How do you tell if someone has good anal tone?

[Benzo4every1]

Thus far, I've only been asked to do two. I mean, how do you tell? Im embarrassed to ask my resident Thanks

---

Members don't see this ad.

 

[8744]

Oh, you'll know. If you can get a couple of fingers in and "waggle" 'em around then I'd call that poor tone. On the other hand, if the patient does not want to be violated and clenches hard enough so his sphincter can be used to straighten nails I'd just write "Normal Sphincter Tone" on the chart.

I would never advocate that you check your own tone. That would be a hard one to explain if the roommate walked in. However, on your surgery rotation you will Guiac almost every patient including those who you absolutely know have normal tone. (Ambulatory, no bowel or bladder incontinence, no neurological deficits, going in for elective surgery etc.)

The first couple dozen DREs you do and all you'll be able to tell is that its warmer in there than outside. But one day you will feel your first prostate nodule and you will find a new and exciting hobby.

("Guiac" is the check for stool occult blood, although I don't know why it is called "Guiac." You basically retrieve some stool and smear it on a card, then put a developer on the smear which reacts with blood. In the MICU were I am working this month we do Guiac with stool retrieved from the bed pad and do not have to go prospecting.)

 

[Man In The Box]

If you have to work it for more than 45min they have a loose one.

 

[Rugger81]

If you have to work it for more than 45min they have a loose one.

I'd say anything less than 2 hours is loose.

 

[ddmo]

Does it take 1 finger or 4?

 

[chameleonknight]

i always heard it's mostly taste oriented. huh.

 

[toofache32]

Remember to use lube or all your guiacs will come back positive. This...umm...guy I know...umm...did several before someone clued him in.

 

[Man In The Box]

[QUOTE=Rugger81]I'd say anything less than 2 hours is loose.[/QUOTE]

Two hours...I feel sorry for your lady

BTW, how do you blue box the quotes?

 

[8744]

As you may or may not know, if you do your rotations in a charity hospital you will probably treat a lot of prisoners from the local jails and prisons. When I did an Emergency Medicine rotation at Earl K. Long in Baton Rouge, for example, we treated patients from the notorious Angola Prison.

I was doing a Urology rotation at LSU Shreveport and was asked to "milk the prostate" of a six-foot, 250 pound prisoner complaining of dysuria and hesitency.

Had the tables been turned, this ferocious looking fellow would probably have made me his bitch. I said, "OK, Mr. Smith, I want you to bend over and milk your penis onto this slide while I stick a finger in your rectum and massage your prostate."

He said, "Say what!?"

I said, "I am going to stick a finger in your rectum and massage your prostate while you milk your penis onto this slide. Relax. We do this all the time."

So I was massaged his prostate and for lack of a better place, I put my other hand on his shoulder. The guy must have jumped ten feet.

I hated urology. I will never milk a prostate again. I suspect it is something they make medical students do for a joke.

 

[Benzo4every1]

As you may or may not know, if you do your rotations in a charity hospital you will probably treat a lot of prisoners from the local jails and prisons. When I did an Emergency Medicine rotation at Earl K. Long in Baton Rouge, for example, we treated patients from the notorious Angola Prison.

I was doing a Urology rotation at LSU Shreveport and was asked to "milk the prostate" of a six-foot, 250 pound prisoner complaining of dysuria and hesitency.

Had the tables been turned, this ferocious looking fellow would probably have made me his bitch. I said, "OK, Mr. Smith, I want you to bend over and milk your penis onto this slide while I stick a finger in your rectum and massage your prostate."

He said, "Say what!?"

I said, "I am going to stick a finger in your rectum and massage your prostate while you milk your penis onto this slide. Relax. We do this all the time."

So I was massaged his prostate and for lack of a better place, I put my other hand on his shoulder. The guy must have jumped ten feet.

I hated urology. I will never milk a prostate again. I suspect it is something they make medical students do for a joke.

I feel sorry for you. LMAO Thanks for all the advice

 

[kaos]

"OK, Mr. Smith, I want you to bend over and milk your penis onto this slide while I stick a finger in your rectum and massage your prostate."

You'd think there'd be a less suggestive way of stating that.

 

[8744]

You'd think there'd be a less suggestive way of stating that.

I was running different, more polite phrasings through my head but I couldn't think of anything less sinister than the truth.

I swear. I will never milk a prostate again. I don't care if it is indicated or if the patient is going to die. If a urologist asks me to do it I will admit the patient and have him do it.

By the way, I don't want to sound like a twelve-year-old or a homophobe but I cannot imagine why anybody would want to specialize in Urology. I can check for hernias and identify chancre sores with the best of 'em but a lifetime of slinging someone else's hash and cupping somebody else's fruit salad is not my idea of a fun time.

Maybe that's just me. Or, as my gay fellow medical student said during the rotation, "Man, I haven't held this many dicks since college."

