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, one of which is calculous prostatitis, one of the most severe forms of the disease. Calculous prostatitis develops from indolent congestive prostatitis and is diagnosed in men over 65 years of age.
Calculous prostatitis
Any form of prostatitis is characterized by inflammation in the prostate gland, which can occur in acute or chronic form. Calculous prostatitis is a form of inflammation caused by the presence of calculi (stones) in the vas deferens of the prostate.
Chronic calculous prostatitis is a rare complicated inflammation of the prostate gland. It is preceded by many years of inadequate therapy for chronic congestive prostatitis or prostate adenoma.
In most cases, a complication is found in men who tried to treat prostatitis on their own or did not follow the recommendations of the attending physician. Interruption of the course of therapy at will, lack of complex treatment, or independent uncontrolled intake of drugs lead 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 urinary system.
The formation of stones in the prostate gland can be due to two factors. The first of these is urolithiasis. In this case, they speak of secondary or false stones that do not form in the prostate, but migrate into it along a downward path along with urine. This occurs against the background of a violation of the urinary system and as a result of a decrease in the tone of the prostate, which causes the reverse reflux of urine with fragments of stones.
Primary or true stones are formed directly in the prostate. This is due to a chronic violation of the trophism of the organ. At the same time, salts and phosphates accumulate in the prostate, which, against the background of thickening of the secretion of the gland, forms dense salt deposits - stones.
Calculous prostatitis does not occur instantly. This is usually a consequence of failure to treat chronic inflammation of the prostate.
Reasons for the development of the disease
The development of calculous prostatitis is due to a long-term dysfunction of the prostate gland or concomitant diseases of the male genital area. Factors provoking the development of this form of the disease can be:
- congestive prostatitis with a chronic course;
- chronic infectious prostatitis;
- BPH;
- malignant neoplasms in the body;
- urolithiasis disease;
- disruption of the kidneys.
The structure of the stones can be organic and inorganic, their diameter rarely exceeds 4 mm. The organic structure of the stones is due to the stagnation of the prostatic secret, such stones are formed directly in the secret of the prostate.
Inorganic stones enter the prostate as a result of urethro-prostatic reflux. This phenomenon is observed when the tone of the prostate gland is weakened and consists in the reflux of urine from the urethra into the ducts of the prostate. As a result, dense calculi are formed, consisting of salts and phosphates, which are excreted from the body with urine.
Among the factors predisposing to the development of calculous prostatitis, there is a violation of lifestyle against the background of chronic inflammation in the prostate. This includes an unbalanced diet rich in fatty and heavy foods, the lack of a regular sexual 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 incorrect or untimely treatment of a sluggish inflammatory process.
Urolithiasis increases the likelihood of calculous prostatitis.
Symptoms of the disease
Symptoms and treatment of chronic calculous prostatitis are not much different from signs of inflammation against 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 urine or seminal fluid that makes it possible to suspect the calculous form of the disease before a visit to the doctor. At the moment of tension of the corresponding muscles, during ejaculation or urination, the stones move and injure the tissues of the prostate gland. 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 itself as a weakening of potency, and problems with ejaculation. Men often complain about the impossibility of reaching a climax during 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
Diagnosis of calculous prostatitis is carried out 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;
- prostatic secretion analysis.
During rectal palpation of the organ, the doctor clearly feels the heterogeneity of the prostate gland, which is manifested by the presence of tubercles and depressions in the organ. If the stones are large, they are clearly felt on 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 the tissues of the organ 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 assess the location of the stones, their size, contours and even structure.
Additionally, ultrasound of the kidneys and urethrography may be needed to exclude the secondary nature of the formation of stones against the background of diseases of the urinary system.
On ultrasound, the presence of stones, their location and size are well determined.
Principle of treatment
Treatment of calculous prostatitis is a long process. Therapy is aimed at stopping inflammation, relieving symptoms, destroying 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, which is based on the use of non-steroidal anti-inflammatory drugs, antibiotics and alpha-blockers. Non-steroidal anti-inflammatory drugs relieve pain and improve well-being. Antibacterial therapy is carried out only if calculous prostatitis develops against the background of infectious inflammation in the prostate, and pathogenic microorganisms are detected during the examination. Preparations of the group of alpha-blockers are indicated for the development of urination disorders. These medicines relax the bladder and make it easier to pass urine.
An important role in the treatment of calculous prostatitis is given to physiotherapy, aimed at improving the trophism of the prostate. Electrophoresis, magnetotherapy, shock wave therapy are practiced.
If the calculi are large, it is possible to perform an operation to remove them. Minimally invasive methods and laser surgery are usually used.
Stones of medium size are successfully crushed by a laser. This procedure is performed on an outpatient basis, is absolutely painless and takes no more than 20 minutes. If there are several stones, a course of procedures is prescribed.
With calculous prostatitis, prostate massage is prohibited, as this leads to damage to the tissues of the organ when the stones set in motion.
How to cure calculous prostatitis - it depends on the size of the stones and the symptoms of the disease. With small stones, treatment is carried out with the help of medicines and physiotherapy, aimed, among other things, at crushing stones. Large stones are removed surgically. The operation is performed under anesthesia.
Possible Complications
Calculous prostatitis is dangerous with the risk of developing an abscess in the prostate gland. Such a complication requires immediate hospitalization and surgical intervention, otherwise the abscess may open on its own, which leads to the development of sepsis.
The 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 have dangerous consequences, up to sepsis and infection of the whole organism.
One of the most common complications in the absence of timely treatment of calculous prostatitis is erectile dysfunction. Often, the presence of stones in the prostate leads to infertility.
The likelihood of complications is determined during the examination and diagnosis. In addition, during the treatment of calculous prostatitis, the patient is shown regular ultrasound and prostate secretion analysis 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 attending physician always warns of the risk of recurrence of stones. To prevent this from happening, a man needs to follow some recommendations.
Prevention of the recurrence of the disease is reduced 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 most often a complication of chronic prostatitis, the specific prevention of the disease is reduced to the timely treatment of inflammation of the prostate. You should follow the doctor's recommendations and do not try to treat prostatitis on your own.
Quite often, men who are faced with this disease do not pay due attention to the symptoms, hoping that the discomfort will pass by itself. As a result, prostatitis is not treated and can proceed in a latent form for many years, periodically manifesting itself with exacerbations. It is important to understand that a timely visit to a doctor and adequate therapy will relieve the disease in a few months.
Another common mistake that leads to the development of calculous prostatitis is to stop treatment of chronic inflammation at the first improvement. As a result, the disease remains untreated and will definitely make itself felt when immunity is reduced.
Thus, to avoid the formation of stones in the prostate, you should follow just a few rules:
- consult a doctor in a timely manner;
- strictly follow the instructions of a specialist;
- do not let the disease take its course.
Every man who has had prostatitis should undergo an annual examination by a urologist.