Chronic prostatitis is a serious disease that develops with periodic exacerbations that require long-term complex treatment. Inadequate therapy or its absence leads to the development of various complications, one of which is calculous prostatitis, one of the most severe forms of the disease. Calculus prostatitis develops from intolerant congestive prostatitis and is diagnosed in men over the age of 65 years.
Calculus prostatitis
Any form of prostatitis is characterized by inflammation in the prostate gland, which can occur in acute or chronic form. Calculus prostatitis is a form of inflammation caused by the presence of stones (stones) in the prostate gland.
Chronic calculous prostatitis is a rare complicated inflammation of the prostate gland. It is preceded by multi-year inadequate therapy for chronic congestive prostatitis or prostate adenoma.
In most cases, the complication occurs in men who have tried to treat prostatitis independently or have not followed the attending physician's recommendations. Optional discontinuation of the therapy course, lack of complex treatment or independent uncontrolled intake of medication leads to the development of complications. Quite often, the calculous form of inflammation of the prostate gland develops against the background of concomitant pathologies of the kidneys and genitourinary system.
The formation of stones in the prostate gland can be caused by two factors. The first of these is urolithiasis. In this case they are talking about secondary or false stones that do not arise in the prostate but pass down into it through the urine. This occurs against the background of a disorder of the urogenital system and a decrease in prostate tone, leading to reverse urinary reflux with fragments of stones.
Primary or true stones arise directly in the prostate. It is caused by a chronic disorder of the body's trophies. At the same time, salts and phosphates accumulate in the prostate, which, against the background of thickening of the glandular secretion, form dense deposits of salt - stones.
Calculus prostatitis does not occur instantly. This is usually the result of failure to treat chronic inflammation of the prostate.
Causes of disease development
The development of calculous prostatitis is due to prolonged dysfunction of the prostate gland or diseases accompanying the male genital area. Factors provoking the development of this form of the disease can be:
- Congenital prostatitis with chronic course;
- Chronic infectious prostatitis;
- BPH;
- Malignant neoplasms in the body;
- Urolithiasis;
- Disruption of the kidneys.
The structure of stones can be organic or inorganic, their diameter rarely exceeds 4 mm. The organic structure of the stones is due to the stagnation of the prostate secretion, such stones are formed directly in the prostate secretion.
Inorganic stones are found in the prostate as a result of urethro-prostate reflux. This phenomenon is observed when the tone of the prostate gland is weakened and consists of urinary reflux from the urethra into the prostate ducts. The result is dense calculi composed of salts and phosphates that are excreted from the body in the urine.
Among the risk factors for the development of calculous prostatitis is a lifestyle disorder on the background of chronic inflammation of the prostate. This includes an unbalanced diet rich in fatty and heavy foods, lack of regular sex life.
Calculus 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 incorrect or timely treatment of a sluggish 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 swelling of 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 the calculus form of the disease before visiting a doctor. At the moment of corresponding muscle tension, during ejaculation or urination, the stones move and damage the tissues of the prostate gland. As a result, blood appears in the urine.
Typically, the calculous form of prostatitis is always accompanied by impaired sexual function. This can manifest as both impotence and ejaculation problems. Men often complain about the inability to reach a climax during sexual intercourse.
However, in some cases, calculous prostatitis may be asymptomatic. This is observed in the formation of small stones.
A distinctive feature 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 tests:
- Rectal palpation of the prostate;
- Ultrasound or TRUS;
- MRI;
- Analysis of prostate secretion.
During rectal palpation of the body, the doctor clearly feels the heterogeneity of the prostate gland, which is manifested by the presence of tubercles and depressions in the body. If the stones are large, they are clearly felt on palpation. Also, prostate massage in the presence of stones can be painful and accompanied by bleeding after manipulation, which is caused by damage to body tissues due to the presence of dense salt deposits.
On ultrasound or TRUS stones are distinguished by increased echogenicity. Such an examination allows you to accurately estimate the location of stones, their size, contours and even structure.
In addition, ultrasound and urethrography of the kidneys may be needed to rule out the secondary nature of stone formation in the setting of urinary tract diseases.
The presence of stones, their location and size are well determined on ultrasound.
Principle of treatment
Treatment of calculous prostatitis is a long process. Therapy aims to stop inflammation, alleviate symptoms, destroy stones, and prevent their recurrence. The course of treatment usually lasts at least one 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 of the prostate and the examination reveals pathogenic microorganisms. Drugs of the alpha-blocker group have been shown to develop urinary incontinence. These medications soothe the bladder and make it easier to pass urine.
Physiotherapy, which aims to improve prostate trophism, plays an important role in the treatment of calculous prostatitis. Electrophoresis, magnetotherapy, shock wave therapy are performed.
If the calculi 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 cut with a laser. This procedure is performed on an outpatient basis, is absolutely painless and lasts no more than 20 minutes. If there are several stones, a course of procedures is prescribed.
In calculous prostatitis, prostate massage is prohibited as it causes damage to the tissues of the body during the movement of stones.
How to treat calculous prostatitis - it depends on the size of the stones and the symptoms of the disease. Treatment of small stones is carried out with medication and physiotherapy, which are aimed, among other things, at the crushing of stones. Large stones are removed surgically. The operation is performed under anesthesia.
Possible complications
Calculus prostatitis is dangerous with the risk of developing an abscess in the prostate gland. Such a complication requires urgent hospitalization and surgical intervention, otherwise the abscess may open on its own, leading 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 that surrounds the rectum. Purulent inflammation can lead to dangerous consequences, up to sepsis and infection of the whole organism.
One of the most common complications of lack of timely treatment for calculous prostatitis is erectile dysfunction. Often, the presence of stones in the prostate causes infertility.
The likelihood of complications is determined during examination and diagnosis, in addition, in the treatment of calculous prostatitis, the patient is shown regular ultrasound and analysis of prostate secretion to evaluate the effectiveness of the chosen treatment regimen.
The most common result is impaired potency.
Disease prevention
Although calculous prostatitis is curable, the attending physician always warns of the risk of recurrence of stones. To avoid this, men should follow certain recommendations.
Prevention of disease recurrence is reduced to a balanced diet, regular sexual activity. Fatty and spicy foods that negatively affect the functioning of the urogenital system should be avoided. Be sure to give up bad habits and exercise regularly to prevent blood and lymph stagnation in the pelvic organs.
Since calculous prostatitis is the most common complication of chronic prostatitis, disease-specific prophylaxis is reduced to timely treatment of prostate inflammation. You should follow your doctor's recommendations and not try to treat prostatitis independently.
Often, men who face this disease do not pay proper attention to the symptoms, hoping that the discomfort will pass by itself. As a result, prostatitis is not treated and can last for many years in a latent form, periodically manifested by exacerbations. It is important to understand that a timely visit to the doctor and adequate therapy will remove the disease in a few months.
Another common mistake that leads to the development of calculous prostatitis is to stop treating chronic inflammation with the first improvement. As a result, the disease remains untreated and will inevitably be felt when immunity is reduced.
Thus, to prevent the formation of stones in the prostate, you should follow only a few rules:
- See a doctor in a timely manner;
- Strictly follow the instructions of the specialist;
- Do not let the disease take its course.
All men who have prostatitis should undergo an annual examination with a urologist.