Calcareous prostatitis

Calcareous prostatitis is accompanied by increased urination, dull pain in the lower abdomen and perineum, erectile dysfunction, blood in the semen, and prostatorrhea. Calcific prostatitis can be diagnosed using digital examination of the prostate, ultrasound of the prostate, survey urography and laboratory examination. Conservative therapy for calcareous prostatitis is carried out with the help of medications, herbal medicine and physiotherapy; If these measures are ineffective, stone destruction with a low-intensity laser or surgical removal is indicated.

General information

Calcific prostatitis is a form of chronic prostatitis that is associated with the formation of stones (prostatoliths). Calcific prostatitis is the most common complication of a long-term inflammatory process in the prostate, which specialists in the field of urology and andrology have to deal with. During preventive ultrasound examination, prostate stones are detected in 8. 4% of men of different ages. The first age peak of the incidence of calcareous prostatitis occurs at the age of 30-39 years and is due to an increase in cases of chronic prostatitis caused by sexually transmitted diseases (chlamydia, trichomoniasis, gonorrhea, ureaplasmosis, mycoplasmosis, etc. ). In men aged 40 to 59 years, calcareous prostatitis usually develops against the background of prostate adenoma and is associated with deterioration in sexual function in patients over 60 years old.

Causes of calcific prostatitis

Depending on the cause, prostate stones can be real (primary) or fake (secondary). Primary stones initially form directly in the acini and ducts of the gland, secondary stones migrate from the upper urinary tract (kidneys, bladder or urethra) into the prostate if the patient suffers from urolithiasis.

The development of calcific prostatitis is caused by congestion and inflammatory changes in the prostate. Impaired emptying of the prostate glands is caused by BPH, irregularities or lack of sexual activity and a sedentary lifestyle. Against this background, the addition of a sluggish infection of the genitourinary tract leads to obstruction of the prostate ducts and a change in the nature of prostate secretion. Prostate stones, in turn, also promote a chronic inflammatory process and a build-up of secretions in the prostate.

In addition to stagnation and inflammatory phenomena, urethro-prostatic reflux plays an important role in the development of calcareous prostatitis - the pathological reflux of a small amount of urine from the urethra into the prostate ducts during urination. At the same time, the salts contained in urine crystallize, thicken and turn into stones over time. The causes of urethro-prostatic reflux can be urethral strictures, trauma to the urethra, atony of the prostate and seminiferous tuberosity, previous transurethral resection of the prostate, etc.

The morphological core of prostate stones consists of amyloid bodies and desquamated epithelium, which gradually "overgrow" with phosphate and lime salts. Prostate stones lie in cystically dilated acini (lobules) or in the excretory ducts. Prostatoliths have a yellowish color, a spherical shape and vary inin size (average 2. 5 to 4 mm); can be single or multiple. In terms of chemical composition, prostate stones are identical to bladder stones. In calcareous prostatitis, oxalate, phosphate and urate stones are most commonly formed.

Symptoms of calcareous prostatitis

The clinical manifestations of calcific prostatitis are generally similar to the course of chronic inflammation of the prostate. The main symptom in the clinic of calcareous prostatitis is pain. The pain is dull and aching; localized in the perineum, scrotum, over the pubic bone, sacrum or coccyx. Worsening of painful attacks may occur with bowel movements, sexual intercourse, physical activity, prolonged sitting on a hard surface, prolonged walking, or bumpy driving. Calcareous prostatitis is accompanied by frequent urination, sometimes with complete urinary retention; Hematuria, prostatorrhea (leakage of prostate secretion), hematospermia. Characterized by decreased libido, weak erection, impaired ejaculation and painful ejaculation.

Endogenous prostate stones can remain in the prostate for a long time without symptoms. However, a prolonged course of chronic inflammation and associated calcareous prostatitis can lead to the formation of a prostate abscess, the development of vesiculitis, atrophy and sclerosis of the glandular tissue.

Diagnosis of calcific prostatitis

To make the diagnosis of calcareous prostatitis, a conversation with a urologist (andrologist), an assessment of existing complaints, and a physical and instrumental examination of the patient are required. During the rectal digital examination of the prostate, palpation reveals the lumpy surface of the stones and a type of crepitus. Using transrectal ultrasound of the prostate, stones are detected in the form of hyperechoic formations with a clear acoustic trace; their location, quantity, size and structure are clarified. Sometimes to detect prostatoliths, investigative urography, CT and MRI of the prostate are used. Exogenous stones are diagnosed by pyelography, cystography and urethrography.

