What can women feel during a digital rectal examination?

Everyone gets sick, but some illnesses are more serious, while others are less serious. Some more serious illnesses require specific examinations in the hospital, such as blood tests, urine tests and other procedures. However, it is time-consuming and laborious to diagnose some diseases of the internal organs, so some doctors choose to use finger pressing to feel the changes in the body in order to understand the severity of the disease. So let’s take a look at what a female rectal digital examination can reveal.

There are three possible patient positions:

(1) Knee-chest position: It is suitable for examining male patients, especially for the prostate and seminal vesicles. It is also a good position for examining the anus and rectum.

(2) Left side lying position: suitable for examining female patients, but can also be used for male patients.

(3) Supine position: This position can be used when there is abdominal disease or it is inconvenient to change body position.

During a digital rectal examination in women, the cervix and the upper part of the posterior wall of the vagina can be felt through the anterior wall of the rectum.

Digital anal examination has the following contents and significance:

1. The first thing to do is to check the tightness of the anal sphincter and anorectal ring. The anorectal ring is composed of the upper edge of the internal and external sphincters and the puborectalis muscle, surrounding the junction of the anal canal and rectum. The internal and external sphincters are ring-shaped, while the puborectalis muscle only exists at the back and on both sides. Therefore, during the digital rectal examination, it can be touched at the back and both sides of the anal canal, but not at the front of the anal canal. When the anal sphincter and anorectal ring are normal, the index finger can be smoothly inserted into the anus. If the index finger is difficult or cannot pass through, it means that the anus has different degrees of stenosis. If the anal sphincter is too relaxed and weak, anal incontinence may occur.

2. Check the anterior and posterior walls of the anal canal and rectum and their surrounding areas for tenderness, pulsation, or lumps, and pay attention to the size, hardness, and mobility of the lumps. For lumps located higher up, digital rectal examination can be performed in the squatting or lithotomy position. These two positions can move the tumor downward, allowing rectal cancer in a higher position to be palpated. If necessary, a rectal and abdominal bimanual examination or a rectal and vaginal bimanual examination can be performed to provide valuable information on the extent of cancer invasion.

3. On the anterior wall of the rectum, the prostate can be felt in men and the cervix can be felt in women, which should not be mistaken for pathological masses;

4. After the examination is completed and the finger is pulled out, check whether there is blood or mucus on the finger sleeve. If necessary, a smear test should be performed.