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Objective@#To analyze the composition of prostatic calculus in patients with BPH and explore its pathogenic factors and histopathological characteristics.@*METHODS@#Strictly following the inclusion and exclusion criteria, we included in this retrospective study 580 cases of bipolar transurethral plasma kinetic prostatectomy (TUPKP) performed in our hospital from May 2015 to May 2019, analyzed the histopathological and calculus-composition features of the patients with BPH complicated by prostatic calculi (the BPH+PC group) and the histopathological data of those with BPH only (the BPH group). We compared the related factors between the two groups of patients and performed uni- and multivariate logistic regression analyses of the data on those in the BPH+PC group.@*RESULTS@#The incidence rate of chronic inflammation was significantly higher in the BPH+PC than in the BPH group (83.1% vs 61.1%, P 0.05). Logistic regression analyses showed that prostatic calculus was significantly correlated with chronic inflammation of the prostate, the patient's age and IPSS (P 0.05).@*CONCLUSIONS@#Prostatic calculus has a high incidence in BPH patients and varies widely in composition, chiefly consisting of calcium oxalate and carbonate apatite. The major factors contributing to prostatic calculi include chronic inflammation of the prostate (primarily the severe type), age and BPH. Prostate calculi may aggravate lower urinary tract symptoms, especially urinary storage symptoms, in patients with BPH, but not significantly affect the PSA level.？.
Subject(s)
Humans , Calculi , Prostatic Hyperplasia , Retrospective StudiesABSTRACT
Objective To reproduce an SD rat model of prostatic calculus by using nanobacteria (NB), and explore the role of NB in contributing to prostatitis and prostatic calculus. Methods Twenty adult male SD rats were randomized to the control group and 20 to the model group. Rat prostate infection models were reproduced by infusing 0. 2 ml (Concentration, 1 Mai unit) NB suspension transurethrally. 0.2 ml physiological saline was infused transurethrally in the rat control group. The rats were sacrificed 4 and 8 weeks later and prostatic pathology were viewed by hematoxylin and eosin (HE) staining. Lithogenesis was observed by scanning electron microscope (SEM) or Transmission electron microscopy (TEM). Re-isolation, culture and identification of nanobacteria were also done in rat prostatic tissues. Results Chronic inflammatory changes of prostates were shown in the model group at both 4 weeks and 8 weeks after infusing NB suspension. Prostatic calculi were detected by SEM and TEM at 8 weeks in the prostates of the rat model group (7/10). Neither chronic inflammatory changes nor prostatic calculus was found in the control group. NB was positive in the model group, but negative in the control group. Conclusions NB infection could cause chronic prostatitis and prostatic calculus in rats.
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Objective To discuss the utilization of signs of a proper depth of ablation during transurethral electrovaporization of the prostate (TUVP). Methods A retrospective analysis was made on clinical records of 616 cases of benign prostatic hyperplasia (BPH). Preoperative color ultrasonography revealed a co-morbidity of prostatic calcification in 310 cases. A total of 156 cases also had vesical calculi and 23 cases complicated tumors of the bladder. On the performance of TUVP, once a co-morbidity of prostatic calculus or a “slipping phenomenon” during mechanical operation was observed, the ablation was stopped. Results The operative time was 30~120 min (mean, 75 min). During the surgery, preoperatively diagnosed prostatic calcification in the 310 cases was confirmed as prostatic calculus, and in the remaining 306 cases prostatic calculus was also found. Vesical perforation occurred during the surgery in 1 case. No urethrorectal fistula or transurethral resection of the prostate syndrome happened. Follow-up observations were conducted for 3~6 months (mean, 4.5 months) in 325 cases. The maximal flow rate (Qmax) was elevated from 6.5~8.5 ml/s to 8~22 ml/s. The residual urine volume (RU) decreased from 70~150 ml to 0~10 ml, and the International Prostate Symptom Scores (I-PSS), from 19~24.5 to 0~7. Of 138 cases of vesical calculus and 23 cases of bladder tumor, no recurrence was noted. Conclusions Prostatic calculus and the “slipping phenomenon” indicate a proper depth of ablation during transurethral electrovaporization of the prostate.
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Objective To explore the distribution of the nanobacteria in the prostatic calculus.Methods Calculus specimens were collected from 40 patients of prostatic calculus during operation.After the stones were crushed and rinsed with saline,the liquid was diluted,filtrated and centrifuged,then cultured in strict aseptic condition.The obtained cells were observed using transmission electron microscopy(TEM),detected with alizarin red staining and Gram staining,and identified by indirect immunofluorescence staining with monoclonal antibody 8D10 against nanobacteria.Results ①After 3 to 4 weeks' culture,a white precipitate adhering to the tube bottom was found.②The positive rate of nanobacteria were 65.0% in 40 calculus patients.③Alizarin red staining and Gram staining indicated nanobacteria were distributed in cluster.④Nanobacteria appeared coccoid or coccobacillary-like in shape and ranged from 100 to 500 nm in size.Conclusion Nanobacteria infection exists in calculus patients.
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Microscopic prostatic calculi are not uncommon in late adult life. But a giant prostatic calculus is a rare finding. No symptoms are pathognomic of calculus disease of the prostate gland. The diagnosis is usually established by rectal palpation of the prostate gland, urethroscopic examination, and roentgenographic or ultrasonic study. Usually, no treatment is indicated for patients with asymptomatic prostatic calculi. In patients with significant symptoms, a transurethral or suprapubic prostatectomy may be contemplated. We report a case of a giant prostatic calculus with bladder stones in a 60-year-old male who was treated endoscopically.
Subject(s)
Adult , Humans , Male , Middle Aged , Calculi , Diagnosis , Digital Rectal Examination , Prostate , Prostatectomy , Ultrasonics , Urinary Bladder Calculi , Urinary BladderABSTRACT
ObjectiveTo explore the distribution of nanobacteria in prostatic calculus and investigate its role in the formation of prostatic calculus. MethodsThe stones of 40 patients with prostatic calculus was used to isolate and culture the possible bacteria. The genomes of obtained bacteria were extracted, and the 16S rRNA was amplified by PCR followed by sequencing. ResultsThe obtained specific fragment had a 98% resemblance with 16S rRNA of nanobacteria: Score=2 480 bits (1 290), Expect=0.0; Identities=1 387/1 409 (98%), Gaps=4/1 409 (0%); Strand=Plus/Plus. ConclusionNanobacteria is proved existing in the stones of prostatic calculus patients by PCR and sequencing.