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 are formed from lime salts, phosphates and prostate secretions. The problem is encountered by patients of different age categories: 30 - 40 years old (due to chronic prostatitis), 40 - 60 years old (due to prostate adenoma), after 60 years old (due to a decrease in intimate function).
There are exogenous and endogenous types of stones. The composition of exogenous stones can be compared with those in the urinary tract. They can arise from prostate adenoma and chronic inflammation and are most common in the distal parts of the prostate. The patient can live with endogenous stones for many years, because they do not cause discomfort and cause less pain. Their cause is congestive prostatitis. Symptoms and treatment of calculous prostatitis require the attention of specialists.
Causes of calculous prostatitis
Chronic calculous prostatitis causes inflammation and blockage in the prostate gland. Benign hyperplasia of the prostate gland, refusal of intimate intercourse or their irregularity, as well as insufficient physical activity lead to improper emptying of the prostate gland. If infection of the urinary tract is observed together with these factors, the nature of prostate secretion gradually changes.
The disease can also be caused by urethro-prostatic reflux, in which a small amount of urine enters the prostate ducts during urination from the urethra. Salts 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, narrowing of the urethra. Urine can enter the prostate after surgical interventions on the genitals, the use of catheters, changes in the kidneys or the presence of stones in the bladder. Stones are mainly urate, oxalate and phosphate.
Chronic stone prostatitis can impair reproductive function.
Symptoms of calculous prostatitis
A symptom 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.
Often the pain intensifies during and after sexual intercourse, after sitting on something hard, walking or shaking. Aching pain can spread to the penis and testicles.
Signals of calculous prostatitis can be the following events:
- frequent urination;
- urinary incontinence;
- the appearance of a small amount of blood in the semen;
- anaphrodisia;
- erectile dysfunction.
A month after the appearance of the first symptoms, the general condition of the patient may be disturbed: malaise, decreased performance, depression, irritability and a slight increase in temperature may be observed.
Diagnosis of calculous prostatitis
When examining a patient, the specialist can only assume that the patient is sick. Ultrasonography 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 degree of the inflammatory process. The following tests are most commonly required:
- general urine test (confirmation of blood, the presence of a large number of leukocytes, protein, epithelial cells);
- general blood test (increased ESR, increased number of leukocytes);
- spermogram (blood is observed, motility and sperm count decrease);
- determination of the level of prostate-specific antigen for the purpose of detecting oncological tumors;
- examination of prostate secretion (amyloid bodies, more leukocytes and epithelium are noted).
Later, during the instrumental examination, certain signs allow to confirm the diagnosis:
- You can directly find out if there are stones in the prostate gland by conducting an ultrasound examination;
- A CT scan of the prostate will help locate and determine its size;
- It is also possible to obtain information about the formation of stones with magnetic resonance imaging of the prostate gland.
Treatment of calculous prostatitis
Treatment of calculous prostatitis is prescribed and carried out by a specialist, using surgery or drugs.
The doctor usually chooses the drug method in the treatment of stone prostatitis, provided that the size of the stone does not exceed 4 mm. The patient receives anti-inflammatory drugs, antibiotics and drugs that normalize blood circulation orally and by injection. Herbal medicines are also used. During drug treatment, constant supervision of the attending physician is important.
Physiotherapy is effective, in many cases it facilitates the process of stone passage. For example, magnetic therapy, which significantly improves blood microcirculation and has an analgesic and calming effect, is successfully used. Ultrasound therapy is often prescribed, during the procedure the emitter comes into contact with the skin through a special gel.
Good results are shown by drug electrophoresis, when the drug is applied through the surface of the skin or mucous membrane using an electric current. In this case, unlike the treatment of chronic prostatitis, where it is effectively used, you should refuse the prostate massage procedure.
Relatively recently, the use of low-frequency laser treatment of the prostate along with drug treatment has been started. During such therapy, the stones are gradually crushed and thrown out with urine.
For large stones, drug treatment does not work, surgical intervention is used to treat stone 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, prostatectomy, adenomectomy or TUR of the prostate is selected.
Prostatectomy refers to the removal of the prostate gland, which is performed under general anesthesia. During the operation, the seminal vesicles are also removed. The operation may be in the abdominal cavity. In this case, the perineum or the front wall of the abdomen is torn. After removal, sutures are placed.
It is also possible to perform surgery using an endoscope by making several punctures in the abdominal cavity. In this case, rehabilitation is faster.
Adenomectomy is used for large adenomas. Access is through the abdominal cavity. The operation may have a number of complications: bladder fistulas, infection of the genitourinary organs, urinary incontinence, etc.
Transurethral resection of the prostate involves cutting the hyperplastic area of the prostate through the urethra using a resectocystoscope. This operation causes fewer side effects and the recovery time is shorter.
Proper nutrition is important not only for prevention, but also in 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 broths, as well as sauces, spicy dishes, spices, garlic, onions, radishes are excluded from the daily diet. Limit consumption of legumes, white cabbage, whole milk and other foods that cause flatulence. The doctor recommends drinking plenty of fluids.
The sooner the patient consults a specialist, the more favorable the prognosis for the treatment of this disease. If calculous prostatitis is not treated, loss of reproductive function, erectile dysfunction, urinary incontinence, prostate gland sclerosis or abscess, and tissue damage near the stone are possible.
Prevention of calculous prostatitis
Prevention of this disease is relevant for men of all ages and includes:
- preventive examinations, not self-medication;
- removal of nicotine from life and acceptable alcohol consumption;
- maintaining an age-appropriate sex life;
- prevention of genital infections;
- physical activity;
- treatment of infectious diseases.