Calculous prostatitis is a disease in which stone inclusions (or stones) form in the ducts of the prostate gland. It occurs as a result of chronic prostatitis. Stones appear from lime salts, phosphates and prostatic secretions. The problem is faced by patients of different ages: 30-40 years old (due to chronic prostatitis), 40-60 years old (due to prostate adenoma), after 60 years (due to a decrease in intimate functions).
There are exogenous and endogenous types of stones. The composition of exogenous stones is comparable to the composition of stones in the urinary tract. They can arise from prostate adenoma and chronic inflammation and are most often found in the distal parts of the prostate. The patient can live with endogenous stones for many years, as they do not cause discomfort, let alone pain. The cause is congestive prostatitis. The symptoms and treatment of calculous prostatitis require the attention of a specialist.
Causes of calculous prostatitis
Chronic calculous prostatitis causes inflammation and congestion in the prostate gland. Benign prostate enlargement, abstinence from intimate relationships or their irregularity, as well as insufficient physical activity cause inadequate prostate emptying. If a urinary tract infection is detected in combination with these factors, the nature of the prostate secretion will gradually change.
The disease can also be caused by urethro-prostatic reflux, when a small amount of urine enters the prostate ducts when urinating from the urethra. The salts present in the urine gradually turn into stones. Urethro-prostatic reflux occurs as a result of trauma to the urethra, transurethral resection of the prostate gland, and urethral stricture. Urine can enter the prostate after surgery on the genitals, the use of catheters, or changes in the kidneys or bladder caused by stones. Stones are mainly composed of urate, oxalate and phosphate.
Chronic calculous prostatitis can impair reproductive function.
Symptoms of calculous prostatitis
The sign of calculous prostatitis is pain in the lower abdomen, perineum, testicles, sacrum and scrotum. The diameter and number of stones directly affect the intensity of pain.
The pain often worsens during and after sexual intercourse, sitting hard, walking, or vibrating. The aching pain may radiate to the penis and scrotum.
Signs of calculous prostatitis can be the following phenomena:
- frequent urination;
- difficulty urinating;
- the appearance of a small amount of blood in the semen;
- anaphrodisiac;
- erectile dysfunction.
One month after the appearance of the first symptoms, the patient's general condition may be disturbed: malaise, decreased performance, depression, irritability, and a slight increase in temperature may be observed.
Diagnosis of calculous prostatitis
When examining the patient, the specialist can only assume that the patient has some kind of illness. Ultrasound examination of the prostate, magnetic resonance imaging and computed tomography help to detect and confirm the diagnosis of calculous prostatitis.
The next stage is a series of laboratory tests that determine the presence of stones in the prostate gland, as well as the presence and extent of the inflammatory process. The following tests are most often required:
- general urinalysis (confirmation is the presence of blood, a large number of leukocytes, protein, epithelial cells);
- general blood test (increased ESR, increased number of leukocytes);
- spermogram (blood is observed, motility and sperm counts decrease);
- determining the level of prostate specific antigen for the purpose of detecting oncological tumors;
- examination of prostate secretion (amyloid bodies, more leukocytes and epithelium can be observed).
Later, during the instrumental examination, certain signs make it possible to confirm the diagnosis:
- With ultrasound, you can find out if there are stones directly in the prostate;
- A CT scan of the prostate helps to determine the location and size;
- Magnetic resonance imaging of the prostate can also provide information on how stones are formed.
Treatment of calculous prostatitis
The treatment of calculous prostatitis is prescribed and carried out by a specialist, using surgery or medication.
The doctor usually chooses a medicinal method in the treatment of calculous prostatitis, provided that the size of the stone does not exceed 4 mm. The patient takes anti-inflammatory drugs, antibiotics, blood circulation normalizing drugs orally and by injection. Medicinal plants are also used. Continuous monitoring by the attending physician is important during drug treatment.
Physiotherapy is effective and in many cases facilitates the passage of stones. For example, magnetic therapy is successfully used, which significantly improves blood microcirculation, has an analgesic and calming effect. Ultrasound therapy is often prescribed, during the procedure the emitter comes into contact with the skin through a special gel.
Drug-electrophoresis, in which the drug is administered through the surface of the skin or mucous membrane with the help of an electric current, shows good results. In this case, you should abandon the procedure of prostate massage, in contrast to the treatment of chronic prostatitis, in which it is effectively used.
Relatively recently, in combination with drug treatment, low-frequency laser treatment of the prostate began to be used. During such therapy, the stones are gradually crushed and excreted in the urine.
In the case of large stones, medical treatment does not bring results, surgical intervention is performed to treat calculous prostatitis. The surgeon removes the stones through an incision in the perineum or suprapubic area.
Calculous prostatitis is often accompanied by BPH. With this option, removal of the prostate, adenomectomy or TUR of the prostate.
Prostatectomy refers to the removal of the prostate gland, which is performed under general anesthesia. During the operation, the seminal vesicles are also removed. Surgery can be abdominal. In this case, the perineum or anterior abdominal wall is dissected. After removal, sutures are applied.
It is also possible to operate with an endoscope with multiple punctures in the abdominal cavity. In this case, rehabilitation is faster.
Adenomectomy is used for large adenomas. Access is through the abdominal cavity. The surgery can have many complications: bladder fistulas, urinary tract infections, urinary incontinence, etc.
Transurethral resection of the prostate involves excision of the hyperplastic area of the prostate through the urethra using a resectocystoscope. This operation is less likely to cause side effects and has a shorter recovery period.
The right diet is important not only for the prevention, but also for the treatment of chronic calculous prostatitis. The diet is prescribed by the attending physician based on various criteria and factors. Basically, meat, fish and mushroom soups, as well as sauces, spicy dishes, spices, garlic, onions and radishes are excluded from the daily diet. Limit consumption of legumes, white cabbage, whole milk and other foods that promote bloating. The doctor recommends lots of fluids.
The sooner the patient consults a specialist, the better the prognosis for the treatment of the disease. If calculous prostatitis is not treated, loss of reproductive function, erectile dysfunction, urinary incontinence, sclerosis or abscess of the prostate gland, and tissue damage near the stone are possible.
Prevention of calculous prostatitis
Prevention of this disease is relevant for men of any age and includes:
- lack of preventive examinations and self-medication;
- removing nicotine from life and reasonable alcohol consumption;
- maintain a sex life appropriate for their age;
- prevention of genital infections;
- physical activity;
- treatment of infectious diseases.