calculus prostatitis

Calculous prostatitis is associated with increased urination, dull pain in the lower abdomen and perineum, erectile dysfunction, blood in semen, and prostate leakage. Calculous prostatitis can be diagnosed by digital prostate examination, prostate ultrasound, urography, and laboratory tests. Conservative treatment of calculus prostatitis is carried out with the help of drugs, herbs and physical therapy; if these measures are ineffective, low-intensity laser destruction of the stones or surgical removal is required.

General information

Calculous prostatitis is a form of chronic prostatitis associated with the formation of stones (prostatic stones). Calculous prostatitis is the most common complication of a long-term inflammatory process of the prostate, which must be managed by specialists in the fields of urology and andrology. Prostate stones were detected in 8. 4% of men of all ages during preventive ultrasound examinations. The first age peak of the incidence of calculus prostatitis occurs between the ages of 30 and 39. This is due to the increase in chronic prostatitis cases caused by sexually transmitted diseases (chlamydia, trichomonas, gonorrhea, ureaplasmosis, mycoplasmosis, etc. ). In men aged 40-59 years, calculus prostatitis usually occurs in the context of prostate adenomas, whereas in patients older than 60 years, calculus prostatitis is associated with decreased sexual function.

Causes of calculus prostatitis

Depending on the cause of formation, prostate stones can be true (primary) or pseudo (secondary). Primary stones initially form directly in the acini and ducts, and if the patient has urolithiasis, secondary stones may migrate from the upper urinary tract (kidney, bladder, or urethra) to the prostate.The occurrence of calculus prostatitis is caused by congestion and inflammatory changes in the prostate. Impaired prostate emptying is caused by benign prostatic hyperplasia, irregular or lack of sexual activity, and a sedentary lifestyle. In this context, slow infection of the genitourinary tract leads to obstruction of the prostatic ducts and changes in the secretory properties of the prostate. Prostate stones, in turn, support chronic inflammatory processes and stagnation of prostate secretions.In addition to stagnation and inflammatory phenomena, urethroprostatic reflux plays an important role in the development of calculus prostatitis - the pathological reflux of small amounts of urine from the urethra into the prostatic duct during urination. At the same time, the salt in the urine crystallizes, thickens, and over time, turns into stones. The causes of urethroprostatic reflux may be urethral stricture, urethral trauma, prostate and seminal tuberculosis, previous transurethral resection of the prostate, etc.The morphological core of prostate stones are amyloid bodies and exfoliated epithelium, which are gradually "overgrown" by phosphate and calcium salts. Prostatic stones are located in cystically dilated acini (lobules) or excretory ducts. Prostatic stones are light yellow, spherical, and vary in size (average 2. 5 to 4 mm); they can be single or multiple. Chemically, prostate stones are identical to bladder stones. Calculous prostatitis most commonly forms oxalate, phosphate, and urate stones.

Symptoms of calculus prostatitis

The clinical manifestations of calculus prostatitis often resemble the course of chronic inflammation of the prostate. The main clinical symptom of calculus prostatitis is pain. The pain is dull, aching in nature; located above the perineum, scrotum, pubic bone, sacrum, or coccyx. Increasing episodes of pain may be associated with bowel movements, sexual intercourse, physical activity, prolonged sitting on hard surfaces, prolonged walking, or bumpy driving. Calculous prostatitis is accompanied by frequent urination and sometimes complete urinary retention; hematuria, prostatic leakage (leakage of prostate secretions), and hematospermia. It is characterized by decreased libido, weak erections, ejaculation disorders, and painful ejaculation.Endogenous prostate stones can remain in the prostate for long periods of time without any symptoms. However, long-term chronic inflammation and associated calculus prostatitis can lead to the formation of prostatic abscesses, development of seminal vesiculitis, atrophy and sclerosis of glandular tissue.

Diagnosis of calculus prostatitis

To confirm the diagnosis of calculus prostatitis, a consultation with a urologist (andrologist) is required, the existing symptoms are evaluated, and the patient is examined physically and instrumentally. When performing a digital rectal examination of the prostate, identify bumps and crepitus on the surface of the stone by palpation. Using transrectal prostate ultrasonography, stones are detected as hyperechoic structures with clear acoustic traces; their location, number, size, and structure are clarified. Prostatic urography, CT, and MRI are sometimes used to detect prostate stones. Extrinsic stones are diagnosed by pyelography, cystography, and urethrography.Instrumental examination in patients with calculus prostatitis is supplemented by laboratory diagnosis: examination of prostate secretions, bacterial culture of urethral secretions and urine, PCR examination of sexually transmitted infection scrapings, biochemical analysis of blood and urine, determination of prostate levels - specificAntigens, sperm biochemistry, semen culture, etc.During examination, calculus prostatitis needs to be differentiated from prostate adenoma, tuberculous prostate cancer, chronic bacterial and non-bacterial prostatitis. In calculus prostatitis not associated with prostatic adenoma, prostate volume and PSA levels remain normal.

