Document Detail

Couch or crouch? Examining the prostate: a randomized study comparing the knee-elbow and the left-lateral position.
MedLine Citation:
PMID:  11251525     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare two methods of examining the prostate, the knee-elbow (KE) and left-lateral (LL) positions, to establish which allows a more complete examination, and to determine if there is any difference in patients' perception of pain or embarrassment for either method. PATIENTS AND METHODS: All men attending two urology clinics who required a prostate examination were eligible for the study. Both the KE and LL methods were used for each participant, by the same clinician. The order in which the examinations were conducted was randomized using the last digit of the patient's hospital number. RESULTS: Five clinicians examined 117 men; three patients refused to participate and the examination data were incomplete for two. Irrespective of the order in which the examinations were conducted (P = 0.6), the KE position permitted a greater proportion of the prostate to be palpated (Wilcoxon signed-ranks test, z = -4.7, P < 0.001) in 35% of patients, but there was no difference in 60%. Most patients found the examinations equally painful and embarrassing. However, for those who expressed a difference, the KE was 1.9 times more comfortable than the LL position and twice as embarrassing. CONCLUSION: The two methods of prostate examination were equal for completeness of examination, pain and embarrassment in most patients. However, the KE offers an alternative to the LL position for those patients in whom the prostate is difficult to palpate or who find the examination painful.
J Frank; K Thomas; S Oliver; S Andrews; S Choong; R Taylor; M Emberton
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  BJU international     Volume:  87     ISSN:  1464-4096     ISO Abbreviation:  BJU Int.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-19     Completed Date:  2001-04-26     Revised Date:  2006-07-18    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  331-3     Citation Subset:  IM    
Whittington Hospital NHS Trust, Clinical Effectiveness Unit (CEU), Royal College of Surgeons of England, Institute of Urology and Nephrology, University College, London, UK.
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MeSH Terms
Aged, 80 and over
Middle Aged
Pain / etiology
Patient Satisfaction
Physical Examination / methods*
Prostatic Diseases / diagnosis*
Comment In:
BJU Int. 2001 Oct;88(6):645   [PMID:  11678769 ]
BJU Int. 2001 Oct;88(6):645   [PMID:  11678768 ]

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