Symptoms and diagnosis: why proctological examination and anorectoscopy are performed
The proctological examination consists of two moments: an interview between patient and proctologist, in which the patient describes all the symptoms for which he or she has decided to consult the specialist, and an external and internal inspection of the anal canal for the diagnosis of presumed anorectal pathologies
Why and when a proctological examination is used
A proctological examination is the quickest and most effective response in the presence of anorectal symptoms (often disabling) such as pain, bleeding, itching, the appearance of swelling, purulent discharge, altered alvus, and enlarged prostate.
It is essential for the diagnosis of hemorrhoidal pathology, fissures, rectal prolapse, rectocele, and other rectal pathologies.
Proctological examination and digital rectal exploration of the prostate is also performed for the prevention of prostatitis and for the diagnosis of prostate cancer.
It is good to perform a proctologic examination as soon as symptoms appear, because these could also be related to cancer pathology, and in general it is useful as a screening examination for the prevention of male cancers.
What the proctological examination consists of and how it is performed
The proctologic examination consists of the collection of a thorough medical history, digital exploration of the anal canal, and anorectoscopy.
The patient who wants to undergo a proctological examination should present after undergoing a small cleansing enema about two hours before the examination.
After the history, the doctor will perform a general examination and rectal exploration: gently inserting a finger into the previously lubricated anus.
Commonly, the patient is made to lie in the fetal position (on the left side with legs flexed) or is made to lie on his knees or in the gynecological position.
How anorectoscopy is performed
Anorettoscopy (or proctoscopy) is the introduction into the anal canal of a small, disposable, transparent plastic cylinder about 5-6 cm long, called anoscope, which allows a view of the anorectal canal (the diameter of this instrument is little more than that of the finger; therefore, discomfort is minimal and, of course, the examination can be discontinued if not endured by the patient).
Anorectoscopy also represents prevention of rectal cancer, because it allows early diagnosis and treatment of polyps that are still asymptomatic.
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