by Frank Frakes

It’s that moment of dread for a lot of middle-aged men. The urologist God arrives into the examination room and asks you to lie prostrate so he can examine your prostate. The finger enters the hole, wiggles around a little bit and soon it’s all over with or without commentary. 

That’s how it used to be. Now we know that medical advances have all but rendered the digital rectal exam or DRE as it is known in the medical community obsolete. Then why are some urologists so reluctant to give it up? The Dragonfly Report flew to Germany to find out.

At a recent conference in Berlin hosted by the German Society of Urology, Dr. Peter Mueller, a Frankfurt based urologist took the stage and announced the official end of the DRE and highlighted the reasons why it is no longer necessary. 

“It started with the development of the PSA test, a highly effective test for prostate cancer screening,” he explained. “Then came the 4K score test, a blood test that checks for aggressive prostate cancer after an abnormal PSA and of course advances in MRI technology,” he continued. “It’s over! We don’t need to use the finger anymore.”

At the end of the presentation, he held up is right index finger high in the air and shouted “Vorbei mit dem finger” repeatedly.

Soon most but notably not all of the urologists in attendance were holding their index fingers high in the air and shouting “Vorbei mit dem finger” over and over. Later, we found out it meant ‘Gone with the finger’. The enthusiasm was so high I felt like I was witnessing a scene from the Third Reich.

A little later, I caught up with one of the urologists, Dr. Krause, who wasn’t shouting or holding his finger up.

Dragonfly Report: You seemed uninspired by Dr. Mueller’s declaration. What gives?

Dr. Krause: I have been using the finger for 25 years. It has served my patients well. I see no reason to change. Everybody seems to trust new technology. I trust the finger.

Dragonfly Report: You don’t use the PSA test in your practice?

Dr. Krause: I’m not a Dummkoph (idiot). I use every test available.  I just refuse to give up the finger. I can determine things quickly and efficiently by measuring the response of my patients to the quick poke and wiggle.

It seems that Dr. Krause is not alone. Back in the Bay Area, we contacted over 20 urologists and three of them claimed to still use the digital rectal exam method in initial consultations. We contacted them to see if there was something we were missing but they were all very unclear on why they still use it.

I decided to pay a visit to a urology clinic on the Oakland side of Piedmont Ave and approached Dr. Dedonocu on why he still uses the DRE after all the latest medical advancements suggest it’s no longer necessary.

“It’s been part of my practice for years and my patients have to come to expect it. I guess even we urologists are creatures of habit,” he explained.

Suddenly he appeared suspicious and his demeanor changed. He began waving his index finger in the air and pointing at me aggressively. He then pointed to the door.

I left the clinic quickly, none the wiser on why some urologists are still reluctant to give up the finger.