Chronic prostatitis is a serious disease that occurs with periodic exacerbations, which requires long-term complex treatment. Inadequate therapy or its absence leads to the development of various complications, of which one of the most severe forms of the disease is calculous prostatitis. Calculous prostatitis arises from indolent congestive prostatitis and is diagnosed in men over 65 years of age.
Calculous prostatitis
Each form of prostatitis is characterized by inflammation of the prostate, which can occur in acute or chronic form. Calculous prostatitis is a form of inflammation caused by the presence of stones in the vas deferens of the prostate.
Chronic calculous prostatitis is a rare complicated inflammation of the prostate. This is preceded by years of inadequate therapy for chronic congestive prostatitis or prostate adenoma.
In most cases, the complication is found in men who have tried to treat prostatitis on their own or have not followed a doctor’s recommendation. Discontinuation of therapy at will, lack of complex treatment or independent uncontrolled medication lead to the development of complications. Very often, the calculous form of prostate inflammation develops in the background of accompanying pathologies of the kidneys and urinary system.
The formation of prostate stones can be the result of two factors. The first of these is urolithiasis. In this case, they are talking about secondary or false stones that do not form in the prostate, but migrate into it along the way down along with the urine. This occurs against the background of violations of the urinary system and as a result of reduced prostate tone, which causes reverse reflux of urine with fragments of stones.
Primary or true stones form directly in the prostate. This is due to chronic injury to organ trophism. At the same time, salts and phosphates accumulate in the prostate, which on the background of thickening of glandular secretions create dense deposits of salt - stones.
Calculous prostatitis does not occur immediately. This is usually due to untreated chronic prostate inflammation.
Reasons for the development of diseases
The onset of calculous prostatitis is due to long-term prostate dysfunction or concomitant diseases of the male genital area. Factors that cause the development of this form of the disease can be:
- congestive congestive prostatitis;
- chronic infectious prostatitis;
- BPH;
- malignant neoplasms in the body;
- urolithiasis disease;
- renal dysfunction.
The structure of stones can be organic and inorganic, their diameter rarely exceeds 4 mm. The organic structure of stones is due to the stagnation of the secretory prostate, such stones are formed directly in the secretory prostate.
Inorganic stones enter the prostate as a result of urethro-prostatic reflux. This phenomenon is observed when prostate tone is weakened and consists of reflux of urine from the urethra into the prostate ducts. As a result, dense stones are formed, consisting of salts and phosphates, which are excreted from the body in the urine.
Among the factors that predispose to the development of calculous prostatitis, there is a violation of lifestyle in the background of chronic inflammation of the prostate. This includes an unbalanced diet rich in fatty and heavy foods, lack of regular sex life.
Calculous prostatitis is diagnosed in men who have been living with chronic prostatitis for more than 10 years. In many ways, the development of this form of the disease is associated with improper or untimely treatment of a slow inflammatory process.
Urolithiasis increases the likelihood of calculous prostatitis.
Symptoms of the disease
The symptoms and treatment of chronic calculous prostatitis do not differ much from the signs of inflammation on the background of congestion in the pelvic organs. Patient complaints include:
- frequent urge to urinate;
- feeling of heaviness in the rectum;
- pain after urination;
- weakening of potency;
- ejaculation disorders;
- blood in urine and semen.
It is the presence of blood in the urine or semen that makes it possible to suspect a calculous form of the disease before visiting a doctor. At the moment of tension of the corresponding muscles, during ejaculation or urination, the stones move and injure the prostate tissues. As a result, blood is found in the urine.
As a rule, the calculous form of prostatitis is always accompanied by a violation of sexual function. This can manifest as impotence and ejaculation problems. Men often complain about the inability to reach orgasm during sex.
However, in some cases, calculous prostatitis may be asymptomatic. This is observed in the formation of small stones.
The peculiarity of this form of prostatitis is the presence of blood in the urine.
Diagnosis of the disease
The diagnosis of calculous prostatitis is made on the basis of the same examinations that reveal chronic inflammation.
To make a diagnosis, you must undergo the following examinations:
- rectal palpation of the prostate;
- Ultrasound or TRUS;
- MRI;
- prostate secretion analysis.
