Calcifications in the prostate

Calcifications in the prostate are dense formations in the ducts of the prostate gland and / or directly in its acini (small “bags” in which the prostatic secretion is produced). Calcifications are otherwise called stones, calculi, and their detection in the prostate – calculosis, prostatolithiasis. The sizes of stones vary from 3 mm to 25 mm, and sometimes more. Most often there are phosphate stones (hydroxyapatite), less often – oxalate, carbonate (calcite). Approximately 10% of young men under the age of 35 have such formations. Over the years, the prevalence of the condition increases, reaching 80% in men older than 80 years.

Stones are both single and multiple (in almost 70% of cases). The main problem with the presence of stones in the prostate gland is their common association with diseases such as chronic prostatitis, which in this case is sometimes called calculous prostatitis, and benign prostatic hyperplasia (adenoma).

Causes

Reliably, the mechanisms of formation of stones in the prostate have not been established. The main factor contributing to stone formation is the prolonged stagnation of the infected prostatic secretion during blockage of the glandular ducts.

There are three concepts of the origin of stones: • the theory of intraprostatic reflux (urine is thrown into the prostate during urination), which is confirmed by a crystallographic study of the composition of stones; • theory of secretory dysfunction; • immune theory. The deposition of components of inorganic nature (calcium carbonate and phosphate) is carried out on protein-polysaccharide complexes (the so-called amyloid bodies) formed due to congestion in the prostate secretion.

The presence of stones in the prostate disrupts the processes of movement of biological fluids in it, injures the surrounding tissues, and due to the presence of microbial agents in the formations themselves, it supports the process of chronic inflammation.

The formation of stones in the prostate gland is favored by: • a sedentary lifestyle; • lack of regular sexual life; • injury to the organs of the urogenital system; • inadequate treatment of infectious diseases; • wrong diet; • smoking, alcohol abuse, etc.

Symptoms and manifestations of calcifications

In the absence of infection, stones in the prostate may not appear in any way. With a combination of prostatolithiasis and prostatitis, as a rule, the infection is also in the formations themselves, contributing to the chronic course and recurrence of the disease. In such situations, patients present complaints typical of prostatitis: • pelvic pain; • disorders of urination; • presence in urine, semen of blood; • violation of sexual function, etc.

With calculous prostatitis, pain intensifies after: • physical activity; • prolonged sitting on a hard surface; • sexual intercourse; • prostate massage, etc.

The long-term nature of the process, chronic inflammation can cause a number of complications: • prostate abscess; • bilateral vesiculitis; • atrophy or sclerosis of the prostate, etc.

Diagnosis and detection

The presence of calcifications in the prostate is confirmed by the following methods: • digital rectal examination, when formations can be determined as compacted areas, sometimes with a characteristic sound when probed (this method does not always detect calculi, it does not allow to differentiate the disease from cancer, tuberculous formations); • Ultrasound with dopplerometry, most effectively transrectal, when clearly defined areas of tissue are detected; • x-ray examination, which allows to reveal only about 30% of the stones, since the latter are mostly X-ray negative; • computer and magnetic resonance imaging.

In the presence of appropriate symptoms, it is also necessary to conduct an examination for prostatitis, including: • general urine and blood tests; • analysis of prostate secretion for the presence of markers of inflammation; • test Meares and Stamey (presence of leukocytes in the 3rd portion of urine); • detection of a bacterial agent by PCR, bacteriological culture; • detection of indirect signs of inflammation on ultrasound; • assessment of prostate function (using spermogram). The determination of PSA (prostate specific agent) in the blood serum makes sense only as part of a comprehensive examination for differentiation from prostate cancer, adenoma.

Treatment of calcifications

In the absence of symptoms, treatment of prostate stones is not required. The presence of manifestations, an inflammatory process (including laboratory signs) suggests the same therapy as with prostatitis.

Conservative methods include taking long-term antibiotics (about 4 weeks) and alpha-blockers – drugs to relax the smooth muscles of the prostate and bladder neck. Additionally, anti-inflammatory and vitamin preparations, physiotherapy (laser and magnetotherapy, phonophoresis, shock wave therapy, etc.) can be prescribed. Important conditions for recovery are the cessation of alcohol and smoking, the normalization of the regime of work and rest. Massage of the prostate in the presence of stones in it can lead to tissue trauma and is not used.

If conservative treatment is ineffective, the doctor may recommend TUR (transurethral resection) or partial / complete removal (prostatectomy) of the prostate. With a mobile small stone, it is possible to remove it into the bladder with subsequent destruction. The volume of intervention is determined by the age of the patient, the presence of concomitant pathological processes (adenomatous changes).

Prevention

The main measures to prevent the formation of calcifications in the prostate are: • timely and adequate treatment of infectious and inflammatory diseases of the genitourinary system; • prevention of congestive changes in the pelvic region; • correction of metabolic disorders; • detection and correction of urinary outflow disorders.