Prostatic calculi
{{Infobox medical condition
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|synonyms = prostatic stones, prostatic calcification, prostatic lithiasis
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|caption = Transrectal ultrasound of prostatic stones in the peri-urethral zone of the prostate
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|specialty = Urology
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Prostatic calculi (PC), prostatic stones, prostatic calcification or prostatic lithiasis, are hyper-echoic mineral deposits in the prostate that are frequently detected incidentally during transabdominal ultrasonography, transrectal ultrasonography, or computed tomography.{{Cite journal |last1=Cao |first1=Jun-Jie |last2=Huang |first2=Wei |last3=Wu |first3=Hong-Shen |last4=Cao |first4=Min |last5=Zhang |first5=Yan |last6=Jin |first6=Xiao-Dong |date=July 2018 |title=Prostatic Calculi: Do They Matter? |journal=Sexual Medicine Reviews |language=en |volume=6 |issue=3 |pages=482–491 |doi=10.1016/j.sxmr.2017.10.003 |pmid=29157875 |s2cid=2162594}}{{Cite journal |last1=Wang |first1=Hao |last2=Ma |first2=Ming |last3=Qin |first3=Feng |last4=Yuan |first4=Jiuhong |date=February 2021 |title=The influence of prostatic calculi on lower urinary tract symptoms and sexual dysfunction: a narrative review |journal=Translational Andrology and Urology |volume=10 |issue=2 |pages=929–938 |doi=10.21037/tau-20-1046 |pmc=7947430 |pmid=33718093 |s2cid=232231107 |doi-access=free}}{{Cite journal |last=Hyun |first=Jae Seog |date=2018 |title=Clinical Significance of Prostatic Calculi: A Review |journal=The World Journal of Men's Health |language=en |volume=36 |issue=1 |pages=15–21 |doi=10.5534/wjmh.17018 |issn=2287-4208 |pmc=5756803 |pmid=29076299 |s2cid=19198319}}
Formation
There are two main types of prostatic calculi:
- Endogenous stones: These are small stones formed within the acini of the prostate. They have a higher correlation with age.
- Extrinsic stones: These stones are usually larger and formed due to the reflux of urine into the prostate.
The exact mechanism of the development of prostatic calculi is still unclear.
Prevalence
In a study of young adults in Greece (aged 21–50, mean age 40.9 years), the prevalence was found to be 7.35%.{{Cite journal |last1=Geramoutsos |first1=Ioannis |last2=Gyftopoulos |first2=Kostis |last3=Perimenis |first3=Petros |last4=Thanou |first4=Vasiliki |last5=Liagka |first5=Dimitra |last6=Siamblis |first6=Dimitrios |last7=Barbalias |first7=George |date=2004 |title=Clinical Correlation of Prostatic Lithiasis with Chronic Pelvic Pain Syndromes in Young Adults |journal=European Urology |language=en |volume=45 |issue=3 |pages=333–338 |doi=10.1016/j.eururo.2003.09.020|pmid=15036679 }} While among urologic patients in South Korea (aged 29–89, mean age 61.9 years), the prevalence was 40.7%.{{Cite journal |last1=Lee |first1=Sang Eun |last2=Ku |first2=J.A. Hyeon |last3=Park |first3=Hyoung Keun |last4=Jeong |first4=Cheol Kwak Hyeon |last5=Kim |first5=Seung Hyup |date=2003 |title=Prostatic Calculi Do Not Influence The Level of Serum Prostate Specific Antigen in Men Without Clinically Detectable Prostate Cancer or Prostatitis |journal=Journal of Urology |language=en |volume=170 |issue=3 |pages=745–748 |doi=10.1097/01.ju.0000081650.23715.4c |pmid=12913688 |issn=0022-5347}}
The prevalence is notably higher in patients with benign prostatic hyperplasia, ranging from 68.8% to 70%. Additionally, a study conducted in Cleveland reported that 46.8% of patients with chronic pelvic pain had stones larger than 3mm.{{Cite journal |last1=Shoskes |first1=Daniel A. |last2=Lee |first2=Chun-Te |last3=Murphy |first3=Donel |last4=Kefer |first4=John |last5=Wood |first5=Hadley M. |date=2007 |title=Incidence and Significance of Prostatic Stones in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome |url=https://linkinghub.elsevier.com/retrieve/pii/S0090429507004943 |journal=Urology |language=en |volume=70 |issue=2 |pages=235–238 |doi=10.1016/j.urology.2007.04.008|pmid=17826477 |url-access=subscription }}
Composition
Calcium phosphate is the most common component of prostatic calculi, accounting for more than 80% of cases.
Clinical significance
Most cases of prostatic calculi are asymptomatic. It's clinical significance is debated. While some studies report no significant association between PC and lower urinary tract symptoms (LUTS), others suggest it can aggravate LUTS, chronic prostatitis, and sexual dysfunction.