Chalcolithic prostatitis

Chalcolithic prostatitis is accompanied by increased urination, dull, aching pain in the lower abdomen and perineum, erectile dysfunction, the presence of blood in the semen, and prostatorrhea. Chalcolithic prostatitis can be diagnosed using a digital prostate exam, a prostate ultrasound, a urography, and a laboratory test. Conservative therapy of chalcolithic prostatitis is carried out with the help of drugs, phytotherapy and physiotherapy; If these measures are ineffective, destruction of the stones with a low-intensity laser or surgical removal is indicated.

general informations

Chalcolithic prostatitis is a form of chronic prostatitis, accompanied by the formation of stones (prostatoliths). Chalcolithic prostatitis is the most common complication of a long-term inflammatory process in the prostate gland, which specialists in the field of urology and andrology have to deal with. During preventive ultrasound examination, prostate stones are detected in 8. 4% of men of various ages. The first age peak in the incidence of stone prostatitis occurs between 30-39 years of age and is due to an increase in cases of chronic prostatitis caused by sexually transmitted diseases (chlamydia, trichomoniasis, gonorrhea, ureaplasmosis, mycoplasmosis, etc. ) . In men aged 40 to 59 years, stone prostatitis, as a rule, develops against the background of prostatic adenoma, and in patients over 60 years of age it is associated with a decline in sexual function.

Causes of chalcolithic prostatitis

Depending on the cause of formation, prostate stones can be true (primary) or false (secondary). Primary stones initially form directly in the acini and ducts of the gland, secondary stones migrate into the prostate from the upper urinary tract (kidneys, bladder or urethra) if the patient suffers from urolithiasis.

The development of stone prostatitis is caused by congestive and inflammatory changes in the prostate gland. Impaired emptying of the prostate glands is caused by BPH, irregularity or lack of sexual activity, and a sedentary lifestyle. In this context, the addition of a slow infection of the genitourinary tract leads to obstruction of the prostatic ducts and a change in the nature of prostatic secretion. In turn, prostatic stones also favor the chronic inflammatory process and the stagnation of secretions in the prostate.

In addition to stagnation and inflammatory phenomena, urethroprostatic reflux plays an important role in the development of calculous prostatitis - the pathological reflux of a small amount of urine from the urethra into the prostatic ducts during urination. At the same time, the salts contained in the urine crystallize, thicken and, over time, transform into stones. The causes of urethro-prostatic reflux can be urethral strictures, trauma to the urethra, atony of the prostate and seminal tubercle, previous transurethral resection of the prostate, etc.

The morphological core of prostatic stones are amyloid bodies and desquamated epithelium, which are gradually "covered" with phosphate and calcareous salts. Prostatic stones are found in cystically dilated acini (lobules) or excretory ducts. Prostatoliths are yellowish in color, spherical in shape and variable in size (on average from 2. 5 to 4 mm); they can be single or multiple. In terms of chemical composition, prostate stones are identical to bladder stones. With chalcolithic prostatitis, oxalate, phosphate and urate stones are most often formed.

Symptoms of chalcolithic prostatitis

The clinical manifestations of chalcolithic prostatitis generally resemble the course of chronic inflammation of the prostate. The main symptom in the clinic of stone prostatitis is pain. The pain is dull, aching in nature; located in the perineum, scrotum, above the pubis, sacrum or coccyx. Exacerbation of painful attacks may be associated with defecation, sexual intercourse, physical activity, prolonged sitting on a hard surface, prolonged walking or driving on rough roads. Chalcolithic prostatitis is accompanied by frequent urination, sometimes by complete urinary retention; haematuria, prostatorrhea (loss of prostatic secretions), haemospermia. Characterized by decreased libido, weak erection, reduced ejaculation and painful ejaculation.

Endogenous prostatic stones can remain in the prostate gland for a long time without symptoms. However, a long course of chronic inflammation and associated calculous prostatitis can lead to the formation of a prostatic abscess, the development of vesiculitis, atrophy and sclerosis of the glandular tissue.

Diagnosis of calculous prostatitis

To establish a diagnosis of stone prostatitis, a consultation with a urologist (andrologist), an assessment of existing complaints, and a physical and instrumental examination of the patient are necessary. When performing a digital rectal examination of the prostate, palpation determines the lumpy surface of the stones and a kind of crepitus. Using transrectal ultrasound of the prostate gland, stones are detected in the form of hyperechoic formations with a clear acoustic trace; their location, quantity, size and structure are clarified. Sometimes urography, CT and MRI of the prostate are used to detect prostatoliths. Exogenous stones are diagnosed by pyelography, cystography and urethrography.