The instrumental examination of a patient with calcareous prostatitis is supplemented by laboratory diagnostics: examination of prostatic secretion, bacteriological culture of urethral discharge and urine, PCR examination of smears for sexually transmitted infections, biochemical analysis of blood and urine, determination of the level of prostate-specific antigen, biochemistry of theSperm, ejaculate culture, etc.

During the examination, a distinction is made between prostate adenoma, tuberculosis and prostate cancer as well as chronic bacterial and abacterial prostatitis. In calcific prostatitis not associated with prostate adenoma, the volume of the prostate and the PSA level remain normal.

Treatment of calcific prostatitis

Uncomplicated stones in combination with chronic inflammation of the prostate require conservative anti-inflammatory therapy. Treatment of calcareous prostatitis includes antibiotic therapy, non-steroidal anti-inflammatory drugs, herbal medicine and physiotherapeutic procedures (magnetotherapy, ultrasound therapy, electrophoresis). In recent years, low-intensity lasers have been used successfully to destroy prostate stones non-invasively. Prostate massage is strictly contraindicated in patients with calcareous prostatitis.

With a complicated course of the disease, which is combined with prostate adenoma, surgical treatment of calcareous prostatitis is usually required. When a prostate abscess forms, the abscess is opened and, in addition to the discharge of pus, the discharge of stones is also noted. Sometimes mobile exogenous stones can be pressed instrumentally into the bladder and subjected to lithotripsy. Large, stuck stones are removed using the perineal or suprapubic incision. If calculous prostatitis is combined with BPH, the optimal method of surgical treatment is adenomectomy, TUR of the prostate, prostatectomy.

Treatment of calcific prostatitis

Calcific prostatitis is an inflammation of the prostate complicated by the formation of stones. This type of prostatitis is a result of long-term chronic inflammation of the prostate. The disease is accompanied by frequent urination, excruciating pain in the lower abdomen and perineum, erectile dysfunction and the presence of blood inclusions in the ejaculate.

Causes of this disease

Calculous is a form of chronic prostatitis characterized by the formation of stones. The disease is often a complication of a long-term inflammatory process in the prostate. Against the background of chronic inflammation under the influence of negative internal and external factors, secretion stagnates, which over time crystallizes and turns into stones.

In addition to congestion and inflammatory phenomena, urethro-prostatic reflux, which is characterized by the pathological backflow of a small amount of urine from the urethra into the ducts of the prostate during urination, plays an important role in the development of calcareous prostatitis. The salts contained in urine gradually crystallize and over time turn into dense stones. Common Causes of Uteroprostatic Reflux:

• urethral injuries;
• Atony of the prostate and seminiferous tubercle;
• previous surgical procedures and invasive procedures.

Other pathologies that increase the risk of stone formation in the prostate:

• varicose veins of the pelvis;
• metabolic disorders due to systemic pathologies;

Factors contributing to the development of calcareous prostatitis:

• an inactive lifestyle, which contributes to the development of stagnant processes in the pelvic organs;
• irregular sex life;
• alcohol abuse, smoking;
• uncontrolled intake of certain groups of medications;
• Damage to the prostate during surgical interventions, long-term catheterization.

Types of stones in calcareous prostatitis

Depending on the number of stones, there are single and multiple stones. Depending on the underlying causes, prostate stones include:

• TRUE. They are formed directly in the acini and ducts of the gland.
• INCORRECT. They migrate from the upper urinary tract into the prostate: kidneys, bladder, urethra.

The formation of stones in the prostate gland is identical in composition to bladder stones. The following types of stones most often form in calcareous prostatitis:

Symptoms of the disease

The symptoms of calcareous prostatitis are similar to the course of a chronic inflammatory process. The key symptom in the clinical picture of the disease is pain, which can be aching and dull. Location of pain: sacrum or coccyx.

A painful attack worsens with bowel movements, sexual intercourse, physical activity, prolonged sitting on a hard surface, and prolonged walking.

Other symptoms of pathology:

• frequent urination or complete urinary retention;
• Hematuria and the presence of blood inclusions in the ejaculate;
• Prostatorrhea – leakage of prostate secretion;
• decreased libido, erectile dysfunction, painful ejaculation;
• neurological disorders: irritability, increased fatigue, insomnia.

If you have any of the above symptoms, you should make an appointment with a urologist as soon as possible. The lack of adequate treatment and the long course of chronic calcareous prostatitis are fraught with serious, sometimes life-threatening consequences:

• atrophy and sclerosis of glandular tissue;
• Prostate abscess.

diagnosis

To make an accurate diagnosis, a consultation with a urologist-andrologist is necessary. During the initial examination, the specialist listens carefully to the patient's complaints, takes an anamnesis and asks additional questions that help determine the causes of prostatitis and risk factors.

