Is a prostate exam supposed to have long lasting effects?
March 29, 2010 9:15 AM   Subscribe

Second time I've had a prostate exam, second time I've felt pain, soreness, and general differences for weeks and even months later. Are my doctors doing it wrong, or is it just me?

As a guy I think it was dumb luck that I never had the ol' prostate or hernia check in my life until a physical around the age of 35. It wasn't a pleasant experience since I had no idea what was coming (aside from a finger in the butt) and the doctor kind of forced stuff up there, moved around, and out. My entire body was clenched during the whole thing, and it was pretty horrible in retrospect.

For weeks afterwards my internal muscles hurt. I guess it's close to those "kegel" muscles since it was difficult to start and stop peeing for weeks after.

A few years later I had some unexplained blood in some excretions and it aligned with possible prostate cancer so we had to do another check (this time, a different doc). I sort of knew it would be unpleasant and this doc held their position long enough to ask if I was merely feeling pressure or feeling pain (I could barely tell the difference).

A few months have gone by since that exam and again, the kegel muscles felt messed up for a good two months, while my butt just feels not quite right, like something has happened to the muscles around my anus. I've been farting more often and I feel like I have less control over "holding" them in.

Anyway, is this all normal wear and tear on your body when someone jams an appendage into an orifice that wasn't expecting it or are the two doctors that examined me doing it wrong?
posted by anonymous to Health & Fitness (10 answers total)
I expect this is something that the doctors should be answering, not a bunch of random shmoes on the internet.
posted by Jilder at 9:20 AM on March 29, 2010 [1 favorite]

Anonymous--pick up the phone and call the Dr's office that did the last exam. They are they only ones that should be answering this question. Seriously.
posted by 6:1 at 9:25 AM on March 29, 2010 [1 favorite]

IANAD nor am I a man, but I don't think any exam should leave you with uncomfortable symptoms months after the fact. So, go to a doctor (same one, different one, doesn't matter), and explain in detail what has happened. It's the only way to know what is going on with your body. Best of luck.
posted by katemcd at 9:28 AM on March 29, 2010

I've had prostate cancer, and totally recovered (fingers crossed!) because they caught it in good time. I must have had the fingers of six or seven different doctors up my anus over the past four years (they keep on checking to make sure it's really gone), and a couple were terrible, most I barely noticed.

I admit there's no way to tell in advance if a doctor's going to be gentle or rough, but just be aware that it's perfectly possible for a sensitive doctor to perform the exam without causing any discomfort at all (except maybe in the head!). If you feel discomfort, tell him (or her), and insist they stop - there's really no need whatever to suffer when there are demonstrably ways of doing this examination without causing pain. Unpleasant, yes, but no more than that.

IANAD, IANYD, but I've been there, and suspect that your muscle tension and clenching is possibly due to anticipation of possible rapidly forthcoming pain/discomfort. Maybe you could discuss this in advance with your doctor and ask for some meds (muscle relaxant? mind relaxant?) to take in preparation.

Plus most doctors/dentists I've consulted tell me they have not only no wish to cause pain/discomfort, but that it actually makes work more difficult for them if their patient is suffering. So they're happy to do whatever it takes to make you feel more comfortable/less uncomfortable with this not very funny treatment.

Good luck - be aware it can be totally bearable if you hit the right note with your physician. And remember you have the right to insist. And (on preview) what all the others said upthread.
posted by aqsakal at 9:32 AM on March 29, 2010

Medical student here - we're taught that prostate examination should be "unpleasant but not painful", and that we really want to know if the patient is finding it painful in case it indicates something wrong (which could well be something we're doing wrong). So chiming in with everyone else to say 'go back to your doctor'.
posted by Coobeastie at 9:37 AM on March 29, 2010

I've had my prostate [ahem] digitally examined on [ahem] several occasions, and it's never hurt. It's been mildly uncomfortable at first, but only in the external sphincter, not "internally". You might be able to make it more comfortable by pushing down while the finger is inserted, as this will cause the external muscle to relax.

However, you should go and see the doctor about this. It's far more embarrassing for you than them. They're used to putting their fingers into people's anuses. It sounds to me like they're doing something wrong, as I've never had the slightest problem afterwards, but they are the only one's who can tell you that for sure.
posted by Solomon at 9:53 AM on March 29, 2010

You need to see the doctor again, or at least another one.
The test should not hurt.

First time for me was slightly uncomfortable. I later found out that it was partially due to: doctor inexperience (really!) and patient inexperience. The doctor needs to know what they are doing. The patient needs to relax. (Yes, I found a new doctor.)
Subsequent tests have not even been uncomfortable to a point or noticing or remarking on it. And certainly not for any time after the exam.

Also, you might want to see a urologist if there is specific pain or concern in the area. And possibly a gastroenterologist for a [uh] different area.
posted by Drasher at 10:58 AM on March 29, 2010

A few years later I had some unexplained blood in some excretions ...

FWIW, I was listening to a radio show interview with a real, live urologist, and the subject was prostate issues and new treatments.

The Urologist stated that blood in semen is, in of itself, not an immediate cause for concern, but that blood in urine ALWAYS is cause for concern and must be checked out.
posted by de void at 11:08 AM on March 29, 2010

Go back to your doctor for SURE.

In the realm of things you can control, try deep breathing and forcing yourself to relax that area insofar as possible during the exam - if you are clenching hard and the doctor is having to force his way in, bruising would not be an unreasonable assumption afterward. Easier said than done I know but it might help.
posted by Billegible at 11:52 AM on March 29, 2010

The doctors ought to know what they're doing and should be responsive to your needs, but you're also able to do this yourself at home and work it out for yourself what's the best approach for your own body.
posted by Ultrahuman at 5:30 PM on March 29, 2010

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