The instrumental examination of a patient with calculous prostatitis is completed by laboratory diagnostics: examination of prostatic secretions, bacteriological culture of urethral secretions and urine, PCR examination of scrapings for sexually transmitted infections, biochemical analysis of blood and urine, determination of prostate level -specific antigen, sperm biochemistry, ejaculate culture, etc.

When carrying out an examination, stone prostatitis is differentiated from prostatic adenoma, tuberculosis and prostate cancer, chronic bacterial and abacterial prostatitis. In chalcolithic prostatitis not associated with prostatic adenoma, the volume of the prostate gland and the PSA level remain normal.

Treatment of chalcolithic prostatitis

Uncomplicated stones in combination with chronic inflammation of the prostate gland require conservative anti-inflammatory therapy. Treatment of chalcolithic prostatitis includes antibiotic therapy, non-steroidal anti-inflammatory drugs, herbal medicine, physiotherapeutic procedures (magnetic therapy, ultrasound therapy, electrophoresis). In recent years, low-intensity laser has been used successfully to noninvasively destroy prostate stones. Prostate massage for patients with stone prostatitis is strictly contraindicated.

Surgical treatment of stone prostatitis is usually required in the case of a complicated course of the disease, in combination with prostatic adenoma. When a prostate abscess is formed, the abscess is opened and, along with the outflow of pus, the passage of stones is also noted. Sometimes mobile exogenous stones can be instrumentally pushed into the bladder and subjected to lithotripsy. Removal of large fixed stones is carried out during the process of perineal or suprapubic section. When prostatitis stones are combined with BPH, the optimal method of surgical treatment is adenomectomy, TUR of the prostate, prostatectomy.

Treatment of chalcolithic prostatitis

Chalcolithic prostatitis is an inflammation of the prostate gland, complicated by the formation of stones. This type of prostatitis is a consequence of long-term chronic inflammation of the prostate. The disease is accompanied by frequent urination, aching and nagging pain in the lower abdomen and perineum, erectile dysfunction and the presence of blood inclusions in the ejaculate.

Causes of this disease

Calculosis is a form of chronic prostatitis characterized by the formation of stones. The disease is often a complication of a long-term inflammatory process in the prostate. Against the background of chronic inflammation, under the influence of negative internal and external factors, secretion stagnates, which over time crystallizes and turns into stones.

In addition to congestion and inflammatory phenomena, urethroprostatic reflux, characterized by the pathological reflux of a small amount of urine from the urethra into the prostate ducts during urination, plays an important role in the development of stone prostatitis. The salts contained in the urine gradually crystallize and over time turn into dense stones. Common causes of urteroprostatic reflux:

• urethral lesions;
• atony of the prostate gland and seminal tubercle;
• previous surgeries and invasive procedures.

Other pathologies that increase the risk of stone formation in the prostate:

• varicose veins of the small pelvis;
• metabolic disorders due to systemic pathologies;

Factors contributing to the development of chalcolithic prostatitis:

• an inactive lifestyle that contributes to the development of stagnant processes in the pelvic organs;
• irregular sexual life;
• alcohol abuse, smoking;
• uncontrolled use of certain groups of drugs;
• damage to the prostate during surgical procedures, long-term catheterization.

Types of stones in chalcolithic prostatitis

Depending on the number of stones, there are single and multiple. Depending on the underlying causes, prostate stones are:

• REAL. They form directly in the acini and ducts of the gland.
• False. They migrate to the prostate from the upper urinary tract: kidneys, bladder, urethra.

Stone formation in the prostate gland is identical in composition to bladder stones. With calculous prostatitis, the following types of stones are most often formed:

Symptoms of the disease

Symptoms of stone prostatitis resemble the course of a chronic inflammatory process. The main symptom in the clinical picture of the disease is pain, the nature of which can be painful and boring. Location of pain: sacrum or coccyx.

A painful attack worsens during defecation, sexual intercourse, physical activity, prolonged sitting on a hard surface, and prolonged walking.

Other symptoms of pathology:

• frequent urination or complete urinary retention;
• hematuria and presence of blood inclusions in the ejaculate;
• prostatorrhea – loss of prostatic secretions;
• decreased libido, erectile dysfunction, painful ejaculation;
• neurological disorders: irritability, increased fatigue, insomnia.

If you experience any of the symptoms listed above, you should make an appointment with a urologist as soon as possible. The lack of adequate treatment and the long course of chronic calculous prostatitis are fraught with serious, sometimes life-threatening consequences:

• atrophy and sclerosis of glandular tissues;
• prostatic abscess.

