Yes, you should do prostate exams. Like anything else, you get accustomed to feeling what is normal and what is not. I do several a day as a urology NP. The PSA, and exam should go hand in hand. How often these are done depends on the patient's situation. A normal exam, combined with a normal range PSA - usually equates to just annual monitoring. Suspicious exam, with a rising PSA, you will monitor more closely, could be as often as every 3 - 6 months. A urology NP organization is being developed. I will keep you posted as they are up and running. The goals will be education on subjects, such as those you are asking about now.