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 from lime salts, phosphates and secretions of the prostate. The problem occurs in patients of different age categories: 30-40 years (due to chronic prostatitis), 40-60 years (due to prostate adenoma), after 60 years (due to a decrease in 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 prostatic 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, since they do not cause discomfort, much less pain. Their cause is congestive prostatitis. Symptoms and treatment of calculous prostatitis require professional attention.
Causes of calculous prostatitis
Chronic calculous prostatitis provokes inflammation and congestion in the prostate gland. Benign prostatic hyperplasia, abstinence from intimate contacts or their irregularity, as well as insufficient physical activity cause improper emptying of the prostate glands. If, in combination with these factors, an infection of the genitourinary system is observed, the character of the prostate secretion gradually undergoes changes.
The disease can also be caused by urethro-prostatic reflux, in which, when urinating from the urethra, a small amount of urine enters the ducts of the prostate. The salts present in the urine gradually turn into stones. Urethro-prostatic reflux occurs as a result of trauma to the urethra, as a result of transurethral resection of the prostate gland, stricture of the urethra. Urine can enter the prostate after changes that occur during genital surgery, use of catheters, or the presence of kidney or bladder stones. Stones are mainly urate, oxalate and phosphate.
Chronic calculous prostatitis can impair 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 pain.
Often the pain becomes stronger during and after intercourse, after sitting on something hard, when walking or vibration. The pain may spread to the penis and scrotum.
Signals of calculous prostatitis can be the following phenomena:
- frequent urination;
- urinary incontinence;
- the appearance of a small amount of blood in the semen;
- anaphrodisia;
- erectile dysfunction.
One month after the appearance of the first symptoms, the patient may experience a disturbance in the general condition: malaise, reduced work capacity, depression, irritability and a slight increase in temperature.
Diagnosis of calculous prostatitis
When examining a patient, a specialist can only assume that the patient has a disease. Ultrasound of the prostate, nuclear magnetic resonance 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 often required:
- general urine test (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, the motility and number of spermatozoa decrease);
- determination of the level of prostate specific antigen in order to detect oncological tumors;
- examination of prostate secretion (amyloid bodies, more leukocytes and epithelium are noted).
Later, during an instrumental examination, some signs allow to confirm the diagnosis:
- You can find out if there are stones directly in the prostate by doing an ultrasound;
- CT of the prostate gland will help to establish the location and determine the size;
- With nuclear magnetic resonance of the prostate gland, it is also possible to obtain information about the way stones are formed.
Treatment of calculous prostatitis
The treatment of calculous prostatitis is prescribed and carried out by a specialist, he uses surgical intervention or medication.
Usually, the doctor chooses a medicinal method for the treatment of calculous prostatitis, provided that the size of the stone does not exceed 4 mm. The patient takes oral and injectable anti-inflammatory drugs, antibiotics and drugs that normalize blood circulation. Herbal medicine is also used. During drug treatment, constant monitoring by the attending physician is important.
Physiotherapy is effective, and in many cases facilitates the process of passing the stones. For example, magnetic therapy is successfully applied, 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.
Electrophoresis with drugs, in which the drug is applied through the surface of the skin or mucous membrane with the help of an electric current, has shown good results. In this case, you should abandon the prostate massage procedure, unlike the treatment of chronic prostatitis, in which it is used effectively.
Relatively recently, in combination with medication, the use of low-frequency laser treatment of the prostate began. During such therapy, the stones are gradually broken up and excreted in the urine.
In the case of large stones, drug treatment does not lead to results, for the treatment of calculous prostatitis, surgical intervention is resorted to. The surgeon removes the stones through an incision in the perineum or suprapubic area.
Calculous prostatitis is often accompanied by DPH. In this option, prostatectomy, adenomectomy or TUR of the prostate is 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, dissection of the perineum or anterior abdominal wall is performed. Sutures are applied after removal.
It is also possible to operate with the help of an endoscope, 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 a number of complications: bladder fistulas, infection of the genitourinary organs, urinary incontinence, etc.
Transurethral resection of the prostate involves cutting out a hyperplastic area of the prostate through the urethra using a resectocystoscope. This surgery is less likely to cause side effects and the recovery period is shorter.
The correct diet is important not only for the purposes of prevention, but also in the treatment of chronic calculous prostatitis. The diet is prescribed by the attending physician, based on various criteria and factors. In general, 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 promote gas formation. 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, sclerosis or abscess of the prostate gland and damage to tissues located near the stone are possible.
Prevention of calculous prostatitis
Prevention of this disease is important for men of any age and includes:
- preventive examinations, lack of self-medication;
- elimination of nicotine from life and reasonable consumption of alcohol;
- maintaining an age-appropriate sex life;
- prevention of genital infections;
- physical activity;
- treatment of infectious diseases.