Diagnostics

To establish an accurate diagnosis, a consultation with a urologist-andrologist is necessary. During the initial examination, the specialist carefully listens to the patient's complaints, collects the medical history and asks additional questions that will help determine the causes of prostatitis and risk factors.

Next, the doctor performs a rectal exam of the prostate, which involves palpating the gland through the rectum. The technique allows you to evaluate the size, shape, structure of the gland, detect stones, determine the inflammatory process by increasing the size and pain when pressing. To confirm the diagnosis, additional laboratory and instrumental methods are prescribed.

Laboratory diagnostics

A number of additional laboratory tests used to diagnose stone prostatitis:

• Culture of prostate secretions. An important information method for identifying pathogenic microorganisms and diagnosing the inflammatory process in the prostate gland.
• Urine culture. It allows you to detect a pathogenic infection in urine and determine its type and concentration. Culture is performed to clarify the diagnosis if inflammation of the prostate gland is suspected.
• PCR study of scrapings. It allows you to detect sexually transmitted infections and identify the pathogen.
• PSA analysis. It allows you to exclude prostate cancer, which often occurs against the background of prostatitis.
• General clinical analysis of blood and urine. It is prescribed to identify hidden inflammatory processes in the urinary tract and kidney disorders.
• Spermogram. Ejaculate analysis to exclude or confirm infertility.

Instrumental diagnostics

Instrumental methods used to diagnose the pathology:

Ultrasound of the prostate. It allows you to detect stones, clarify their position, quantity, size, structure. Ultrasound will also help differentiate inflammation of the prostate from other diseases accompanied by similar symptoms.

Survey urography. An X-ray method with contrast enhancement, which allows you to detect prostate stones, their size and location.

CT or MRI of the prostate. It allows layer-by-layer scanning of the prostate gland and surrounding tissues. Using CT or MRI images, the doctor can study the structure of the prostate in detail, detect pathological foci, evaluate its location, size and relationship with surrounding tissues.

Treatment of chalcolithic prostatitis

If the disease is not complicated and the general condition of the patient is satisfactory, treatment of chalcolithic prostatitis is carried out on an outpatient basis. If the disease is accompanied by complications, combined with prostatic adenoma, hospitalization of the patient is necessary.

Conservative treatment

The main goals of conservative therapy are the elimination of pathological symptoms. For this, the patient is prescribed a course of drug therapy, which involves the use of the following groups of drugs:

• Antibiotics. Destroy the infection, stop the inflammation. The type of drug, dosage and duration of the course for each patient are determined individually.
• Non-steroidal anti-inflammatory drugs. They stop the inflammatory process and help eliminate pathological symptoms: pain, swelling.
• Antispasmodics. Relieves muscle spasms and relieves pain.
• Alpha adrenergic blockers. Facilitate the urination process.
• Vitamin-mineral complexes, immunomodulators. Strengthen the immune system and promote a speedy recovery.

As a complement to complex drug therapy, doctors often prescribe physiotherapeutic procedures that allow:

• eliminate stagnant processes;
• activate tissue regeneration.
• The most effective methods of physiotherapy for stone prostatitis:
• ultrasound therapy, shock wave therapy.

The effective treatment of calculous prostatitis is guaranteed by lifestyle changes. To prevent relapses, it is recommended to include physical activity, especially if work forces you to lead a sedentary lifestyle. Moderate physical activity improves blood circulation in the pelvic organs, eliminates congestion and strengthens local immunity.

Surgery

Surgical treatment is carried out in case of complicated course of the disease and combination with prostatic hyperplasia. When an abscess forms, the surgeon opens the abscess. Along with the outflow of pus, the passage of stones is often observed. Large fixed stones are removed during perineal or suprapubic section. When chalcolithic prostatitis is combined with benign prostatic hyperplasia, the optimal method of surgical treatment is transurethral resection of the prostate.

Chronic calculous prostatitis

The term chalcolithic prostatitis defines the pathology of the prostate gland, in which stones form in its tubules. This disease is characterized by reduced erection of the penis and pain in the groin area.

Causes and mechanism of development of calculous prostatitis

A prolonged inflammatory process or congestion in the prostatic tubules leads to the accumulation of secretions and mucus inside them. Bacteria settle on these accumulations and calcium salts precipitate. The mucus becomes thicker over time and turns into small, sand-like stones. They come together and form pebbles.

There are several predisposing factors for the development of stone prostatitis:

• Chronic sexually transmitted infections (STDs)
• prolonged course of the infectious process with inflammation of the ducts and tissues of the prostate;
• prostate congestion, which is mainly associated with a man's irregular sexual life;
• urethro-prostatic reflux - pathological reflux of a small volume of urine into the prostate;
• genetic predisposition – presence of relatives with chalcolithic prostatitis.

