Prostatic calcifications are associated with a more severe symptom burden in men with type II chronic bacterial prostatitis

Abstract

Introduction/Aim: Although prostatic calculi/calcifications are encountered frequently in the urological practice, little is known about the incidence of such lesions, their mechanism of formation, their relationship to other prostate conditions and their clinical significance. The purpose of this study is to describe the characteristics and to investigate the clinical significance of prostatic calcifications (PCs) in patients with chronic bacterial prostatitis (CBP). Materials and methods: This study was conducted between 01/02/2013 and 20/02/2018. The patient population for this study included subjects with or without PCs and a confirmed diagnosis of NIH category II Chronic Bacterial Prostatitis (CBP). Demographics and clinical history of each assessed patient were reviewed. Eligible patients underwent prostatic ultrasound with post-void residual measurement, and the Meares-Stamey “4-glass” test. Symptom severity was measured using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostatic Symptoms Score (IPSS). Antimicrobials were administered to confirmed cases of CBP according to the results of susceptibility tests. After four weeks off-therapy, the NIH-CPSI and IPSS tests were repeated. Variables were compared between patients with and without prostatic calcifications. Results: Ninety-five CBP patients were included in the study. According to the presence of PCs detected by ultrasound examination, patients were divided into two groups: 41 had PCs (group 1) and 54 didn’t (group 2). No significant between-group baseline differences were found regarding age, marital status, prostate volume, the proportion of common CBP pathogens. Concerning highrisk sexual behavior, a significantly higher number of men with PCs practiced anal penetration. Moreover, a significantly higher number of men with PCs had a history of chronic prostatitis relapsing episodes. Microbiological eradication and the complete resolution of clinical symptoms occurred in similar proportions between the two groups. However, intergroup analysis resulted in significantly higher scores of the NIH-CPSI test in group 1, both at the pre-therapy and at the post-therapy time points. Conversely, no IPSS score differences between groups 1 and 2 were found at both pre- and post-therapy time points. Conclusions: Prostatic calcifications do not seem to influence the microbiological outcome of antibacterial treatment. However, the CBP symptoms appear to be more severe in carriers of prostatic calcifications, either before or after antibacterial therapy.

Identification of an anaplastic subtype of prostate cancer amenable to therapies targeting SP1 or translation elongation

“…Many biomineralization regulators [e.g., fibrillin 2 ( FBN2 ), neural EGFL like 1 ( NELL1 ), and transforming growth factor beta 3 ( TGFB3 )] and solute carrier family transporters [e.g., solute carrier family 15 member 1 ( SLC15A1 ), solute carrier family 18 member A2 ( SLC18A2 ), solute carrier family 22 member 3 ( SLC22A3 ), and solute carrier family 5 member 8 ( SLC5A8 )] were up-regulated in LC1 (table S4). Prostate fibrosis and subsequent calcification are often associated with pathological conditions such as prostate enlargement, prostatitis, or PCa ( 37 ). This would suggest that the activity of LC1 may contribute to precancerous conditions of prostate diseases, and thus, targeting the LC1 population may serve as a potential approach to combating tumor initiation.…”

How urologists deal with chronic prostatitis? The preliminary results of a Mediterranean survey

“…None of them is specifically recommended in the evaluation of patients with prostatitis. However, ultrasonography and uroflowmetry are non-invasive, low cost tests for a rapid study of the anatomy of the urinary system and for a general estimation of the urinary function; hence they could be adopted in CP diagnostic work up (24).…”

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

“…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).…”

“…At present, the definition and classification of PC has not been standardized. The terms "prostatic calculi", "prostatic calcification", and "prostatic stones" are variably used to describe hyper-echoic calcium deposits in the prostate (2). In clinical practice, most patients with PC present in health examination centers or urology clinics.…”