Prospective Study on Association of Prostatic Calcifications with Clinical Symptoms and Results of Treatment in Men with type III prostatitis

Abstract

The purpose is to investigate the clinical significance of prostatic calculi in patients with chronic prostatitis and to discuss the possible treatment.The data from 277 young males with CP/CPPS were analyzed prospectively. Symptom severity was measured using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostatic Symptoms Score (IPSS). Sexual function was assessed by the International Index of Erectile Function (IIEF-5) questionnaire. After four weeks of therapy, the NIH-CPSI, IPSS, and IIEF-5 tests were repeated. The variables were compared between patients with and without prostatic calcifications using the Students t-test or chi-square test. No significant differences were found between CP/CPPS patients with and without prostatic calcifications regarding age, body mass index, prostate volume, CPSI, IPSS and IIEF-5. Men with calcifications endured symptoms significantly longer (37.9 ± 25.2 versus 19.0 ± 16.4 months, P < 0.01), and had significantly higher white blood cell counts per high power field in expressed prostatic secretions (7.7 ± 12.8 versus 3.9 ± 4.7; P < 0.01), than patients without prostatic calcifications, who responded better to medication compared with patients with prostatic calcifications. In conclusion, patients with calcifications were more likely to have category IIIA disease and they required a longer medication period.Category III prostatitis, or chronic prostatitis/chronic pelvic pain syndrome, (CP/CPPS) is a common yet poorly understood condition. The prevalence of CP/CPPS has been estimated to be over 90% of all chronic prostatitis patients 1 .Prostatitis produces lower urinary tract symptoms (LUTS) by causing contraction of the smooth muscle of the prostate and bladder neck, and also causes chronic pelvic pain 2 . Moreover, CP/CPPS is associated with significant sexual dysfunction, including erectile dysfunction (ED), decreased sexual desire, and decreased frequency of sexual activities [3][4][5] .The prostatic calcifications are identified by transrectal ultrasound (TRUS)during clinical practice from time to time. Some authors suggest that prostatic calculi simply accompany the presence of prostatic hyperplasia and carcinoma 6, 7 . However, some studies have correlated the presence of prostatic calcifications with CP/CPPS-related symptoms 8,9 . Histology reveals that most calculi are associated with inflammatory changes. Intraprostatic urinary reflux, which causes chemical prostatitis, has an important role in the pathogenesis of nonbacterial prostatitis and prostatodynia 10 . It is also reported that prostatic calculi are formed by the precipitation of prostatic secretions and calcification of the corpora amylacea under inflammatory conditions 11 .There have been several studies concerning the influence of prostatic calculi on LUTS or CP/CPPS-related symptoms, with conflicting results 2,8,12 ; therefore, it remains unclear whether different treatment should be applied to chronic prostatitis patients with calculi versus those w...

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“…TA B L E 3 Correlation between subgroups of Age, BMI, Height, FBG and prostate volume TG, VLDL-C, FBG, TPSA and fPSA were significantly different between the mild and severe enlarged prostate patient groups. Kidney stones and prostate calculi were reported to be affected by an enlarged prostate,[29][30][31] whereas Fei et al32 reported that the PV was not different in choric prostatitis patients with or without prostate calculi. In our study, we found that PV did not impact the incidence of kidney stones, whereas prostate calculi were positively associated with the prevalence of severely enlarged prostates.…”

Associated Factors for Prostate Enlargement in Chinese Adult Men Aged <40 Receiving Checkups

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