The presence of stones in the prostate (also known as prostatic stones and prostate calculi) is common, yet many men are not aware of the role they may play in prostatitis. Just how bothersome can these calcifications be? What should you know about prostate stones and prostatitis?
What are prostate stones?
Prostate stones are believed to be formed through several different avenues. One idea is that when secretions from the prostate are unable to escape the gland because of inflammation or growth (e.g., benign prostatic hypertrophy [BPH]), the secretions thicken and bond with proteinaceous substances. These in turn become calcified.
Another possibility is when men have an infection with pus and other debris, they eventually transform into stones. Prostatic stones also may form from calcification of waste material in the ejaculatory ducts.
Men can have as few as one to hundreds of prostatic stones, and they may not even know it. Yes, even if there are dozens or scores of tiny (about 1-4 mm typically) stones in a man’s prostate, he may have no symptoms.
However, when symptoms do appear, they may be associated with chronic prostatitis, BPH, or urethral stricture. The presence of prostate stones may contribute to inflammation of the prostate by blocking the central prostatic ducts. This in turn prevents urine from exiting and then provides a breeding ground for bacteria.
Since symptoms of prostate stones can be the same as those seen in cases of prostatitis (e.g., lower urinary tract symptoms, aching pain in the lower back), men and their physicians may not think to look for the presence of stones. For now, experts are not certain whether prostate stones independently cause lower urinary tract symptoms.
Do you have prostate stones?
Your doctor can make a diagnosis of prostatic stones using digital rectal examination, plain X-rays, or an ultrasound scan. They also can be found during transurethral resection of the prostate (TURP).
In a study reported in Urology, experts looked at the incidence of prostate stones in men who had chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Of the 47 men, all of whom had undergone transrectal ultrasonography, nearly half (47%) of them had significant stones.
When the men with and without calcifications were compared, the authors concluded that men with prostate stones had greater presence of bacteria and inflammation and had experienced symptoms longer than had men without stones.
What to do about prostate stones and prostatitis
Treatment of prostate stones typically includes the following options.
Antibiotics. These are prescribed to treat bacterial infection and usually are necessary for 8 to 10 weeks. However, even if the infection is resolved, the stones are still there and so inflammation continues.
Transurethral resection of the prostate (TURP). This involves partial removal of the prostate. One downside of this approach is the lack of a guarantee that all of the stones will be located and removed.
TURP plus ultrasound. This approach allows the surgeon to visualize the prostatic stones, so chances are much better that all the offenders will be removed.
Supra-pubic prostatectomy. This surgical procedure is usually reserved for men who have large stones or significant enlargement of the prostate.
In addition to these options, men should make some lifestyle modifications to facilitate the healing process, especially reduction of inflammation. It’s time to cut out sugary foods, saturated fats (e.g., sirloin steak, butter), and processed foods and focus on whole foods (veggies, fruits, nuts, seeds, organic whenever possible), fatty fish, and choices high in lycopene (promotes prostate health). Also explore supplements associated with fighting inflammation of prostatitis, such as green tea, curcumin, and stinging nettle.
Have you and your doctor discussed the possibility of your having prostate stones? Men who have infected prostatic stones may experience recurring urinary tract infections. If this is the case, the buggers may need to be removed before such infections or chronic prostatitis can be resolved. Let’s hope your prostate is not harboring these calcifications. However, if it is, treating them may put you on the road to a more rapid recovery.
Shoskes DA et al. Incidence and significance of prostatic stones in men with chronic prostatitis/chroic pelvic pain syndrome. Urology 2007 Aug; 70(2): 235-38