Knowledge of the causes of the development of stones in the prostate gland is necessary for adequate and high-quality etiological therapy, which helps to prevent the new development of stone prostatitis.

Symptoms of chalcolithic prostatitis

Symptoms of chalcolithic prostatitis develop over a long period of time, and a man may not pay attention to them. The clinical picture of the disease may include symptoms such as dull, aching pain in the lower abdomen and lower back, sacrum, perineum and pubis.

Pain may begin or intensify after defecation, sexual intercourse, strenuous physical activity, and other provoking factors. Dysuric disorders are noted: frequent need to go to the toilet, painful or difficult urination, burning in the urethra and lower abdomen, and sometimes urinary retention occurs due to obstructions in the form of stones.

Patients experience prostatorrhea - involuntary secretion of the prostate gland during rest or during physical exertion, tension during bowel movements or urination. There may be blood in your urine and semen.

Almost always, against the background of persistent inflammation with stone formation, sexual dysfunctions develop: weakened erection, premature ejaculation, decreased libido.

The main signs of chalcolithic prostatitis include:

• erectile dysfunction;
• pain in the groin area, which can be spasmodic and paroxysmal in nature;
• during ejaculation – indicates damage to the vessels of the prostatic tubules due to sharp edges of the stones;
• premature and painful ejaculation.

Such symptoms lead to a decrease in sexual desire.

Often men attribute this to the age factor, mistakenly believing that such sexual dysfunctions will not disappear. Sometimes they begin self-medication using various erection-stimulating drugs (PDE-5 inhibitors).

This approach is very dangerous, since it can aggravate the course of the pathological process and lead to the development of complications.

Prostatitis is an inflammatory pathological process in the prostate gland of a man. In most cases, it is caused by an infection, which gradually leads to a long-term chronic course of the disease and the development of complications.

The treatment of chalcolithic prostatitis is complex

• antibiotics,
• anti-inflammatory drugs,
• enzymes
• immune drugs
• phytotherapy,
• physiotherapeutic procedures.

Antibacterial agentsprescribed as part of etiotropic treatment. Their intake is necessary to suppress the activity of the causative agent of the infectious-inflammatory process. It can be both non-specific microbial flora (streptococci, staphylococci, enterococci, Escherichia coli, Proteus), and specific pathogens of urogenital infections - gonococci, chlamydia, ureaplasma, trichomonas, etc.

The choice of antibiotics can be based on the results of a culture study of prostatic secretions and on the determination of the sensitivity of the microbial pathogen to the drugs. Sometimes antibiotics are prescribed empirically based on the scientifically proven antimicrobial efficacy of the drugs. The selection of antibiotics, determination of the dose and duration of their use can be carried out exclusively by the attending physician, since their uncontrolled use can lead to serious complications and aggravate the course of the underlying disease.

If the tissues of the prostate gland are parasitized by polyassociated microbial flora (bacterial, viral microorganisms, protozoa), the etiotropic therapeutic regimen will consist of a complex of several drugs acting in a certain antimicrobial spectrum.

To stimulate the body's immune defensesand its resistance to infections, immunomodulatory drugs are prescribed: Immunomax, Panavir, Interferon and its derivatives. To improve the antimicrobial effect of etiotropic drugs, enzymatic agents are prescribed along with them: longidase, chemotrypsin. They facilitate the release of active antibiotic substances in the affected tissues, have an indirect analgesic effect and have an anti-inflammatory and regenerating effect.

The pain syndrome is relievedusing nonsteroidal anti-inflammatory drugs. Along with antibiotic therapy, probiotics are prescribed to prevent the development of intestinal dysbiosis. To protect the liver parenchyma from the toxic effects of antibacterial drugs and improve its functional state, hepaprotectors are prescribed. After the acute inflammatory phenomena subside, physiotherapeutic procedures are prescribed: laser treatment, magnetic therapy, mud therapy, galvanization, medicinal electrophoresis, reflexology therapy, hardware treatment, etc.

This improves metabolic processes, microcirculation, lymphatic drainage and trophism of the prostate tissue, stimulates the restoration of its functional state and helps resolve inflammatory processes. A low-frequency laser is used to destroy the stones. It shatters stones and allows small stones to escape from the tubules. In case of complications in the form of adenoma or prostatic abscess (a limited cavity filled with pus), surgical intervention is performed.

This involves the removal of part of the prostate gland (resection). To avoid this, at the first signs of pathology, which are expressed in erectile dysfunction, it is necessary to consult a doctor. Self-medication or ignoring the problem always leads to the subsequent development of complications.