Effects of Calcium Oxalate on Expression of Clusterin and Lower Urinary Tract Symptoms in Prostatitis and Benign Prostatic Hyperplasia Patients with Calculi

Abstract

BackgroundProstatic calculi are common in urological treatments. Our major purpose in the present study was to explore the occurrence and composition of prostatic calculi, and investigate the effect of calcium oxalate (CaOx) on clusterin expression and lower urinary tract symptom (LUTS) in prostatitis and benign prostatic hyperplasia (BPH) patients with calculi.Material/MethodsFrom December 2016 to January 2017, a total of 79 prostatitis patients aged more than 50 years were enrolled. The patients were divided into 3 groups: group A had small calculi (discrete, small echoes); group B had large calculi (large masses of multiple echoes, much coarser), and group C had no calculi. Immunohistochemical analysis was performed to evaluate the tissue scores. The clusterin expression was detected by quantitative real-time CR (qRT-PCR), Western blot, and immunofluorescence.ResultsAccording to multifactor analysis, age was significantly associated with prostatic calculus. The composition of prostatic calculus was an independent factor of LUTS. The clusterin expression was elevated in group B. The mRNA and protein levels of clusterin in prostatitis and BPH patients with stones were obviously higher than those in prostatitis and BPH patients without stones. CaOx enhanced clusterin expression in a dose-dependent manner.ConclusionsLarge prostatic calculi were associated with LUST. Furthermore, CaOx enhanced clusterin expression, leading to large prostatic calculi. These results may provide a therapeutic strategy for prostatitis and BPH.

The influence of prostatic calculi on lower urinary tract symptoms and sexual dysfunction: a narrative review

“…Sun et al enrolled 79 prostatitis patients over 50 years of age, and the composition of PC in patients with LUTS was detected by quantitative realtime polymerase chain reaction, Western blotting, and immunofluorescence. Their conclusion suggested that large PC were related to LUTS, and that calcium oxalate (the main component of PC) leads to the occurrence of large PC (16). The results of Geramoutsos et al are consistent with those of Sun et al; that is, the small PC observed in elderly men were normal, but large PC were associated with chronic prostate inflammation and LUTS (26).…”

“…The results of the reviewed studies suggested that type I PC may be caused by the obstruction of prostatic secretions around benign prostatic hyperplasia or occlusion caused by chronic inflammation (1), and that type II PC may be associated with urinary reflux, which leads to the formation of PC via changing local ion and pondus hydrogenii (2,9). Other studies have analyzed the chemical composition of PC and consistently reported that calcium phosphate stones were the main components of PC (16). However, there does exist an inconsistency, as calcium phosphate is not a component of prostate secretion.…”

“…Large or marked PC is a significant risk factor for severe LUTS (16,26,28,30,43). Sun et al enrolled 79 prostatitis patients over 50 years of age, and the composition of PC in patients with LUTS was detected by quantitative realtime polymerase chain reaction, Western blotting, and immunofluorescence.…”

Extracorporeal Shock Wave Therapy in the Treatment of Chronic Calculous Prostatitis

“…There are data both in favor and against the connection between lower urinary tract symptoms and the presence of prostate calcifications. Gross calcification of the prostate can be associated with inflammation and requires further evaluation and, if necessary, treatment of its consequences [1][2][3][4]. In clinical practice, in such a case, we diagnose chronic calculous prostatitis, which in most cases proceeds as chronic pelvic pain syndrome.…”