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.