel any discomfort during the exam, tell your doctor right away.
After the Exam
You’ll usually get your PSA test results back pretty quickly. Your doctor will discuss the results with you and let you know if any further testing is needed.
After the DRE, you might feel a little bit of mild discomfort or notice a tiny bit of light rectal bleeding. But that’s rare.
If you experience heavy bleeding or any unusual symptoms after the exam, give your doctor a call.
Interpreting Results and Follow-Up
After your prostate exam, your doctor will discuss the results with you. It’s important to remember that neither the DRE nor the PSA test is perfect. They’re screening tools, not definitive diagnoses.
Elevated PSA Levels
An elevated PSA level doesn’t automatically mean you have prostate cancer. Other conditions, such as an enlarged prostate (BPH) or prostatitis (inflammation of the prostate), can also cause PSA levels to rise. How often you should be retested depends on your PSA level.
- Men with a PSA level of less than 2.5 ng/mL may only need to be retested every 2 years.
- Men with a PSA level of 2.5 ng/mL or greater should be screened annually.
Abnormal DRE Findings
If your doctor finds anything unusual during the DRE, it will require further investigation.
Next Steps
Depending on the results of your DRE and PSA test, your doctor may recommend additional tests, such as a prostate biopsy. A biopsy is the only way to definitively diagnose prostate cancer. Be sure to openly discuss all your concerns and the pros and cons of any recommended tests or treatments with your doctor so you can make an informed decision together.
Addressing related concerns
Pain and discomfort
Let’s be honest, the idea of a prostate exam isn’t exactly pleasant. But the good news is that a DRE usually isn’t very painful. You might feel a little pressure or discomfort, but it’s generally mild and over quickly.
Self-prostate exams
While you might be tempted to try and check things out yourself, please don’t! A DRE needs to be done by a trained medical professional. They know what to look for and how to properly assess your prostate health.
Impact of ejaculation on PSA levels
Here’s something else to keep in mind: ejaculation can temporarily raise your PSA levels. So, if you’re getting a PSA test done, your doctor will likely tell you to avoid ejaculating for a day or two beforehand (usually around 48 hours). This helps ensure the most accurate PSA reading.
Frequently Asked Questions
How do you prepare for a prostate test?
Preparation for a prostate exam is generally minimal. Your doctor may advise you to empty your bladder beforehand. If a prostate-specific antigen (PSA) blood test is part of the evaluation, discuss any medications you’re taking, as some can affect PSA levels. Also, inform your doctor about any recent urinary procedures or infections.
What should I avoid before a prostate blood test?
To ensure accurate PSA test results, it’s often recommended to avoid ejaculation for 24-48 hours beforehand, as this can temporarily elevate PSA levels. Also, refrain from strenuous exercise that could irritate the prostate. Discuss any concerns about medications or other factors with your doctor.
Does ejaculating before a PSA test affect the results?
Yes, ejaculating before a PSA test can temporarily increase PSA levels, which could lead to a falsely elevated reading. It’s generally advised to abstain from ejaculation for at least 24-48 hours before the test to ensure the most accurate results.
What does a prostate infection feel like?
A prostate infection, or prostatitis, can cause a range of symptoms, including pain in the groin, lower back, or perineum (the area between the scrotum and anus). It can also cause painful urination, frequent urination, difficulty urinating, and sometimes flu-like symptoms such as fever and chills.
Do you have to pull your pants down during a physical?
The extent to which you undress during a physical exam depends on the specific exam and your doctor’s needs. For a routine check-up, you may only need to loosen your clothing. However, for a prostate exam or other specific assessments, you may be asked to remove your pants and underwear, but you will be provided a gown or sheet for privacy.
Closing Thoughts
The short answer is that you don’t usually need to empty your bowels before a prostate exam. So you probably don’t need to change your regular routine.
But it’s always a good idea to talk with your doctor about prostate cancer screening. Together, you can make a plan that’s right for you based on your individual risk factors.
Being informed and taking an active role in your prostate health is a smart move. Your doctor can help you decide what screenings and other steps make the most sense for you.