Chronic prostatitis is a serious disease that occurs with periodic exacerbations, which requires complex long-term 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 the age of 65.
Calculous prostatitis
Any form of prostatitis is characterized by inflammation of the prostate, which can occur in an 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. It is preceded by many years of inadequate treatment of 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 treatment at will, the absence of complex treatment or the independent and uncontrolled intake of drugs leads to the development of complications. Quite often, the calculous form of inflammation of the prostate develops against the background of concomitant pathologies of the kidneys and urinary system.
The formation of stones in the prostate can be due to two factors. The first of them is urolithiasis. In this case, they speak of secondary or false stones that do not form in the prostate, but migrate there along a downward path 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 gland, which causes the reverse reflux of urine with fragments of stones.
Primary or true stones form 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 happen instantly. This is usually a consequence of failed treatment for chronic inflammation of the prostate.
Reasons for the development of the disease
The development of calculous prostatitis is due to long-term dysfunction of the prostate or concomitant diseases of the male genital area. The 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;
- disturbance of the kidneys.
The structure of 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, these stones are formed directly in the secret of the prostate.
Inorganic stones enter the prostate as a result of urethroprostatic reflux. This phenomenon is observed when the tone of the prostate is weakened and consists of a 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 with 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, the absence of a regular sex life.
Calculous prostatitis is diagnosed in men who have lived with chronic prostatitis for more than 10 years. In many respects, the development of this form of the disease is associated with incorrect or untimely treatment of a sluggish inflammatory process.
Urolithiasis increases the risk of calculous prostatitis.
Disease symptoms
Symptoms and treatment of chronic calculous prostatitis are not much different from signs of inflammation against the background of congestion of the pelvic organs. Patient complaints include:
- frequent urination;
- 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 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. 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 in a weakening of potency and problems with ejaculation. Men often complain about the inability to climax during sex.
However, in some cases, calculous prostatitis can 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 prostatic secretion.
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 on palpation. In addition, prostate massage in the presence of stones can be painful and accompanied by the release of blood after manipulation, 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 their structure.
In addition, ultrasound of the kidneys and urethrography may be required to exclude the secondary nature of stone formation 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. The therapy is aimed at stopping the inflammation, relieving the symptoms, destroying the stones and preventing their reformation. As a rule, treatment lasts at least a month.
Treatment of calculous prostatitis begins with symptomatic therapy, which is 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 against the background of infectious inflammation of the prostate gland and pathogenic microorganisms are detected during the examination. Preparations from the group of alpha-blockers are indicated for the development of urination disorders. These drugs 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, magnetic therapy, shock wave therapy are performed.
If the stones are large, it is possible to perform an operation to remove them. Minimally invasive methods and laser surgery are generally used.
Medium-sized stones 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 damages the tissues of the organ when the stones get 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 drugs and physiotherapy, aimed, among other things, at crushing stones. Large stones are surgically removed. The operation is performed under anesthesia.
Possible complications
Calculous prostatitis is dangerous with the risk of developing an abscess in the prostate. 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 treatment 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 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 examination and diagnosis. Also, when treating calculous prostatitis, the patient undergoes 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.
Disease prevention
Despite the fact that calculous prostatitis is curable, the attending physician always warns about the risk of recurrence of stones. To prevent this from happening, a man must follow certain recommendations.
Prevention of 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 avoid stagnation of blood and lymph in the pelvic organs.
Since calculous prostatitis is most often a complication of chronic prostatitis, specific prevention of the disease is reduced to timely treatment of inflammation of the prostate. You should follow the doctor's recommendations and not try to treat prostatitis on your own.
Very often, men faced with this disease do not pay due attention to the symptoms, hoping that the discomfort will pass on its own. As a result, prostatitis is not treated and can proceed in a latent form for many years, periodically manifesting in exacerbations. It is important to understand that a timely visit to a doctor and adequate therapy will relieve the disease within 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 certainly make itself felt when immunity is reduced.
Thus, to avoid the formation of stones in the prostate, you must follow a few rules:
- consult a doctor in a timely manner;
- strictly follow the instructions of a specialist;
- don't let the disease take its course.
Every man who has had prostatitis must undergo an annual examination by a urologist.