Introduction
Prostatic calculi are classed as exogenous or endogenous based on their origin. Urine salts form exogenous calculi and might begin as ureteral or bladder stones before becoming stuck in the prostatic urethra. They are not real prostatic stones in certain ways, but they have been classified as such.
This form of stone has been encountered after prostatectomy and can get fairly large. Urinary salt deposition in prostatic diverticula may result in the production of calculi in the prostate. These stones are regularly discovered during endoscopic examinations and are frequently found right below the mucosal membrane of the prostatic urethra. True prostatic stones, on the other hand, are located in the deeper prostate structures and are generally numerous.
What Are Prostate Stones?
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Small calcium deposits called prostate stones can accumulate in a man's prostatic gland, especially with aging.
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Prostate stones typically range from half a millimeter to five millimeters, making them comparable to millet or poppy seeds.
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They should not be confused with kidney stones, which can develop in the kidneys, ureters, or bladder.
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Typically innocuous, prostate stones are only found by accident, such as during an ultrasound screening. They can occasionally, nevertheless, become problematic.
How Can Stone Be Formed?
Prostatic calculus refers specifically to endogenous prostatic calculus. Prostatic secretions, corpora amylacea, or prostate inflammation may clog the secretory tube, causing stone thickening and calcification. Stones can be found in various sizes ranging from 0.5 to 5.0 mm. Stones are pathophysiologic phenomena that occur during the aging process, particularly after the age of 50.
The head (front) portion of the posterior lobe and the big tube and acini of the lateral lobe of the prostate are where endogenous prostatic calculi are most frequently discovered. The calculi inside the tube are huge and obvious, unlike the little calculi inside the acini. Extrinsic prostatic calculi are less common than endogenous prostate calculi, but they are frequently larger since they are primarily brought on by urine reflux into the prostate.
Extrinsic prostatic calculi can develop at any age, and rather than developing because of age, they frequently develop due to neurogenic bladder or chronic urinary tract infection. Prostate enlargement has been shown to result in urethral closure in extreme circumstances.
What Causes Prostatic Calculi?
Prostatic calcification can occur either initially (idiopathic) or as a result of
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Infections such as tuberculosis or bacterial prostatitis.
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Radiation therapy.
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Urethral stents or surgery may cause benign prostatic hypertrophy.
What Are the Symptoms of Prostatic Calculi?
Asymptomatic prostatic calculi frequently accompany simple benign prostatic hyperplasia. Lower urinary tract symptoms may be directly related to prostatic calculi associated with chronic prostatitis. Symptoms of underlying diseases, such as benign prostatic hyperplasia, might be considered prostatic calculi.
However, in patients with pelvic pain, prolonged prostate inflammation may result from causes other than straightforward benign prostatic hyperplasia. Prostatic calculi in these people not only allow infectious germs to colonize the area and encourage the prostate's secretory tubes to close, which may result in antibiotic and other drug resistance.
Urinary urgency, especially at night, as well as difficulty urinating and pain in the perineum, penis, or lower back, may be experienced by the patient.
How Common Are Prostate Stones?
Many men develop prostate stones, especially beyond the age of 50. They are frequently discovered in men whose prostates are checked for conditions including benign prostatic hyperplasia or chronic prostate inflammation. However, the precise relationship between these disorders and prostate stones is yet unclear. Men with prostate cancer frequently have calcification in the prostatic gland.
How to Diagnose Prostatic Calculi?
Prostatic calculi can be diagnosed by using different techniques:
1. Radiograph
Although unilateral calcification can also be present, bilateral calcifications of the prostate are most frequently found in the posterior and lateral lobes. Sizes can range from 1 to 40 mm and have a variety of appearances, including fine granules and uneven lumps. The calcifications can extend much above the pubic symphysis if there is substantial prostatic enlargement.
2. Ultrasound
Calcifications on ultrasound are visible as strongly echogenic foci that may or may not have posterior shadowing.
3. Computed Tomography
Calcifications on the CT scan are visible as variable-thickness hyperattenuating foci.
4. MRI
The normal MRI appearance is a small signal void, similar to calcifications elsewhere in the body, and is frequently challenging to see. It might be easier to spot calcifications using gradient echo sequences like SWI.
How Are Prostate Stones Treated?
Prostate stones typically don't require any kind of therapy. The body will occasionally just eliminate them through urination. If they hurt, however, specific therapy is offered. Doctors will give antibiotics if there is a bacterial infection.
The deposits can be removed through the urethra using a thin surgical instrument (endoscope) introduced outside in situations of chronic inflammation or bigger prostate stones. Prostate tissue is also eliminated if the prostate is enlarged during the procedure. Transurethral prostate resection, or TURP, is the name of this procedure is to be done.
Conclusion
Prostate stones are frequently thought to be clinically insignificant. However, SEM (scanning electron microscope) revealed the high frequency of bacterial imprints in these stones for the first time.
The distinct chemistry of calcium phosphate phases, specifically the predominance of whitlockite and ACCP (amorphous carbonated calcium phosphate) in these calcifications. It demonstrates the prevalence of bacterial infections in the prostate, which frequently occur without any overt clinical signs.
An infection-induced inflammation may cause the tissue to become cancerous. A search for an asymptomatic chronic infection may be suggested if prostatic calcifications or stones are discovered early. If an infection is found, medical supervision and antibiotic therapy may be used to prevent chronic tissue inflammation and other harmful effects. Therefore, imaging can be used to detect prostatic calcifications. To know more about the condition, consult the doctor online.
