Diagnostic yield of digital rectal examination during routine physical medical examination in a sub- urban African population

TOPIC: Diagnostic yield of Digital Rectal Examination during routine physical  medical examination in semi-urban African population.
Introduction: The higher frequencies of performing a DRE, diagnostic confidence, and adequacy were directly related to level of experience with the examination. Training in DRE technique has diminished and may be lost.
Objective: To assess the diagnostic yield of DRE in a semi-urban African population, thus estimating its relevance.
Method: This is a prospective observational hospital based study. Random consecutive consented adult patients are subjected to DRE.
Results: A total of 450 patients with mean age of 52.6 years were studied.  Only 6.3% reported it to be discomforting, tolerability was neither significantly affected by the performer’s status (x2 4.602, P 0.504) nor the patient’s BMI (x2 4.6, p 0.79). DRE findings added information which modified the diagnosis in 10.7%, provide additional diagnosis in 22% and identify correct diagnosis which could have been missed in 16.7%. Change in working Diagnosis occurred in 7.3% of all patients, this appears to vary among the diagnosis groups and with patient’s age (p= 0.648). Being overweight or not did not affect incidences of unrelated DRE findings (X2  0.449, p 0.5025, OR 1.2083).
Conclusion: DRE is very relevant in clinical practice.