 

[Discobolus]

From the title I thought this thread was going to be about uptight gunners, but instead I get stories of milking prostates!

 

[nabeya]

I had a doc do that to me once. Also the funny thing was he had both his hands on my shoulders. I didn't mind but then he kissed me afterwards

I was running different, more polite phrasings through my head but I couldn't think of anything less sinister than the truth.

I swear. I will never milk a prostate again. I don't care if it is indicated or if the patient is going to die. If a urologist asks me to do it I will admit the patient and have him do it.

By the way, I don't want to sound like a twelve-year-old or a homophobe but I cannot imagine why anybody would want to specialize in Urology. I can check for hernias and identify chancre sores with the best of 'em but a lifetime of slinging someone else's hash and cupping somebody else's fruit salad is not my idea of a fun time.

Maybe that's just me. Or, as my gay fellow medical student said during the rotation, "Man, I haven't held this many dicks since college."

 

[Dr. Donkey]

Can't you just leave the guy in the room with a porn mag, or are you looking for fluid not contaminated with full ejaculate (sorry to be graphic)?

I hated urology. I will never milk a prostate again. I suspect it is something they make medical students do for a joke.

 

[Dr Turninkoff]

I had a doc do that to me once. Also the funny thing was he had both his hands on my shoulders. I didn't mind but then he kissed me afterwards

hahaha

 

[Blake]

I had a doc do that to me once. Also the funny thing was he had both his hands on my shoulders. I didn't mind but then he kissed me afterwards

 

[alpinism]

Bumping for posterity

So this is what comes up when you search anal...I mean LSU...on SDN

 

[Jabbed]

Bumping for posterity

So this is what comes up when you search anal...I mean LSU...on SDN

Thank you for this.

 

[Mad Jack]

This is the only necrobump I'll ever allow without complaint. This and @Jalby

 

[pageantry]

Bumping for posterity

So this is what comes up when you search anal...I mean LSU...on SDN

This is a treasure.

 

[tiedyeddog]

As you may or may not know, if you do your rotations in a charity hospital you will probably treat a lot of prisoners from the local jails and prisons. When I did an Emergency Medicine rotation at Earl K. Long in Baton Rouge, for example, we treated patients from the notorious Angola Prison.

I was doing a Urology rotation at LSU Shreveport and was asked to "milk the prostate" of a six-foot, 250 pound prisoner complaining of dysuria and hesitency.

Had the tables been turned, this ferocious looking fellow would probably have made me his bitch. I said, "OK, Mr. Smith, I want you to bend over and milk your penis onto this slide while I stick a finger in your rectum and massage your prostate."

He said, "Say what!?"

I said, "I am going to stick a finger in your rectum and massage your prostate while you milk your penis onto this slide. Relax. We do this all the time."

So I was massaged his prostate and for lack of a better place, I put my other hand on his shoulder. The guy must have jumped ten feet.

I hated urology. I will never milk a prostate again. I suspect it is something they make medical students do for a joke.

What....

Wait.









What??






Srs






What

 

[TraumaLlamaMD]

Just stick yo finger in it.

 

[JimmyB123]

I've always heard rectal tone. Never anal tone....

 

[PL198]

What....

Wait.









What??






Srs






What

would be the worst thing ever

 

[cbrons]

Oh, you'll know. If you can get a couple of fingers in and "waggle" 'em around then I'd call that poor tone. On the other hand, if the patient does not want to be violated and clenches hard enough so his sphincter can be used to straighten nails I'd just write "Normal Sphincter Tone" on the chart.

I would never advocate that you check your own tone. That would be a hard one to explain if the roommate walked in. However, on your surgery rotation you will Guiac almost every patient including those who you absolutely know have normal tone. (Ambulatory, no bowel or bladder incontinence, no neurological deficits, going in for elective surgery etc.)

The first couple dozen DREs you do and all you'll be able to tell is that its warmer in there than outside. But one day you will feel your first prostate nodule and you will find a new and exciting hobby.

("Guiac" is the check for stool occult blood, although I don't know why it is called "Guiac." You basically retrieve some stool and smear it on a card, then put a developer on the smear which reacts with blood. In the MICU were I am working this month we do Guiac with stool retrieved from the bed pad and do not have to go prospecting.)

haha

 

[Psai]

I've always heard rectal tone. Never anal tone....

You gotta know something's up when the anus won't stop winking at you

 

[slopes23]

I always thought you got out a tuning fork and checked the pitch of the Anus. If it falls within normal range then they have good tone, if not then they have poor tone.

 

[Dajaleymon Kiwi]

This is the first time I ever took a trip over to the med threads. I think imma like this place...

 

[evilbooyaa]

What??



What

In the butt.

 

[TheShaker]

Ok, I'm not ashamed. What's the "milk" that comes out?

