Kalkulezny prostatitis – the complication of a chronic inflammation of a prostate gland which is characterized by formation of concrements in atsinusa or output channels of gland. Kalkulezny prostatitis is followed by increase of an urination, the dull aching aches in the bottom of a stomach and a crotch, violation of an erection, blood impurity availability in semen, prostatorey. Kalkulezny prostatitis can be diagnosed by means of a manual research of a prostate, ultrasonography of a prostate gland, survey urography, laboratory inspection. Conservative therapy of kalkulezny prostatitis is carried out by means of medicines, phytotherapy, physical therapy; at inefficiency of these actions destruction of stones by the low-intensive laser or surgical removal is shown.
Kalkulezny prostatitis – the form of chronic prostatitis which is followed by formation of concrements (prostatolit). Kalkulezny prostatitis is the most frequent complication is long the current inflammatory process in a prostate gland which experts should face in the field of urology and andrology. At preventive ultrasonography stones of a prostate come to light at 8,4% of men of various age. The first age peak of incidence of kalkulezny prostatitis falls on 30-39 years and is caused by increase in the cases of chronic prostatitis caused by STD (clamidiosis, trichomoniasis, gonorrhea, ureaplasmosis, mycoplasmosis, etc.). At men of 40-59 years kalkulezny prostatitis, as a rule, develops against the background of prostate gland adenoma, and at patients 60 years are more senior it is connected with fading of sexual function.
Reasons of kalkulezny prostatitis
Depending on the education reason stones of a prostate gland can be true (primary) or false (secondary). Primary concrements are initially formed directly in atsinusa and channels of gland, secondary – migrate in a prostate from the top uric ways (kidneys, a bladder or an urethra) in the presence at the patient of an urolithic disease.
Development of kalkulezny prostatitis is caused by stagnant and inflammatory changes in a prostate gland. Violation of depletion of pro-static pieces of iron is promoted by DGPZh, an irregularity or lack of sex life, an inactive way of life. On this background accession of a slow infection of an urinogenital path leads to obstruction of channels of a prostate gland and change of character of a secret of a prostate. In turn, prostate gland stones also support chronic inflammatory process and stagnation of a secret in a prostate.
Except the stagnant and inflammatory phenomena, an important role in development of kalkulezny prostatitis is played by an uretro-pro-static reflux – pathological throwing of a small amount of urine from an urethra to canals of a prostate gland at an urination. At the same time the salts which are contained in urine crystallize, condensed and over time and turn into stones. As the reasons of an uretro-pro-static reflux striktura of an urethra, an urethra injury, an atoniya of a prostate and a seed hillock, the postponed transurethral resection of a prostate gland, etc. can serve.
As morphological kernel for concrements of a prostate serve amyloid little bodies and a slushchenny epithelium which gradually "acquire" fosfornokisly and limy salts. Stones of a prostate gland lie in kistozno the stretched atsinusa (segments) or in output channels. Prostatolita have yellowish color, spherical shape, various size (on average from 2,5 to 4 mm); can be single or multiple. On the chemical composition concrements of a prostate gland are identical to bladder stones. At kalkulezny prostatitis oksalatny, phosphatic and uratny stones are most often formed.
Symptoms of kalkulezny prostatitis
Clinical displays of kalkulezny prostatitis in general remind a current of a chronic inflammation of a prostate. As the leader in clinic of kalkulezny prostatitis the pain syndrome acts. Pains differ in the stupid, aching character; are localized in a crotch, a scrotum, over a pubis, in a sacrum or a tailbone. The aggravation of painful attacks can be connected with defecation, sexual intercourse, physical activity, long sitting on a rigid surface, long walking or jolty driving. Kalkulezny prostatitis is followed by the speeded-up urination, sometimes - a full delay of urine; gematuriy, prostatorey (expiration of a secret of a prostate gland), gemospermiya. Decrease in sexual desire, a weak erection, violation of an ejaculation, a painful ejaculation is characteristic.
Endogenous stones of a prostate can be long time in a prostate gland asymptomatically. Nevertheless, the long current of a chronic inflammation and the related kalkulezny prostatitis can lead to formation of abscess of a prostate gland, development of a vezikulit, atrophy and a sklerozirovaniye of ferruterous fabric.
Diagnosis of kalkulezny prostatitis
Establishment of the diagnosis of kalkulezny prostatitis requires consultation of the specialist urologist (andrologist), assessment of the available complaints, fizikalny and tool inspection of the patient. When carrying out a rectal manual research of a prostate the hilly surface of concrements and a peculiar krepitation is palpatorno defined. By means of transrectal ultrasonography of a prostate gland stones come to light in the form of giperekhogenny educations with an accurate acoustic path; their localization, quantity, the size and structure is specified. Sometimes for detection of prostatolit the survey urography, prostate KT and MPT is used. Exogenous concrements are diagnosed at a piyelografiya, a tsistografiya and an uretrografiya.
Tool inspection of the patient with kalkulezny prostatitis is supplemented with laboratory diagnostics: the prostate secret research, bacteriological crops separated an urethra and urine, a scrape PTsR-research on sexually transmitted infections, biochemical blood test and urine, determination of level of a prostatspetsifichesky anti-gene, sperm biochemistry, crops of an eyakulyat, etc.
When carrying out inspection kalkulezny prostatitis is differentiated from adenoma of a prostate, tuberculosis and a prostate cancer, chronic bacterial and abacterial prostatitis. At the kalkulezny prostatitis which is not associated with prostate adenoma, the volume of a prostate gland and the DOG level remain normal.
Treatment of kalkulezny prostatitis
Uncomplicated stones in combination with a chronic inflammation of a prostate gland demand performing conservative anti-inflammatory therapy. Treatment of kalkulezny prostatitis includes antibiotic treatment, reception of nonsteroid anti-inflammatory medicines, phytotherapy, physiotherapeutic procedures (magnetotherapy, ultrasonic therapy, an electrophoresis). The low-intensive laser is successfully used to noninvasive destruction of stones of a prostate in recent years. Massage of a prostate gland is categorically contraindicated to patients with kalkulezny prostatitis.
Surgical treatment of kalkulezny prostatitis usually is required in case of the complicated course of a disease, its combination to prostate adenoma. When forming abscess of a prostate gland opening of an abscess is made, together with outflow of pus also the otkhozhdeniye of stones is noted. Sometimes mobile exogenous stones manage to be pushed instrumentalno in a bladder and to subject lithotripsies. Removal of the fixed concrements of the big sizes is made in the course of promezhnostny or nadlobkovy section. At a combination of kalkulezny prostatitis to DGPZh as an optimum method of surgical treatment serve the adenomektomiya, the TOUR of a prostate, a prostatektomiya.
Forecast and prevention of kalkulezny prostatitis
In most cases forecast of conservative and surgical treatment of kalkulezny prostatitis favorable. A complication of promezhnostny removal of stones of a prostate gland not healing uric fistulas can serve long. In the absence of treatment the abstsedirovaniye and a sclerosis of a prostate gland, an urine incontience, impotence, male infertility becomes an outcome of kalkulezny prostatitis.
The most effective measure of the prevention of a kamneobrazovaniye in a prostate gland is the address to the expert at emergence of the first symptoms of prostatitis. The important role belongs to the prevention of STD, elimination of the contributing factors (an uretro-pro-static reflux, exchange violations) corresponding to age of physical and sexual activity. Preventive visits to the urologist, timely treatment of an urolitiaz will help to avoid development of kalkulezny prostatitis.