Prostatic Calculi: A Review of the Literature

Background: Prostatic calculi are common in men who are evaluated for benign prostatic hyperplasia (BPH) or prostate cancer, but the significance of prostatic calculi with respect to urological diseases and symptoms is obscure. In most cases, when symptoms are present, they are usually nonspecific. The majority of calculi are discovered incidentally, usually by means of a radiological investigation for other medical conditions. The incidental finding of prostatic calculi often produces a diagnostic and therapeutic dilemma. Objective: To review the literature on prostatic calculi Results: Prostatic calculi are presumed to be formed by the precipitation of prostatic secretions and calcification of the corpora amylacea under inflammatory conditions. The number of calculi found in the prostate gland may vary from single to several hundreds. There are no specific symptoms that are pathognomonic for the presence of prostatic calculi. A number of men with prostatic calculi may have no symptoms. The symptoms when they occur may be related to prostatic hypertrophy, chronic prostatitis or perhaps urethral stricture. Diagnosis of prostatic calculi may be made following digital rectal examination, plain radiographs or ultrasound scan. Asyptomatic patients with prostatic calculi do not require any treatment but those patients who have symptoms may require treatment to remove the calculi. Recurrences of prostatic calculi may be observed after treatment of prostatic calculi for a number of reasons which may be summarized as follows: 1. After prostatotomy if related diverticula are not excised or obliterated recurrence of prostatic calculi may occur. 2. De novo calculi may subsequently form in the remaining cavities of the prostate gland. 3. False recurrences which represent calculi that were overlooked at the time of the original operation may be subsequently identified. In view of this plain radiographs or ultrasound scans should be performed post-operatively to ensure there are no residual stones before the patients are discharged. 4. Following trans-urethral resection true or new calculi may subsequently form. Conclusions: Prostatic calculi quite often are asyptomatic. Prostatic calculi may also co-exist with prostatitis or benign prostatic hyperplasia (BPH) in elderly men. These patients suffer LUTS for underlying prostatic disease, such as prostatitis or BPH. It is unclear whether prostatic calculi independently produce LUTS. Recurrences of prostatic calculi may be observed after treatment of prostatic calculi for a number of reasons. Plain radiographs or ultrasound scans should be performed post-operatively to ensure there are no residual stones before the patients are discharged.