Prostatic calculi
Prostatic calculi are of two varieties:
endogenous, which are common, and exogenous, which are comparatively rare.
An exogenous prostatic calculus is a urinary (commonly ureteric) calculus that
becomes arrested in the prostatic urethra. This is considered in Chapter 60.
Endogenous prostatic calculi are usually composed of calcium phosphate combined
with about 20 per cent of organic material.
Clinical features
Prostatic calculi are usually symptomless,
being discovered on TRUS, radiography of the pelvis, during prostatectomy, or
associated with carcinoma of the prostate or chronic prostatitis. In cases
associated with severe chronic prostatic infection, the associated fibrosis and
nodularity are difficult to differentiate from carcinoma. On X-ray or ultrasound
scanning, these stones often form a horseshoe (Fig.
66.15) or a circle.
Treatment of
prostatic calculi
They usually require no treatment.
Conservative
measures
Associated chronic prostatic infection may be
treated by means of ciprofloxacin or trimethoprim.
Transurethral
resection
Transurethral resection will often release
small calculi as the strips of prostatic tissue are excised. Others are passed per
urethram at a later date.
Corpora
amylaceae
Corpora amylaceae are tiny calcified
lamellated bodies found in the glandular alveoli of the prostates of elderly men
and apes, but not in the prostates of animals lower in the phylogenetic scale
than anthropoids. Corpora amylaceae are probably the forerunners of endogenous
prostatic calculi.