prostate calculus

Prostate calculus, also known as prostatic calculi or prostate stones, can cause a range of symptoms in men. Here are some of the common signs and symptoms:

• Urinary urgency: Men with prostate calculus may experience a sudden and intense need to urinate, especially during the night [3].
• Difficulty urinating: Prostate stones can cause obstruction in the urinary tract, making it difficult for men to empty their bladder completely [7].
• Pain in the pelvis, lower back, penis or perineum: Men with prostate calculus may experience pain in these areas due to inflammation and irritation caused by the stone [3][4].
• Chronic pelvic pain: In some cases, prostatic calculi can be associated with chronic pelvic pain, which can be a persistent and debilitating symptom [4].
• Dysuria: Prostate stones can cause painful urination or discomfort while urinating [5].
• Hematuria: Men with prostate calculus may experience blood in their urine due to the stone causing irritation and inflammation in the urinary tract [5].
• Obstruction: Large or multiple prostatic calculi can cause severe lower urinary tract symptoms, including obstruction of the urinary tract [6].

It's essential for men to seek medical attention if they experience any of these symptoms, as early diagnosis and treatment can help prevent complications and improve quality of life.

References:

[3] Context 3 [4] Context 4 [5] Context 5 [6] Context 6 [7] Context 7

Diagnostic Tests for Prostate Calculus

Prostate calculus, also known as prostatic calculi or stones, can be diagnosed through various tests and examinations. Here are some of the diagnostic tests used to detect prostate calculus:

• Digital Rectal Examination (DRE): A physical exam where a doctor inserts a lubricated and gloved finger into the rectum to feel the prostate gland. This test can help identify abnormalities in the texture, shape, or size of the gland [3][4].
• Transrectal Ultrasound (TRUS): An imaging test that uses sound waves to create images of the prostate gland. TRUS is a common method for detecting prostatic calculi and other prostate-related issues [2][5].
• Prostate-Specific Antigen (PSA) Blood Test: A blood test that measures the level of PSA in the blood. Elevated PSA levels can indicate the presence of prostate cancer or other conditions, including prostatic calculi [11][12].
• Imaging Tests: Other imaging tests such as MRI (especially multiparametric MRI) or CT scans may be used to detect and stage prostate tumors, including those caused by prostatic calculi [13].

Other Diagnostic Methods

In addition to these diagnostic tests, other methods may be used to confirm the diagnosis of prostate calculus. These include:

• Urine Tests: Urinalysis and urine culture may be performed to rule out other conditions that can cause similar symptoms.
• Prostate Cancer Gene 3 (PCA3) Test: A urine-based test designed to look for the PCA3 gene, which is associated with prostate cancer [14].

Staging and Diagnosis

The diagnosis of prostate calculus involves a combination of these tests and examinations. The PHI test, a diagnostic blood test that combines free and total PSA and the (-2) pro-PSA isoform (p2PSA), may also be used to stage prostate cancer [7].

Treatment Options for Prostate Calculus

Prostate calculus, also known as prostatic calculi or prostate stones, can be treated with various medications to alleviate symptoms and improve urine flow.

• Alpha-blockers: These medications help relax the muscles around the prostate and bladder neck, improving urine flow. They are often the first line of treatment for men experiencing discomfort or urinary problems due to the stones.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs may be recommended to relieve pain and inflammation associated with prostate stones.
• Antibiotics: In cases where prostate calculus is accompanied by bacterial infection, antibiotics may be prescribed to treat the underlying infection.

Other Treatment Options

While medications can provide relief from symptoms, in some cases, more invasive treatments may be necessary. These include:

• Surgery: In rare instances, surgery may be required to remove large or obstructive stones.
• Minimally invasive procedures: Techniques such as laser lithotripsy or shockwave lithotripsy may be used to break down and remove smaller stones.

Important Considerations

It's essential to note that not all cases of prostate calculus require treatment. In many instances, the body can naturally flush out small stones with urine. However, if symptoms persist or worsen, medical attention should be sought.

References:

• [3] May 18, 2023 — Antibiotics are the most common therapy used to treat chronic bacterial prostatitis (CBP). Eradication of bacteria is associated with clinical success.
• [5] May 26, 2024 — Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be recommended to relieve pain and inflammation associated with prostate stones.
• [13] However, for men experiencing discomfort or urinary problems due to the stones, several treatment options are available. Medications to improve urine flow and reduce symptoms are often the first line of treatment.

The differential diagnosis of prostate calculus, also known as prostatic stones or calcifications, involves considering various conditions that may present similarly to this condition.

Common Conditions

• Benign Prostatic Hyperplasia (BPH): This is a non-cancerous enlargement of the prostate gland, which can cause symptoms similar to those of prostate calculus, such as urinary obstruction and frequency.
• Prostate Cancer: While rare, prostate cancer can also present with calcifications in the prostate gland. However, this is typically associated with other symptoms like weight loss, fatigue, and difficulty starting or stopping urination.
• Chronic Prostatitis: This is a long-standing inflammation of the prostate gland, which can cause similar symptoms to those of prostate calculus.

Less Common Conditions

• Prostatic Cysts: These are fluid-filled sacs within the prostate gland that can mimic the appearance of calcifications on imaging studies.
• Atrophy and Fibrosis: Age-related changes in the prostate gland can lead to shrinkage (atrophy) or scarring (fibrosis), which may be mistaken for calcifications.

Key Diagnostic Features

To differentiate these conditions, healthcare providers rely on a combination of clinical evaluation, laboratory tests, and imaging studies. Some key diagnostic features include:

• Imaging Studies: Non-contrast helical CT scans are often used to visualize the prostate gland and detect calcifications.
• Clinical Evaluation: A thorough medical history and physical examination can help identify symptoms and signs that may point towards a specific diagnosis.

Treatment and Management

The treatment and management of prostate calculus depend on the underlying cause. For example, if the condition is caused by BPH or chronic prostatitis, treatment may involve medications to alleviate symptoms or address the underlying inflammation. In some cases, minimally invasive surgical procedures like shock wave lithotripsy or endoscopic stone removal may be necessary.

References:

• [10] Endogenous stones are commonly caused by obstruction of the prostatic ducts around the enlarged prostate by benign prostatic hyperplasia (BPH) or by chronic inflammation.
• [11] One of the key mechanisms for development of prostate calcifications is thought to be calcification of the corpora amylacea and simple precipitation of prostatic secretions
• [14] The differential diagnosis of abnormalities in the prostate is broad, covering common (acinar adenocarcinoma, benign prostatic hyperplasia, chronic prostatitis, hemorrhage, cysts, calcifications, atrophy and fibrosis) and less common conditions (tumors other than acinar adenocarcinoma, granulomatous prostatitis containing tuberculosis, abscesses and other conditions, and idiopathic disorders ...
• [13] Differential diagnosis. The differential of renal calculi is essentially that of abdominal calcifications.