Cross-leg lithotomy: is it a better position for digital rectal examination of the prostate?. (September 2013)

• Record Type: Journal Article
• Authors: Nagathan, Deepak Sharanappa; Dalela, Divakar; Sankhwar, Satyanarayan; Goel, Apul; Dwivedi, Amod Kumar; Yadav, Rahul; Dalela, Deepansh; Gupta, Dheeraj Kumar; Mandal, Swarnendu
• Is Part Of: Journal of clinical urology. Volume 6:Number 5(2013)
• Page Start: 311
• Page End: 316
• Publication Date: 2013-09
• Subjects: Cancer prostate -- digital rectal examination -- prostate examination; Genitourinary organs -- Surgery -- Periodicals; Genitourinary organs -- Diseases -- Periodicals; Urology -- Periodicals; 616.6005
• DOI: 10.1016/j.bjmsu.2012.06.006
• Languages: English
• ISSNs: 2051-4158

Abstract

Objectives: To evaluate whether "cross-leg lithotomy" (CL) is better position for digital rectal examination (DRE) than left lateral (LL) position from urologist and patient's perspective. Materials and methods: Two urologists performed DRE in 120 patients in LL and CL positions. Each patient was randomised, sequentially examined in both positions and responses were objectively assessed using a questionnaire and statistically analysed. Results: Men found DRE uncomfortable [LL (81.7%), CL (85.0%)] and embarrassing [LL: (81.7%), CL (78.3%)] in both the positions. DRE was painful [LL (11.7%), CL (8.3%)] with a mean pain score of 1.92 and 1.85 respectively. Patient apprehension regarding pain was significantly higher [LL (62.5%) vs. CL (21.7%), p < 0.001] in LL position. Overall, men preferred CL to LL position [CL (78.3%), LL (21.75%), p < 0.001] for DRE. From urologist perspective, the extent of prostate felt in CL position was significantly higher (CL: 11.15 ± 1.96/12 vs. LL: 9.25 ± 2.50/12, p < 0.001). Withdrawal response was significantly higher in LL and urologist had to sit down to perform DRE in LL position. Conclusions: Men preferred CL to LL position for DRE and CL allowed more complete examination of the prostate from urologist perspective. CL position is a better alternative for performing DRE of the prostate.