Interobserver variation of prostatic volume estimation with digital rectal examination by urological staffs with different experiences

Cheng, Wai C; Ng, Fai C; Chan, Kwok C; Cheung, Yuen H; Chan, Wai Lam; Wong, Sang W

doi:10.1590/s1677-55382004000600003

Cited by 12 publications

(9 citation statements)

References 9 publications

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“…8 Further research has shown that more experienced urologists tend to as-sess the size of a prostate more accurately. 9 These findings support the idea that technical skill is important to successfully performing DREs. One means to address this is through improved education of medical trainees, a topic addressed later in this article.…”

Section: Role Of Dre In Prostate Cancer Screeningsupporting

confidence: 60%

Digital rectal examination in prostate cancer screening

Zhang¹,

Ahmed²,

Jordan³

2013

UWOMJ

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Section: Role Of Dre In Prostate Cancer Screeningsupporting

confidence: 60%

Digital rectal examination in prostate cancer screening

Zhang¹,

Ahmed²,

Jordan³

2013

UWOMJ

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“…Cheng et al reported the accuracy of estimating the PV with DRE by urological staff members with different levels of experience. 19 The difference between the PV measured with TRUS and that estimated with DRE was statistically significant only between a junior urology trainee (2 months working experience) and a trained urologist (>5 years working experience; P = 0.003). There was no significant difference between a senior urology trainee (20 months working experience) and the trained urologist.…”

Section: Discussionmentioning

confidence: 85%

Does digital rectal examination predict prostate volume greater than 30 mL?

2017

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Abbreviations & Acronyms BPH = benign prostatic hyperplasia DRE = digital rectal examination F = flat LUTS = lower urinary tract symptoms LUTS/BPH = lower urinary tract symptoms suggestive of benign prostatic hyperplasia Ma = markedly enlarged Mo = moderately enlarged N = normal PV = prostate volume S = slightly enlarged TRUS = transrectal ultrasound Objectives: To investigate the accuracy of digital rectal examination in estimating prostate volume in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Methods: A community-based study was carried out in Japan to investigate the prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia. A total of 457 men were screened and deemed eligible for the present analysis. Findings on digital rectal examination were compared with prostate volume measurement by transrectal ultrasound. Five groups were identified on digital rectal examination: flat, normal, slightly enlarged, moderately enlarged and markedly enlarged. Results: The median age and prostate volume were 64 years and 19.7 mL, respectively. Prostate volumes for the flat, normal, slightly enlarged, moderately enlarged, and markedly enlarged groups were 16.4, 18.3, 27.0, 41.9 and 86.3 mL, respectively. There were significant differences in prostate volume between the groups. The positive predictive value was 94.1% if flat, and normal were assumed to have a prostate volume <30 mL. The value was 80.8% if moderately enlarged, and markedly enlarged were assumed to have a prostate volume ≥30 mL. Of the men in the slightly enlarged group, 61.0% had a prostate volume <30 mL. Conclusions: It is possible to stratify prostate volume according to digital rectal examination. We could determine the prostates in the flat and normal groups to have a prostate volume <30 mL, and those in the moderately enlarged and markedly enlarged groups to have a prostate volume ≥30 mL by digital rectal examination with high accuracy. Transrectal ultrasound was required for those in the slightly enlarged group.

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“…At the same time, a tendency for accuracy improvement after performing more examinations is also expected after introducing DRE standardization [14], and future studies are warranted focusing particularly on the learning curve that is beyond the present study targets. …”

Section: Discussionmentioning

confidence: 96%

Digital Rectal Examination Standardization for Inexperienced Hands: Teaching Medical Students

Reis

Simão

Baracat

et al. 2013

Advances in Urology

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Objectives. To standardize digital rectal examination (DRE) and set how it correlates with the comprehensive evaluation of lower urinary tract symptoms (LUTS). Methods. After scaled standardization of DRE based on fingertips graphical schema: 10 cubic centimeters—cc for each fingertip prostate surface area on DRE, four randomly selected senior medical students examined 48 male patients presenting with LUTS in an outpatient clinical setting, totaling 12 DRE each. Standardized DRE, international prostate symptom score (IPSS), serum PSA, transabdominal ultrasound (US), urodynamic evaluation, and postvoid residue were compared. Results. The mean and median PVs were US—45 and 34.7 cc (5.5 to 155) and DRE—39 and 37.5 cc (15 to 80). Comparing DRE and US by simple linear regression: US PV = 11.93 + 0.85 × (DRE PV); P = 0.0009. Among patients classified as nonobstructed, inconclusive, and obstructed, the US PVs were 29.8, 43.2, and 53.6 cc (P = 0.033), and DRE PVs were 20, 35, and 60 cc (P = 0.026), respectively. Conclusion. This is the first attempt to DRE standardization focusing on teaching-learning process, establishing a linear correlation of DRE and US PVs with only 12 examinations by inexperienced hands, satisfactorily validated in an outpatient clinical setting.

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Interobserver variation of prostatic volume estimation with digital rectal examination by urological staffs with different experiences

Abstract: The trained urologist was more accurate in estimating prostatic volume with DRE than the urology junior trainee.

Cited by 12 publications

References 9 publications

Digital rectal examination in prostate cancer screening

Digital rectal examination in prostate cancer screening

Does digital rectal examination predict prostate volume greater than 30 mL?

Digital Rectal Examination Standardization for Inexperienced Hands: Teaching Medical Students

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