The doctor then performs a rectal examination of the prostate, feeling the gland through the rectum. This technique allows you to assess the size, shape and structure of the gland, detect stones and determine the inflammatory process by increasing its size and pain when pressed. To confirm the diagnosis, additional laboratory and instrumental methods are prescribed.

Laboratory diagnostics

A series of additional laboratory tests to diagnose calcareous prostatitis:

• Culture of prostate secretions. An important informative method for identifying pathogenic microorganisms and diagnosing the inflammatory process in the prostate.
• Urine culture. Allows you to detect a pathogenic infection in urine, as well as determine its type and concentration. If inflammation of the prostate is suspected, a culture is carried out to clarify the diagnosis.
• PCR examination of scrapings. Allows detection of sexually transmitted infections and identification of the pathogen.
• PSA analysis. Allows you to exclude prostate cancer, which often occurs against the background of prostatitis.
• General clinical analysis of blood and urine. It is prescribed to detect hidden inflammatory processes in the urinary tract and kidney diseases.
• Spermogram. Analysis of ejaculate to rule out or confirm infertility.

Instrumental diagnostics

Instrumental methods for diagnosing pathology:

Ultrasound of the prostate. Allows you to recognize stones and clarify their position, quantity, size and structure. Ultrasound also helps distinguish prostate inflammation from other diseases with similar symptoms.

Survey urography. An X-ray procedure with contrast enhancement that makes it possible to detect prostate stones, their size and location.

CT or MRI of the prostate. Allows layer-by-layer scanning of the prostate and surrounding tissue. Using CT or MRI images, the doctor can examine the structure of the prostate in detail, identify pathological foci and assess their location, size and relationship to the surrounding tissue.

Treatment of calcific prostatitis

If the disease is uncomplicated and the patient's general condition is satisfactory, treatment of calcific prostatitis is carried out on an outpatient basis. If the disease is accompanied by complications associated with prostate adenoma, hospitalization of the patient is required.

Conservative treatment

The main goals of conservative therapy are the elimination of pathological symptoms. For this purpose, the patient is prescribed drug therapy, in which the following groups of drugs are used:

• Antibiotics. Destroy infections, stop inflammation. The type of drug, dosage and duration of treatment are determined individually for each patient.
• Non-steroidal anti-inflammatory drugs. They stop the inflammatory process and help eliminate pathological symptoms: pain, swelling.
• Antispasmodics. Relieves muscle spasms and relieves pain.
• Alpha-adrenergic blockers. Facilitate the process of urination.
• Vitamin-mineral complexes, immunomodulators. Strengthen the immune system and promote quick recovery.

As a complement to complex drug therapy, doctors often prescribe physiotherapeutic procedures that allow:

• eliminate stagnant processes;
• Activate tissue regeneration.
• The most effective methods of physiotherapy for calcareous prostatitis:
• Ultrasound therapy, shock wave therapy.

Effective treatment of calcareous prostatitis is ensured by lifestyle changes. To prevent relapses, it is recommended to include physical activity, especially if work forces you to lead a sedentary lifestyle. Moderate physical activity improves blood circulation in the pelvic organs, eliminates congestion and strengthens local immunity.

surgery

If the course of the disease is complicated and combined with prostatic hyperplasia, surgical treatment is carried out. If an abscess forms, the surgeon opens the abscess. In addition to the discharge of pus, the discharge of stones is also often observed. Large lodged stones are removed using a perineal or suprapubic incision. When calcific prostatitis is combined with benign prostatic hyperplasia, transurethral resection of the prostate is the optimal surgical treatment method.

Chronic calcific prostatitis

The term calcific prostatitis defines the pathology of the prostate in which stones form in its tubules. This disease is characterized by impaired erection of the penis and pain in the groin area.

Causes and mechanism of development of calcareous prostatitis

A prolonged inflammatory process or blockage of the prostate tubules leads to the accumulation of secretions and mucus in them. Bacteria settle on these accumulations and calcium salts precipitate. The mucus becomes denser over time and turns into small sand-like stones. They stick together and form pebbles.

There are several predisposing factors for the development of calcareous prostatitis:

• Chronic sexually transmitted infections (STDs)
• prolonged course of the infectious process with inflammation of the ducts and tissues of the prostate;
• Constipation of the prostate gland, which is mainly associated with a man's irregular sexual life;
• Urethral-prostate reflux – pathological backflow of a small amount of urine into the prostate;
• genetic predisposition – presence of relatives with calcareous prostatitis.

