DIGITAL RECTAL EXAMINATION- Skill Lab- OSCE #digitalrectalexamination #surgicaleducator #babysurgeon #skilllab #osce Subscription Link: http://youtube.com/c/surgicaleducator... Surgical Educator Android App link: https://play.google.com/store/apps/de... Dear viewers, • Greetings from “Surgical Educator” • Today I am uploading one more video on Skill Lab procedure for your OSCE exam. • In this episode, I am talking about the DRE- Digital Rectal Examination , the skill which should be mastered by all medical students. • I hope you can master the skill by watching this video and can do all the steps in the correct sequence. • You can enjoy all my videos in the following link: • youtube.com/c/surgicaleducator • Thank you for watching the video.

1. DIGITAL
RECTAL
EXAMINATION
SKILL
LAB
OSCE
Dr.B.SELVARAJ
MS;Mch;FICS;
“SURGICAL EDUCATOR”
MALAYSIA

2. DIGITAL RECTAL
EXAMINATION
DEFINITION
A physician insert his/her gloved fingers
into anal opening to find out anal/rectal
pathology, prostatic pathology or anal
sphincter tone.
INDICATIONS
1. After all local abdominal examination
2. BRBPR- Passing Bright Red Blood Per
Rectum
3. Altered bowel habits- Constipation/ Diarrhea
4. Suspected prostatic pathology
5. Anal incontinence

3. DIGITAL RECTAL
EXAMINATION
CONTRAINDICATIONS
ABSOLUTE
1. Imperforate Anus
2. After Abdomino-perineal resection surgery
CONTRAINDICATIONS
RELATIVE 1. Acute Fissure-in-Ano

4. DIGITAL RECTAL
EXAMINATION
EQUIPMENTS

5. DIGITAL RECTAL
EXAMINATION
SEQUENTIAL STEPS
1.Introduction & Informed
consent
 Introduce yourself to the
patient
 Tell the patient why and
what you are going to do?
 Tell the possible
complications also and then
obtain the informed consent.
2. Chaperone & Privacy
 Ask for a chaperone
 Maintain privacy by putting
the curtain

6. DIGITAL RECTAL
EXAMINATION
SEQUENTIAL STEPS
3. Wear PPD, wash hands
and wear glove
 PPD/PPE: Wear apron, cap,
mask and goggles
 Wash hands
 Wear examination glove

7. DIGITAL RECTAL
EXAMINATION
SEQUENTIAL STEPS
4. Patient’s position
 Sim’s position- Lt lateral 5. Expose the area
adequately

8. DIGITAL RECTAL
EXAMINATION
SEQUENTIAL STEPS
6. Inspect peri-anal skin 7. Lubricate index finger
with Xylocaine jelly

9. DIGITAL RECTAL
EXAMINATION
SEQUENTIAL STEPS
8. Apply finger gently into
anal opening at 6-O clock
position
 Tell the patient before
introducing finger
9. Rotate finger 360*
 Clockwise 180* and anti
clockwise 180*

10. DIGITAL RECTAL
EXAMINATION
SEQUENTIAL STEPS
10. Palpate anteriorly in
males for Prostate
 Feel for size, median sulcus
and nodules
11. Check anal tone by
asking patient to grip
palpating finger
 By contracting perineal
muscles

11. DIGITAL RECTAL
EXAMINATION
SEQUENTIAL STEPS
12. Gently remove finger &
Inspect finger for blood/
mucus/ feces
13. Clean anal area

12. DIGITAL RECTAL
EXAMINATION
SEQUENTIAL STEPS
14. Cover the area
15. Thank the patient &
throw the glove into yellow
color bin

13. DIGITAL RECTAL
EXAMINATION
SEQUENTIAL STEPS
16. Inference about the DRE
 Prostate: enlarged, smooth surface and median sulcus
felt BPH
 Prostate: Single nodule with normal median sulcus
Carcinoma Prostate
 Prostate: Whole prostate is nodular Craggy
ProstateMedian sulcus obliterated Carcinoma
Prostate
 Rectal & Anal canal: Polyp & CA Rectum
 Anal Sphincter tone decreased Fecal incontinence

14. DIGITAL RECTAL EXAMINATON
SEQUENTIAL STEPS-RECAP
1. Introduce yourself ,Explain the procedure
and take informed consent
2. Ask for a chaperone &Provide privacy
3. Don apron/ wash hands/ don gloves
4. Position patient Sim’s position
5. Expose the area adequately
6. Inspect peri-anal skin
7. Lubricate index finger with xylocaine jelly
8. Gently introduce the finger into anal
opening at 6-O clock position
9. Rotate the finger 360*
10. Palpate anteriorly in males for Prostate
11. Check the anal sphincter tone
12. Gently remove finger & Inspect finger
for blood/ mucus/ feces
13. Clean anal area
14. Cover the area
15. Thank the patient & throw the glove
into yellow color bin
16. Inference of DRE to examiner