Prostate calculi in cancer and BPH in a cohort of Korean men: Presence of calculi did not correlate with cancer risk.
ABSTRACT Prostatic calculi are common and are associated with inflammation of the prostate. Recently, it has been suggested that this inflammation may be associated with prostate carcinogenesis. The aim of this study was to investigate the relationship between prostatic calculi and prostate cancer (PCa) in prostate biopsy specimens. We retrospectively analyzed 417 consecutive patients who underwent transrectal ultrasonography (TRUS) and prostate biopsies between January 2005 and January 2008. Based on the biopsy findings, patients were divided into benign prostatic hyperplasia and PCa groups. TRUS was used to detect prostatic calculi and to measure prostate volume. The correlations between PCa risk and age, serum total PSA levels, prostate volume, and prostatic calculi were analyzed. Patient age and PSA, as well as the frequency of prostatic calculi in the biopsy specimens, differed significantly between both the groups (P < 0.05). In the PCa group, the Gleason scores (GSs) were higher in patients with prostatic calculi than in patients without prostatic calculi (P = 0.023). Using multivariate logistic regression analysis, we found that patient age, serum total PSA and prostate volume were risk factors for PCa (P = 0.001), but that the presence of prostatic calculi was not associated with an increased risk of PCa (P = 0.13). In conclusion, although the presence of prostatic calculi was not shown to be a risk factor for PCa, prostatic calculi were more common in patients with PCa and were associated with a higher GS among these men.
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ABSTRACT: To evaluate the prevalence and to classify prostatic calcification on transrectal ultrasonography (TRUS) and correlate the findings with histology. A prospective, blinded study of men undergoing TRUS and prostatic biopsy was designed. A standardized reproducible technique was used with a BK 7.5- to 12.5-MHz multiplanar probe. Representative images of the calcification in the sagittal and transverse planes were captured. Blind analysis by an experienced observer was performed. TRUS findings were categorized using a novel classification and correlated with histologic data. A total of 274 patients (58.8%) had prostate cancer, 88 patients (18.9%) inflammation, and 104 patients (22.3%) had benign pathology. Interface calcification was present in 42.3% of patients. Peripheral or transitional zone calcification was unusual (6.8% and 9.0%, respectively). Of the peripheral zone calcification group patients, 78.1% had cancer on histology examination (P = .020). Prevalence and characteristics of prostatic calcification have been described using this novel and practical classification. Although interface calcification is common and not associated with any particular pathology, peripheral zone calcification appears to be strongly associated with prostate cancer. Copyright © 2015 Elsevier Inc. All rights reserved.Urology 01/2015; 85(1):178-181. DOI:10.1016/j.urology.2014.09.026 · 2.13 Impact Factor
Article: Cálculos prostáticos[Show abstract] [Hide abstract]
ABSTRACT: Los cálculos prostáticos se diagnostican por lo general de manera fortuita en pacientes mayores de 50 años. Raramente se presentan antes de los 40 años y su incidencia aumenta con la edad. Hay que distinguir los cálculos que se desarrollan en el parénquima prostático de aquellos que proceden del tracto urinario superior y han migrado a la uretra prostática. Tanto si se forman a partir de las secreciones prostáticas (cálculos «endógenos») como si lo hacen a partir de los componentes de la orina (cálculos «exógenos»), los cálculos prostáticos se componen en su mayor parte de fosfatos de calcio, siempre contienen proteínas y pueden presentar una importante variedad de fases cristalinas. Por regla general, los cálculos prostáticos son asintomáticos. Se descubren fortuitamente cuando se estudian enfermedades asociadas, las más frecuentes de las cuales son la hipertrofia prostática benigna y las prostatitis crónicas. No parece existir relación entre los cálculos prostáticos y el adenocarcinoma de próstata. El descubrimiento de cálculos prostáticos no tiene por sí mismo un valor diagnóstico específico. Su diagnóstico es radiológico, con ocasión de una exploración ecográfica o una tomografía computarizada (TC). La exploración física puede hallar un nódulo duro en el tacto rectal en pacientes portadores de cálculos voluminosos, lo que plantea el problema del diagnóstico diferencial con el cáncer de próstata. Muy a menudo asintomáticos, los cálculos prostáticos no requieren tratamiento. Cuando están presentes, los síntomas se deben principalmente a enfermedades asociadas y requieren el tratamiento clásico de estas enfermedades. En raras ocasiones, los cálculos prostáticos son directamente responsables de síntomas, en cuyo caso se un tratamiento quirúrgico específico puede estar indicado.09/2013; 45(3):1–7. DOI:10.1016/S1761-3310(13)64510-7
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ABSTRACT: We studied the efficacy of culture-specific antibiotic therapy for chronic bacterial prostatitis (CBP) patients with or without prostatic calculi. This study included 101 patients (21-62 years old) who met the consensus criteria for CBP (National Institutes of Health category II). According to the results of transrectal ultrasonography (TRUS), all patients were divided into two groups: Group 1, CBP with prostatic calculi, n=39; Group 2, CBP without prostatic calculi, n=62. All patients received optimal antimicrobial therapy for 4 weeks and followed up for a minimum of 3 months (range: 3-8 months). In addition to expressed prostatic secretions (EPS) and urine culture, all patients were asked to complete the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the subjective global assessment (SGA). The microbiological eradication rate at the end of treatment were 32/39 (82.1%) and 54/62 (87.1%), while the rates for continued eradication at the end of study were 17/39 (43.6%) and 45/62 (72.6%) in Group 1 and Group 2 (P<0.01), respectively. We observed a decrease in the total NIH-CPSI score median values from 24 to 19 in Group 1 and from 24 to 11 in Group 2. The pain subscore (P<0.01), urinary sunscore (P<0.05) and quality of life (QoL; P<0.05) as well as the total NIH-CPSI score (P<0.01) were significantly improved after antimicrobial treatment in Group 2 compared to Group 1. Response, defined as a decrease of the NIH-CPSI total score by at least 50%, was seen in Group 1 versus Group 2 in 38.5% and 58.1% (P<0.01), respectively. Our results showed that prostatic calculi influence the antimicrobial efficacy in men with CBP. There was a noticeable decrease in the cure rate of CBP patients with prostatic calculi due to relapse after antimicrobial therapy.Asian Journal of Andrology 07/2012; 14(5):715-9. DOI:10.1038/aja.2012.40 · 2.53 Impact Factor