Treatment of calculus prostatitis

Simple stones combined with chronic inflammation of the prostate require conservative anti-inflammatory treatment. Treatment of calculus prostatitis includes antibiotic therapy, nonsteroidal anti-inflammatory drugs, herbal medicine, physical therapy procedures (magnetic therapy, ultrasound therapy, electrophoresis). In recent years, low-intensity lasers have been successfully used to non-invasively destroy prostate stones. Patients with calculus prostatitis are strictly prohibited from prostate massage.If the course of calculus prostatitis is complicated and associated with prostate adenoma, surgical treatment is usually required. When a prostate abscess forms, the abscess is opened and the stones pass as the pus drains out. Sometimes an instrument can be used to push a displaced exogenous stone into the bladder and perform lithotripsy. Removal of large fixed stones is performed in the perineal or suprapubic part of the procedure. When calculus prostatitis is complicated by BPH, the best surgical treatment is adenoma resection, prostate TUR, or prostatectomy.

Treatment of calculus prostatitis

Calculous prostatitis is inflammation of the prostate, accompanied by the formation of stones. This type of prostatitis is the result of long-term chronic inflammation of the prostate. The disease is associated with frequent urination, persistent pain in the lower abdomen and perineum, erectile dysfunction, and the presence of blood inclusions in the ejaculate.

the cause of this disease

Litholithiasis is a form of chronic prostatitis characterized by the formation of stones. The disease is usually a complication of a long-term inflammatory process in the prostate. In the context of chronic inflammation, under the influence of negative internal and external factors, secretions stagnate, crystallize over time and turn into stones.In addition to congestion and inflammatory phenomena, urethroprostatic reflux (characterized by the pathological reflux of small amounts of urine from the urethra into the prostate ducts during urination) plays an important role in the development of calculus prostatitis. The salts contained in the urine gradually crystallize, turning into dense stones over time. Common causes of uteroprostatic reflux:

• Urinary tract injury;
• Weakness of the prostate and seminal tubercle;
• Previous surgeries and invasive procedures.

Other pathologies that increase the risk of prostate stone formation:

• Small pelvic varicose veins;
• Metabolic disorders caused by systemic pathology;

Factors leading to the occurrence of calculus prostatitis:

• An inactive lifestyle can lead to the development of pelvic organ stagnation;
• Irregular sex life;
• Alcoholism, smoking;
• uncontrolled use of certain drugs;
• Damage to the prostate during surgery and long-term catheterization.

Types of stones in calculus prostatitis

According to the number of stones, there are single stones and multiple stones. Depending on the underlying cause, prostate stones are:

• real. They form directly in the acini and ducts.
• Incorrect. They migrate from the upper urinary tract (kidneys, bladder, urethra) to the prostate.

Prostate stones are formed from the same ingredients as bladder stones. With calculus prostatitis, the following types of stones are most commonly formed:

disease symptoms

The symptoms of calculus prostatitis resemble a chronic inflammatory process. The main clinical symptom of the disease is pain, which can be sore and dull in nature. Location of pain: Sacrum or coccyx.Pain attacks may worsen during bowel movements, sexual intercourse, physical activity, prolonged sitting on hard surfaces, and prolonged walking.Other pathological symptoms:

• Frequent urination or complete urinary retention;
• Hematuria and presence of blood inclusions in semen;
• Prostatic leakage – leakage of secretions from the prostate;
• Decreased libido, erectile dysfunction, painful ejaculation;
• Nervous system disorders: irritability, increased fatigue, insomnia.