For high-quality and adequate etiological therapy, knowledge of the causes of stone formation in the prostate is necessary to prevent the re-development of calcareous prostatitis.

Symptoms of calcareous prostatitis

Symptoms of calcareous prostatitis develop over a long period of time and a man may not pay attention to them. The clinical picture of the disease may include symptoms such as dull, aching pain in the lower abdomen and lower back, sacrum, perineum and pubic bone.

Pain may begin or increase after bowel movements, sexual intercourse, intense physical activity and other provoking factors. Dysuric disorders are noted - frequent urge to go to the toilet, painful or difficult urination, burning in the urethra and lower abdomen, and sometimes there is urinary retention due to blockages in the form of stones.

Patients suffer from prostatorrhea - an involuntary secretion of the prostate at rest or during physical exertion, straining during bowel movements or urination. There may be blood in the urine and semen.

Almost always, against the background of persistent inflammation with stone formation, sexual dysfunction occurs - weakened erection, premature ejaculation, reduced libido.

The main signs of calcareous prostatitis include:

• erectile dysfunction;
• pain in the groin area, which may be cramping and paroxysmal in nature;
• during ejaculation – indicates damage to the vessels of the prostatic tubules by the sharp edges of the stones;
• premature and painful ejaculation.

Such symptoms lead to a decrease in sexual desire.

Often men attribute this to the age factor and mistakenly believe that such sexual dysfunctions will not go away. Sometimes they start self-medicating with various erection-stimulating drugs (PDE-5 inhibitors).

This approach is very dangerous as it can aggravate the course of the pathological process and lead to the development of complications.

Prostatitis is an inflammatory pathological process in a man's prostate. In most cases, it is caused by an infection that gradually leads to a chronic, long-term course of the disease and the development of complications.

Treatment of calcific prostatitis is complex

• antibiotics,
• anti-inflammatory drugs,
• Enzymes
• Immune drugs
• phytotherapy,
• physiotherapeutic procedures.

Antibacterial agentsprescribed as part of etiotropic treatment. Their intake is necessary to suppress the activity of the causative agent of the infectious-inflammatory process. These can be both non-specific microbial flora (streptococci, staphylococci, enterococci, Escherichia coli, Proteus) and specific pathogens of urogenital infections - gonococci, chlamydia, ureaplasma, trichomonas, etc.

The choice of antibiotics can be based on the results of a culture study of prostate secretions and determination of the sensitivity of the microbial pathogen to drugs. Sometimes antibiotics are prescribed empirically based on the drugs' scientifically proven antimicrobial effectiveness. The selection of antibiotics and the determination of the dose and duration of their use can only be made by the attending physician, as their uncontrolled use can lead to serious complications and worsen the course of the underlying disease.

If the tissue of the prostate is parasitized by a polyassociated microbial flora (bacterial, viral microorganisms, protozoa), the etiotropic therapy regimen consists of a complex of various drugs that act in a certain antimicrobial spectrum.

To stimulate the body's own immune defensesand its resistance to infection, immunomodulatory drugs are prescribed - Immunomax, Panavir, Interferon and its derivatives. To improve the antimicrobial effect of etiotropic drugs, enzymatic agents are prescribed along with them - longidase, chemotrypsin. They facilitate the delivery of antibiotic active ingredients to affected tissues, have an indirect analgesic effect and have an anti-inflammatory and regenerating effect.

The pain syndrome is relievedUse of non-steroidal anti-inflammatory drugs. Along with antibiotic therapy, probiotics are prescribed to prevent the development of intestinal dysbiosis. To protect the liver parenchyma from the toxic effects of antibacterial drugs and improve its functional state, hepaprotectors are prescribed. After the acute inflammatory phenomena subside, physiotherapeutic procedures are prescribed - laser treatment, magnetic therapy, mud therapy, galvanization, medical electrophoresis, reflexology therapy, hardware treatment, etc.

This improves metabolic processes, microcirculation, lymphatic drainage and trophism of prostate tissue, stimulates the restoration of its functional state and helps resolve inflammatory processes. A low-frequency laser is used to destroy the stones. It crushes the stones and allows small stones to come out of the tubes. If complications arise in the form of an adenoma or a prostate abscess (a limited cavity filled with pus), surgical intervention is performed.

Part of the prostate is removed (resection). To avoid this, you need to consult a doctor at the first signs of pathology, manifested by erectile dysfunction. Self-medication or ignoring the problem always leads to the subsequent development of complications.