 

[swindoll]

So glad I'm a pre-dent

 

[VisionaryTics]

So glad I'm a pre-dent

Tomorrow is my last day of general surg. No more butts....forever!

 

[KinasePro]

I always thought you got out a tuning fork and checked the pitch of the Anus. If it falls within normal range then they have good tone, if not then they have poor tone.

Funny, I always thought this exam was done with an otoscope. Why else would the disposable tips be shaped like that?

 

[awared2]

The best part is that these guys are attendings now. Hopefully they have stayed the same

 

[Mad Jack]

Ok, I'm not ashamed. What's the "milk" that comes out?

Prostatic fluid.

 

[slopes23]

I always thought you got out a tuning fork and checked the pitch of the Anus. If it falls within normal range then they have good tone, if not then they have poor tone.

I received a pm asking me how you check the pitch of the anus. Well from what I understand you insert the finger half way to your knuckle. From there, arch your finger ever so slightly like a much more erect Captain Hook finger, and pull out so that you proceed to "finger pop" the patients a**hole. With the tuning fork in the other hand, proceed to check the pitch and continue as mentioned in the quoted post above.

 

[slopes23]

Funny, I always thought this exam was done with an otoscope. Why else would the disposable tips be shaped like that?

View attachment 191693

Don't be silly. That's for your ears bro. Although I do hear it has a dual use. There is talk from the nurses that many parents request to "channel the force" in their new borns and so those caps are used actually as a Darth Vader helmet on the new born's penis.

Appears to be some really interesting research being conducted now looking at some of the health benefits of this rare and yet seemingly common practice.

 

[notbobtrustme]

i had to milk a prostate, it's every bit as awkward as stated above.

 

[WaterPog]

I received a pm asking me how you check the pitch of the anus. Well from what I understand you insert the finger half way to your knuckle. From there, arch your finger ever so slightly like a much more erect Captain Hook finger, and pull out so that you proceed to "finger pop" the patients a**hole. With the tuning fork in the other hand, proceed to check the pitch and continue as mentioned in the quoted post above.

I was told to blow across the opening "like a coke bottle" and compare to a pitch pipe. Luckily the guitar tuning app on my iPhone worked very well as I had forgotten my pitch pipe.

 

[slopes23]

I was told to blow across the opening "like a coke bottle" and compare to a pitch pipe. Luckily the guitar tuning app on my iPhone worked very well as I had forgotten my pitch pipe.

Ahh, your attending must have been a DO. Sounds much more of an osteopathic method.

 

[WaterPog]

....treat the hole patient....

 

[NontradCA]

i had to milk a prostate, it's every bit as awkward as stated above.

In your free time?

 

[acceptmeplease]

I always thought you got out a tuning fork and checked the pitch of the Anus. If it falls within normal range then they have good tone, if not then they have poor tone.

Guaranteed to get honors if you can sing harmony with it.

 

[Mad Jack]

I was told to blow across the opening "like a coke bottle" and compare to a pitch pipe. Luckily the guitar tuning app on my iPhone worked very well as I had forgotten my pitch pipe.

Ahh, your attending must have been a DO. Sounds much more of an osteopathic method.

....treat the hole patient....

This exchange is solid gold.

 

[MetalloBetalactamase]

When you think of a witty reply, a week too late....

 

[asdf123g]

^

 

[The Knife & Gun Club]

Personally I have always wondered where they get standardized patients for prostate exams. Like how must that conversation have gone...

 

[LostinLift]

Personally I have always wondered where they get standardized patients for prostate exams. Like how must that conversation have gone...

Something like this:

"You want me to do what?"

"For $300/hour."

"Oh, ok sure."

 

[Terry Toma]

As you may or may not know, if you do your rotations in a charity hospital you will probably treat a lot of prisoners from the local jails and prisons. When I did an Emergency Medicine rotation at Earl K. Long in Baton Rouge, for example, we treated patients from the notorious Angola Prison.

I was doing a Urology rotation at LSU Shreveport and was asked to "milk the prostate" of a six-foot, 250 pound prisoner complaining of dysuria and hesitency.

Had the tables been turned, this ferocious looking fellow would probably have made me his bitch. I said, "OK, Mr. Smith, I want you to bend over and milk your penis onto this slide while I stick a finger in your rectum and massage your prostate."

He said, "Say what!?"

I said, "I am going to stick a finger in your rectum and massage your prostate while you milk your penis onto this slide. Relax. We do this all the time."

So I was massaged his prostate and for lack of a better place, I put my other hand on his shoulder. The guy must have jumped ten feet.

I hated urology. I will never milk a prostate again. I suspect it is something they make medical students do for a joke.

"Hey mom and dad, y'know how I was planning on going to med school and all? Well, law school is starting to look a lot better now, actually. Why? No reason, really. Well, actually I'm scared that if I don't makes some life changes, I'll end up with my fingers inside of a prisoner's rectum while he milks his penis."