Calculous prostatitis is a disease in which stony inclusions (or stones) form in the ducts of the prostate gland. It occurs as a consequence of chronic prostatitis. Stones appear due to lime salts, phosphates and prostate secretions. The problem is faced by patients of different age categories: 30-40 years (due to chronic prostatitis), 40-60 years (due to prostate adenoma), after 60 years (due to decreased intimate function).
There are exogenous and endogenous types of stones. The composition of exogenous stones can be compared to those found in the urinary tract. They can arise from prostate adenoma and chronic inflammation and are most commonly found in the distal parts of the prostate. The patient can live with endogenous stones for many years, since they do not cause discomfort, much less pain. Its cause is congestive prostatitis. The symptoms and treatment of calculous prostatitis require the attention of professionals.
Causes of calculous prostatitis.
Chronic calculous prostatitis causes inflammation and congestion in the prostate gland. Benign prostatic hyperplasia, abstinence from intimate contacts or their irregularity, as well as insufficient physical activity cause inadequate emptying of the prostate. If, in combination with these factors, an infection of the genitourinary tract is observed, the nature of the secretion of the prostate gradually undergoes changes.
The disease can also be caused by urethroprostatic reflux, in which, when urinating through the urethra, a small amount of urine enters the prostate ducts. The salts present in the urine are gradually transformed into stones. Urethroprostatic reflux occurs as a consequence of trauma to the urethra, as a result of transurethral resection of the prostate, urethral stricture. Urine can enter the prostate after changes that occur during surgery on the genitals, the use of catheters, or the presence of stones in the kidneys or bladder. The stones are mainly urate, oxalate and phosphate.
Chronic calculous prostatitis can affect reproductive function.
Symptoms of calculous prostatitis.
A 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 the pain.
The pain often becomes more intense during and after sexual intercourse, after sitting on something hard, when walking, or from vibrations. The pain may radiate to the penis and scrotum.
Signs of calculous prostatitis may be the following phenomena:
- 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 patient may experience an alteration in his general condition: general malaise, decreased performance, depression, irritability and a slight increase in temperature may be observed.
Diagnosis of calculous prostatitis.
When examining a patient, a specialist can only assume that the patient has a disease. Prostate ultrasound, MRI, and CT scan help 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, as well as the presence and degree of the inflammatory process. The following tests are most often needed:
- general urine analysis (confirmation is the presence of blood, a large number of leukocytes, proteins, 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 in order to detect oncological tumors;
- examination of prostate secretions (amyloid bodies, more leukocytes and epithelium are noted).
Subsequently, during the instrumental examination, certain signs allow us to confirm the diagnosis:
- You can tell if there are stones directly in the prostate by doing an ultrasound;
- A CT scan of the prostate will help discover the location and determine the size;
- With MRI of the prostate it is also possible to obtain information about the method of stone formation.
Treatment of calculous prostatitis.
Treatment of calculous prostatitis is prescribed and performed by a specialist, who uses surgery or medications.
The doctor usually chooses a medicinal method in the treatment of calculous prostatitis, as long as the size of the stone does not exceed 4 mm. The patient takes anti-inflammatory drugs, antibiotics and drugs that normalize blood circulation orally and by injection. Medicinal herbs are also used. During drug treatment, constant monitoring by the treating physician is important.
Physiotherapy is effective, facilitating the stone removal process in many cases. For example, magnetic therapy is successfully used, which significantly improves blood microcirculation and 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.
Good results are obtained by drug electrophoresis, in which the drug is administered through the surface of the skin or mucous membranes using an electrical current. In this case, it is necessary to abandon the prostate massage procedure, unlike the treatment of chronic prostatitis, in which it is effectively used.
Relatively recently, in combination with medications, low-frequency laser treatment of the prostate has begun to be used. When carrying out such therapy, the stones are gradually crushed and excreted with urine.
For large stones, drug treatment does not work; 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 usually accompanied by BPH. With this option, prostatectomy, adenomectomy or TUR of the prostate are chosen.
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 can be abdominal. In this case, the perineum or the anterior abdominal wall is dissected. After removal, sutures are applied.
It is also possible to operate with 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 can have various complications: bladder fistulas, infection of the genitourinary organs, urinary incontinence, etc.
Transurethral resection of the prostate involves excision of a hyperplastic area of the prostate through the urethra using a resectocystoscope. This operation is less likely to cause side effects and the recovery period is shorter.
An adequate diet is important not only for preventive purposes, but also in the treatment of chronic stone prostatitis. The diet is prescribed by the treating doctor, based on various criteria and factors. Basically, meat, fish and mushroom broths are excluded from the daily diet, as well as sauces, spicy dishes, spices, garlic, onions and radishes. Limit the consumption of legumes, white cabbage, whole milk and other foods that promote flatulence. The doctor recommends drinking plenty of fluids.
The sooner the patient consults a specialist, the more favorable the prognosis will be for the treatment of this disease. If treatment for calculous prostatitis is not performed, loss of reproductive function, erectile dysfunction, urinary incontinence, sclerosis or abscess of the prostate gland, and injury to tissues located near the stone are possible.
Prevention of calculous prostatitis.
Prevention of this disease is relevant for men of any age and includes:
- preventive examinations, lack of self-medication;
- eliminate nicotine from life and reasonable alcohol consumption;
- maintain an age-appropriate sex life;
- prevention of genital infections;
- physical activity;
- Carrying out treatments for infectious diseases.