During rectal palpation of the organ, the doctor clearly feels the heterogeneity of the prostate, which is manifested by the presence of tubercles and depressions in the organ. If the stones are large, they are clearly felt by palpation. Also, prostate massage in the presence of stones can be painful and be accompanied by the release of blood after manipulation, which is due to damage to organ tissue due to the presence of dense salt deposits.
On ultrasound or TRUS, the stones are characterized by increased echogenicity. Such an examination allows you to accurately estimate the location of stones, their size, contours, and even structure.
In addition, renal ultrasound and urethrography may be required to rule out the secondary nature of urinary stone formation on the background of urinary tract disease.
The presence of stones, their location and size were well determined on ultrasound.
The principle of treatment
Treatment of calculous prostatitis is a long process. Therapy is aimed at stopping the inflammation, alleviating the symptoms, destroying the stones and preventing their re-formation. As a rule, the course of treatment lasts at least a month.
Treatment of calculous prostatitis begins with symptomatic therapy based on the use of nonsteroidal anti-inflammatory drugs, antibiotics and alpha-blockers. Nonsteroidal anti-inflammatory drugs relieve pain and improve well-being. Antibacterial therapy is carried out only if calculous prostatitis develops on the background of infectious inflammation in the prostate, and pathogenic microorganisms are detected during the examination. Alpha-blocker preparations are indicated for the development of urinary disorders. These medications relax the bladder and make it easier to urinate.
An important role in the treatment of calculous prostatitis is played by physiotherapy, which aims to improve prostate trophism. Electrophoresis, magnetotherapy, shock wave therapy are practiced.
If the stones are large, it is possible to perform an operation to remove them. Minimally invasive methods and laser surgery are commonly used.
Medium-sized stones are successfully crushed with a laser. This procedure is performed on an outpatient basis, is absolutely painless and does not last more than 20 minutes. If there are more stones, the course of the procedure is prescribed.
In calculous prostatitis, prostate massage is forbidden, because it leads to damage to the tissues of the organs when the stones move.
How to cure calculous prostatitis - depends on the size of the stones and the symptoms of the disease. In the case of small stones, the treatment is carried out with the help of drugs and physiotherapy, aimed, among other things, at crushing the stones. Large stones are removed surgically. The operation is performed under anesthesia.
Possible complications
Calculous prostatitis is a dangerous risk of developing an abscess in the prostate. Such a complication requires urgent hospitalization and surgical intervention, otherwise the abscess can open on its own, which leads to the development of sepsis.
Lack of adequate and timely therapy can lead to the development of paraproctitis. This disease is characterized by inflammation of the subcutaneous tissue surrounding the rectum. Purulent inflammation can have dangerous consequences, all the way to sepsis and infection of the whole organism.
One of the most common complications in the lack of timely treatment of calculous prostatitis is erectile dysfunction. Often the presence of stones in the prostate leads to infertility.
The probability of complications is determined during the examination and diagnosis. In addition, during the treatment of calculous prostatitis, the patient is regularly shown ultrasound and analysis of prostate secretions to assess the effectiveness of the chosen treatment regimen.
The most common consequence is a violation of potency.
Disease prevention
Despite the fact that calculous prostatitis is curable, the doctor always warns of the risk of stone recurrence. To prevent this from happening, a man should follow some recommendations.
Prevention of recurrence of the disease comes down to a balanced diet, regular sexual activity. Fatty and spicy foods that negatively affect the functioning of the urinary system should be avoided. Be sure to give up bad habits and exercise regularly to prevent stagnation of blood and lymph in the pelvic organs.
Since calculous prostatitis is the most common complication of chronic prostatitis, specific prevention of the disease comes down to timely treatment of prostatitis. The doctor's recommendations should be followed and you should not try to treat prostatitis yourself.
Often, men who are faced with this disease do not pay due attention to the symptoms, hoping that the discomfort will go away on its own. As a result, prostatitis is not treated and can take place in a latent form for many years, occasionally manifesting itself in exacerbations. It is important to understand that a timely visit to the doctor and adequate therapy will alleviate the disease in a few months.
Another common mistake that leads to the development of calculous prostatitis is to stop the treatment of chronic inflammation at the first improvement. As a result, the disease remains untreated and will definitely be felt when immunity is reduced.
So, to avoid the formation of prostate stones, only a few rules should be followed:
- consult a doctor in a timely manner;
- strictly follow the instructions of experts;
- don't let the disease go its course.
Every man who has had prostatitis should undergo an annual examination by a urologist.