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Couch or crouch? Examining the prostate: a randomized study comparing the knee‐elbow and the left‐lateral position
Author(s) -
Frank J.,
Thomas K.,
Oliver S.,
Andrews S.,
Choong S.,
Taylor R.,
Emberton M.
Publication year - 2001
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.2001.00066.x
Subject(s) - medicine , embarrassment , physical examination , physical therapy , elbow , rectal examination , wilcoxon signed rank test , straight leg raise , significant difference , prostate , surgery , mann–whitney u test , psychology , range of motion , social psychology , cancer
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.