The Utility of Digital Rectal Examination in Estimating Prostate Volume in a Rural Hospital Setting

To determine the correlation between prostate volume estimated by digital rectal examination (DRE) and that estimated by abdominal ultrasound in the same patients.

Men who presented to our urology outpatient clinic with lower urinary tract symptoms were recruited in this study. We estimated the prostate size by digital rectal examination using the sliding scale as a guide and subsequently measured the prostate volume by transabdominal ultrasound.

A total of 100 patients completed this study. The mean age was 65.6 ± 9.84 years. The Kappa's reliability test comparing the prostate size estimated by DRE and the prostate size measured by transabdominal ultrasound was 0.579832, the Kappa's standard error was 0.097768 and Kappa's t value was 5.93. The Kappa's reliability test fell into good agreement range (0.4-0.75). This is further validated by the Pearson's correlation test ascertaining correlation between Ultrasound and DRE and generated a correlation coefficient(®) of 0.59 (P = 0.00). This implies a high positive correlation between ultrasound estimated prostate volume and that estimated by DRE that is statistically significant (P < 0.01).

Estimation of prostate volume by digital rectal examination is reliable. This is very important in an environment where esoteric laboratory facilities are not readily available, and the clinician has to depend mainly on his clinical acumen.