Calculous prostatitis is a disease in which stone inclusions (or stones) form in the ducts of the prostate. It occurs as a consequence of chronic prostatitis. Stones appear from lime salts, phosphates and prostatic 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 the decline of 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 due to 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, because they do not cause discomfort, much less pain. Their cause is congestive prostatitis. Symptoms and treatment of calculous prostatitis require expert attention.
Causes of calculous prostatitis
Chronic calculous prostatitis causes inflammation and congestion in the prostate. Benign prostate hyperplasia, abstinence from intimate contacts or their irregularity, as well as insufficient physical activity cause irregular discharge of the prostate. If, in combination with these factors, an infection of the genitourinary tract is observed, the nature of the prostate secretion gradually changes.
The disease can also be caused by urethro-prostatic reflux, whereby, when urinating from the urethra, a small amount of urine enters the prostate ducts. Salts present in urine gradually turn into stones. Urethro-prostatic 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 surgical interventions 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 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 sexual intercourse, after sitting on something hard, when walking or vibrations. Aching pain can spread to the penis and scrotum.
Signs 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.
A month after the appearance of the first symptoms, the patient may feel disturbances in his general condition: malaise, decrease in performance, 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, 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, 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, proteins, epithelial cells);
- general blood test (increased ESR, increased number of leukocytes);
- spermogram (blood is observed, the mobility and number of spermatozoa decrease);
- determining the level of prostate specific antigen for the purpose of detecting oncological tumors;
- examination of prostate secretions (amyloid bodies, more leukocytes and epithelium are observed).
Later, during the instrumental examination, certain signs make it possible to confirm the diagnosis:
- You can find out if there are stones directly in the prostate by ultrasound;
- A CT scan of the prostate will help reveal the location and determine the size;
- Magnetic resonance imaging of the prostate can also provide information on how stones are formed.
Treatment of calculous prostatitis
Treatment of calculous prostatitis is prescribed and carried out by a specialist, he uses surgery or drugs.
The doctor usually chooses a medical 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 and drugs that normalize blood circulation orally and by injection. Herbal medicine is also used. During drug treatment, constant monitoring by a doctor is important.
Physiotherapy is effective, in many cases it facilitates the process of stone passage. 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 shown by electrophoresis of drugs, in which the drug is applied through the surface of the skin or mucous membrane using an electric current. In this case, you have to 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 drugs, the application of low-frequency laser treatment of the prostate began. During the implementation of such therapy, the stones are gradually crushed and excreted in the urine.
In the case of large stones, drug treatment does not give results, surgical intervention is undertaken for the treatment of 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, prostatectomy, adenomectomy or TUR of the prostate are chosen.
Prostatectomy refers to the removal of the prostate, 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 anterior abdominal wall is dissected. After removal, sutures are placed.
Endoscope surgery is also possible 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 a number of complications: bladder fistulas, infection of the genitourinary organs, urinary incontinence, etc.
Transurethral resection of the prostate involves excision of the 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.
Proper nutrition is important not only for the purpose 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. Basically, meat, fish and mushrooms, 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 bloating. The doctor recommends that you drink plenty of fluids.
The sooner the patient consults with a specialist, the more favorable the prognosis for the treatment of this disease. If the treatment of calculous prostatitis is not carried out, loss of reproductive function, erectile dysfunction, urinary incontinence, sclerosis or abscess of the prostate, and tissue injury 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;
- 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.