Granted, I've never been through an exam, but my husband just recently had the prostate issue come up. The PSA is just bloodwork, so no problem there. GP sent DH to local urologist after psa level up, and this Dr. would not do exam--sent him back to major hospital where JPouch surgeon is. They did do a digital exam (with some discomfort). A biopsy is different with a jpouch, so when it comes to that the Urologist at MUSC will do it. Very conservative approach to prostate cancer these days as reflected in the medical research literature and my husband's experience. The PSA is watched, wait & see--no rush to do biopsy or remove prostate.

Prostrate exams can be a chore. Because I have some scaring in that area, when the Dr. trys to do a digital exam its been hard to acually feel the prostrate. It was decided that I would need a Prostate biopsy due to elevated PSA. It's fairly simple and was done as out-patient. There is some pain. The surgeon must pearce the pouch wall and then take samples from the prostrate (24 samples) If the urologist has questions he should consult with your 'Pouch' Dr. I would start with a PSA test first. However the digital exam is no big deal if you don't have a lot of scar tissue in that area. Its just something 'men of a certine age go through.