Chronic prostatitis is a serious disease with periodic exacerbations that requires long-term comprehensive 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.
Each form of prostatitis is characterized by inflammation in the prostate gland, which can manifest itself in acute or chronic form. Calculous prostatitis is a form of inflammation caused by the presence of stones (stones) in the vas deferens of the prostate.
Chronic calculous prostatitis is a rarely 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 have tried to treat prostatitis on their own or have not followed the doctor's recommendations. Interruption of the course of therapy at will, lack of complex treatment or independent uncontrolled medication 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 prostate stones can be due to 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 in a descending way with the urine. This occurs against the background of a violation of the urinary system and as a result of reduced prostate tone, which causes reflux of urine with fragments of stones.
Primary or true stones form directly in the prostate. This is due to a chronic violation of organ trophism. At the same time, salts and phosphates accumulate in the prostate, which, against the background of thickening of the gland's secretion, form dense salt deposits - stones.
Calculous prostatitis does not appear immediately. This is usually a consequence of unsuccessful treatment of chronic inflammation of the prostate.
Causes of the disease
The development of calculous prostatitis is due to prolonged 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 chronic course;
- chronic infectious prostatitis;
- malignant neoplasms in the body;
- urolithiasis disease;
- impaired renal function.
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 prostate secretion, such stones are formed directly in the prostate secretion.
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 of reflux of urine from the urethra into the ducts of the prostate. As a result, dense stones are formed, consisting of salts and phosphates, which are excreted from the body in the urine.
Among the factors predisposing to the development of calculous prostatitis, there is a violation of lifestyle against the background of chronic inflammation of the prostate. This includes an unbalanced diet, rich in fatty and heavy foods, lack of regular sex.
Calculous prostatitis is diagnosed in men who have been living with chronic prostatitis for more than 10 years. In many respects, 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. Patients' 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 calculous form of the disease before visiting a doctor. At the moment of tension of the relevant 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 sexual dysfunction. This can manifest itself as a weakening of potency and ejaculation problems. Men often complain about the inability to reach 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
The diagnosis of calculous prostatitis is made on the basis of the same tests that reveal chronic inflammation.
To make a diagnosis, you must undergo the following tests:
- rectal palpation of the prostate;
- Ultrasound or TRUS;
- analysis of prostate secretion.
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 dents 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 bleeding after manipulation, which is due to damage to body tissues due to the presence of dense deposits of salt.
In ultrasound or TRUS the stones are characterized by increased echogenicity. Such a study allows you to accurately assess the location of stones, their size, contours and even structure.
In addition, ultrasound of the kidneys and urethrography may be needed to rule out 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
The treatment of calculous prostatitis is a long process. The therapy is aimed at stopping the inflammation, relieving the symptoms, destroying the stones and preventing their recurrence. As a rule, the course of treatment 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. 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. Drugs from the group of alpha-blockers are indicated for the development of urinary 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 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 usually used.
Medium-sized stones are successfully crushed with a laser. This procedure is performed on an outpatient basis, is completely painless and takes 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 leads to damage to the tissues of the body when the stones move.
How to treat calculous prostatitis - depends on the size of the stones and the symptoms of the disease. For small stones, treatment is done with the help of drugs and physiotherapy, aimed, among other things, at crushing stones. Large stones are removed surgically. The operation is performed under anesthesia.
Calculous prostatitis is dangerous with the risk of developing an abscess in the prostate gland. Such a complication requires immediate hospitalization and surgery, 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 have dangerous consequences, leading to sepsis and infection of the whole body.
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 analysis of prostate secretion to assess the effectiveness of the chosen treatment regimen.
The most common consequence is a violation of potency.
Despite the fact that calculous prostatitis is treatable, the doctor always warns about the risk of recurrence of stones. To prevent this, the man must follow some recommendations.
Preventing the recurrence of the disease comes down to a balanced diet, regular sexual activity. Fatty and spicy foods that adversely affect the urinary system should be avoided. Remember 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 is reduced to timely treatment of prostatitis. You should follow your doctor's recommendations and not try to treat prostatitis yourself.
Quite often men who face this disease do not pay the necessary attention to the symptoms, hoping that the discomfort will pass by itself. As a result, prostatitis is incurable and can be dormant for many years, with periodic 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 stopping the treatment of chronic inflammation at the first improvement. As a result, the disease remains untreated and will definitely be felt when the immunity is reduced.
Thus, to avoid the formation of prostate stones, you need to follow only a few rules:
- consult a doctor in a timely manner;
- strictly follow the instructions of a specialist;
- do not allow the disease to take over.
Every man who has had prostatitis should have an annual check-up with a urologist.