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What is the alternative to surgery to remove prostatic stones?

Thursday, 29 May 2008
Answered by: Dr. Rajesh Ahlawat
Director, Urology and Renal Transplantation
Fortis Hospitals
New Delhi
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Q. Is it possible to treat prostate calculus without surgery? If yes, how? If someone has prostate calculus and fever whenever he has sex, does this indicate the need to immediately remove the calculus?

A.  Prostatic stones are very common. When ultrasound exams of the prostate are done for other reasons, 75% of middle-aged men and nearly 100% of older men are found to have prostate stones. These may be seen in younger men too having chronic prostatitis. They aren't always apparent during a rectal exam or on X-rays. Prostate stones are usually tiny and do not cause symptoms. In some men, association of prostatic stones with prostatitis may cause recurrent urine infection (UTIs) difficult to cure. Association of fever and act of ejaculation also points to such a possibility in your case. You need to be evaluated for the infection and treated with appropriate antibiotic therapy for a long period, usually upto 8 to 10 weeks. Prostatic calculi are not removed like kidney or ureteric stones, and it is necessary to remove part of prostate gland (trans urethral resection of prostate) to remove them. In young patients it is not advisable to offer any surgical treatment for prostate or its contained calculi since it carries a risk of retrograde ejaculation, and thus infertility.

A.  Prostatic stones are very common. When ultrasound exams of the prostate are done for other reasons, 75% of middle-aged men and nearly 100% of older men are found to have prostate stones. These may be seen in younger men too having chronic prostatitis. They aren't always apparent during a rectal exam or on X-rays. Prostate stones are usually tiny and do not cause symptoms. In some men, association of prostatic stones with prostatitis may cause recurrent urine infection (UTIs) difficult to cure. Association of fever and act of ejaculation also points to such a possibility in your case. You need to be evaluated for the infection and treated with appropriate antibiotic therapy for a long period, usually upto 8 to 10 weeks. Prostatic calculi are not removed like kidney or ureteric stones, and it is necessary to remove part of prostate gland (trans urethral resection of prostate) to remove them. In young patients it is not advisable to offer any surgical treatment for prostate or its contained calculi since it carries a risk of retrograde ejaculation, and thus infertility.

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