Is Digital Rectal Examination Still Valuable for Measuring the Prostate Volume in Clinical Practice?

Background and objectiveTo investigate the usefulness of digital rectal examination (DRE), a cost-effective and simple way to mea-sure prostate volume versus transrectal ultrasound (TRUS), and the gold standard method for measuring prostate volume. Material and methodsFrom 2018 to 2019, a total of 580 patients who underwent DRE and TRUS for the initial evaluation of benign prostatic hyperplasia (BPH) were included in this study. DRE was performed twice at two appointments by a single urologist, and TRUS was performed once by a single radiologist. The patients were divided into seven groups according to TRUS-estimated prostate volume (A, 80 cc). We investigated the agreement between the TRUS and DRE measurements. ResultsThere was a high percent agreement of DRE and TRUS in groups B–D (84.6, 84.1, and 79.1%, respectively). The highest over- and underestimations of prostate volume on DRE were 23.1 and 79.5% in groups A and G, respectively. In the Bland–Altman plot, the mean difference between TRUS and DRE in group A–D was closer to zero-line than that in groups E–G. The variability in differences between TRUS and DRE in groups A, B, and C was lower than that in groups D, E, F, and G. ConclusionDRE was accurate in measuring the prostate volume of 30~49 cc. We suggested that DRE remains a simple and cost-effective method for measuring prostate volume.