If you have any of the above symptoms, you should make an appointment with a urologist as soon as possible. The lack of adequate treatment and the long duration of chronic calculus prostatitis can lead to serious and sometimes life-threatening consequences:

• Atrophy and hardening of glandular tissue;
• Prostate abscess.

diagnosis

In order to make an accurate diagnosis, a consultation with a uro-andrologist is required. During the initial examination, the specialist will listen carefully to the patient's complaints, take a medical history, and ask other questions that will help determine the cause and risk factors for prostatitis.Next, the doctor performs a rectal examination of the prostate, which involves palpating the gland through the rectum. This technique allows you to evaluate the size, shape and structure of the glands, detect stones, determine the inflammatory process through increased size and pain during stress. To confirm the diagnosis, additional laboratory and instrumental methods are required.

laboratory diagnosis

Some other laboratory tests used to diagnose calculus prostatitis:

• Culture of prostate secretions. Importantly informative method for identifying pathogenic microorganisms and diagnosing prostatic inflammatory processes.
• Urine culture. Allows you to detect pathogenic infections in urine and determine their type and concentration. If prostatic inflammation is suspected, a culture is obtained to confirm the diagnosis.
• PCR studies of scrapings. Allows you to detect sexually transmitted infections and identify pathogens.
• PSA analysis. Allows you to rule out prostate cancer, which usually occurs against the background of prostatitis.
• General clinical analysis of blood and urine. It is used to identify hidden inflammatory processes and kidney diseases in the urinary tract.
• Sperm diagram. Ejaculations are analyzed to rule out or confirm infertility.

Instrument diagnostics

Instrumental methods used in diagnosing pathology:Prostate ultrasound. Allows you to detect stones and determine their location, quantity, size, and structure. Ultrasound can also help distinguish prostate inflammation from other conditions with similar symptoms.urography. A contrast-enhanced X-ray method that can detect prostate stones, their size and location.Prostate CT or MRI. Allows layer-by-layer scanning of the prostate and surrounding tissue. Using CT or MRI images, doctors can study the structure of the prostate in detail, detect lesions of pathology, and assess their location, size, and relationship to surrounding tissue.

Treatment of calculus prostatitis

Treatment of calculus prostatitis can be performed on an outpatient basis if the disease is uncomplicated and the patient's general condition is satisfactory. If the disease is accompanied by complications such as prostate adenoma, the patient may need to be hospitalized.

Conservative treatment

The main goal of conservative treatment is to eliminate pathological symptoms. For this purpose, the patient is prescribed a course of drug therapy, which involves the use of the following groups of drugs:

• antibiotic. Eliminate infection and stop inflammation. Drug type, dose, and course duration were determined individually for each patient.
• NSAIDs. They block the inflammatory process and help eliminate pathological symptoms: pain, swelling.
• Antispasmodics. Relieve muscle spasms and reduce pain.
• Alpha adrenergic blockers. Facilitates the urination process.
• Vitamin mineral complex, immune modulator. Strengthens the immune system and promotes speedy recovery.

As a supplement to complex medical treatments, doctors often prescribe physical therapy procedures that can:

• Eliminate stalled processes;
• Activates tissue regeneration.
• The most effective physical therapy method for treating calculus prostatitis:
• Ultrasound therapy, shock wave therapy.

Lifestyle changes can ensure effective treatment of calculus prostatitis. To prevent relapse, physical activity is recommended, especially if your job forces you to adopt a sedentary lifestyle. Moderate physical activity can improve blood circulation in pelvic organs, eliminate congestion, and enhance local immunity.

Surgery

When the disease course is complex and combined with prostatic hyperplasia, surgical treatment is required. When an abscess forms, a surgeon opens the abscess. Along with the drainage of pus, the passage of stones is often observed. Large fixed stones are removed in the perineal or suprapubic portion. When calculus prostatitis is combined with benign prostatic hyperplasia, the best surgical treatment is transurethral resection of the prostate.

chronic calculus prostatitis

The term calculus prostatitis defines the pathology of the prostate in which stones form in its canaliculi. This disease is characterized by impaired penile erection and pain in the groin area.Causes and mechanisms of calculus prostatitisLong-term inflammatory processes or congestion of the prostatic tubules can lead to accumulation of secretions and mucus in them. Bacteria settle on these deposits and calcium salts precipitate. Over time, the mucus becomes denser and turns into small, sand-like stones. They stick together to form pebbles.The occurrence of calculus prostatitis has the following predisposing factors:

• Chronic Sexually Transmitted Infections (STDs)
• Prolonged infection process, inflammation of prostate ducts and tissues;
• Prostate congestion, which is mainly related to irregular sexual life in men;
• Urethroprostatic reflux - pathological reflux of small amounts of urine into the prostate;
• Genetic predisposition – A relative has calculus prostatitis.

Understanding the causes of prostate stone formation is necessary for high-quality and adequate treatment of the cause, which can help prevent the recurrence of calculus prostatitis.

Symptoms of calculus prostatitis

Symptoms of calculus prostatitis can last for a long time and men may not notice them. Clinical manifestations of the disease may include symptoms such as dull pain in the lower abdomen and lower back, sacrum, perineum, and pubic bone.Pain may begin or worsen after bowel movements, sexual intercourse, strenuous physical activity, and other triggers. Difficulty urinating is noted - the urge to go to the toilet frequently, painful or difficult urination, a burning sensation in the urethra and lower abdomen, and sometimes urinary retention due to obstruction in the form of stones.Patients develop prostatic leakage - involuntary secretions from the prostate during rest or physical activity, or when straining during defecation or urination. Urine and semen may contain blood.Almost always against the background of persistent inflammation and stone formation, sexual dysfunction occurs - weakened erections, premature ejaculation, decreased libido.The main symptoms of calculus prostatitis include:

• erectile dysfunction;
• Pain in the groin area, which may be spasmodic and paroxysmal in nature;
• During ejaculation – indicates damage to the prostatic canaliculi and blood vessels by the sharp edges of the stones;
• Premature ejaculation and painful ejaculation.

These symptoms can lead to a decrease in sexual desire.Men often attribute this to age, mistakenly believing that this sexual dysfunction will never go away. Sometimes they begin self-medicating with various erection-stimulating drugs (PDE-5 inhibitors).

This method is very dangerous because it can exacerbate the pathological process and lead to the development of complications.

Prostatitis is an inflammatory pathological process of the male prostate. In most cases, it is caused by infection, which gradually leads to a chronic, long-term course and the development of complications.

The treatment of calculus prostatitis is complex

• antibiotic,
• anti-inflammatory drugs,
• enzyme
• immune drugs
• Phytotherapy,
• Physical therapy procedures.

Antibacterial agentsAs part of symptomatic treatment. Their intake is necessary to inhibit the activity of pathogens in the infectious-inflammatory process. This can be both non-specific microbial flora (Streptococci, Staphylococci, Enterococci, Escherichia coli, Proteus) and specific pathogens of genitourinary tract infections - Neisseria gonorrhoeae, Chlamydia, Ureaplasma, Trichomonas, etc. .Antibiotic selection can be based on the results of culture studies of prostate secretions and determination of the susceptibility of the microbial pathogen to the drug. Antibiotics are sometimes prescribed empirically based on the scientifically proven antibacterial efficacy of the drug. Determination of the selection, dosage and duration of antibiotic use can only be made by the attending physician, since uncontrolled use of antibiotics can lead to serious complications and exacerbate the course of the underlying disease.If the prostate tissue is colonized by a polyassociated microbial flora (bacteria, viral microorganisms, protozoa), the heterogeneous treatment regimen will consist of a complex of different drugs acting on a specific antibacterial spectrum.Stimulates the body's immune defensesand its resistance to infections, immunomodulatory drugs - Immunomax, Panavir, interferons and their derivatives are prescribed. To increase the antibacterial effect of symptomatic drugs, enzyme preparations are used together with them - long enzyme, chemical trypsin. They help deliver active antibiotic substances to affected tissues, have indirect analgesic effects, and have anti-inflammatory and regenerative effects.Pain syndrome can be relievedUse non-steroidal anti-inflammatory drugs. In addition to antibiotic treatment, probiotics can be used to prevent the occurrence of intestinal dysbiosis. To protect the liver parenchyma from the toxic effects of antimicrobial drugs and improve its functional status, hepatoprotective agents are required. After the acute inflammatory phenomenon subsides, physical therapy - laser therapy, magnetic therapy, mud therapy, electroplating, medicinal electrophoresis, reflexology, hardware therapy, etc.This improves the metabolic processes, microcirculation, lymphatic drainage and nutritional effects of the prostate tissue, stimulates the restoration of its functional status and helps resolve the inflammatory process. To destroy the stone, a low-frequency laser is used. It crushes the stone and allows the small stones to pass out of the kidney tubules. If complications arise in the form of adenomas or prostatic abscesses (limited cavities filled with pus), surgical intervention is required.It involves removing part of the prostate (resection). To avoid this, you need to consult a doctor at the first pathological signs of erectile dysfunction. Self-medicating or ignoring the problem always leads to subsequent complications.