prostatic stones removal - surgery, nanobacteria?

[Richie]

I have the stones and they are quite common. I am pretty convinced the correlation between our symptoms and the stones is nill since half the population has them.

I certainly would not go cutting myself open over it. You want irritation, nerve damage and scar tissue, there you go.

[dshoskes]

Londoner:
Could you tell me what the "anti-nanobacteria therapy" for prostate stones is that you mentioned? Is the therapy medication, surgery, etc? A CT scan and a TRUS both showed that I have a rather large prostate calcifications (stone).
I would like to pursue this therapy as a possibility. Or at least learn about it.
Thanks
gifford

I use the following compounding pharmacy for convenience since they can combine the 3 components (tetracycline 500 mg per day, Calgenex capsules, EDTA suppository) into 1 order. Your MD will have to write a prescription (there is a pdf sample).

http://www.westchasepharmacy.com/caldetox.html

Pending FDA and IRB approval, a multicenter randomized placebo controlled trial of this treatment approach should begin in early 2007.

[gifford]

Dear Dr. Shoskes:

Thank you for the information and web site. Could you tell me how many months are recommended for this treatment so I have an idea how much to order.?

Thanks again.

gifford

[dshoskes]

Dear Dr. Shoskes:

Thank you for the information and web site. Could you tell me how many months are recommended for this treatment so I have an idea how much to order.?

Thanks again.

gifford

In the study, most patients used 3-4 months. Almost all patients who get better at least begin to get better after the first month.

[londoner]

Dr. Shoskes - do you define 'get better' by a measurable reduction in stones?

and...

why do some get better and others don't? Mystery of the universe, I guess, but I wondered if there were any theories in your mind.

Thanks...

[gifford]

In the study, most patients used 3-4 months. Almost al patients who get better at least begin to get better after the first month. Pending FDA and IRB approval, a multicenter randomized placebo controlled trial of this treatment approach should begin in early 2007.

I see the cost is $285 /month.. I am not sure I should wait for the trial or not before going through yet another treatment... When will you know if trial is approved? Who will be doing the trial? Thanks again for your help.
gifford

[Howden]

I learned early on that I have calcification too, but I have ignored it, largely because the therapy called for removal by surgery. Still, it has been a small 'worry' in the back of my mind for some years. Less so now that I have read these posts. I had no idea calcification was so common, but if treatment by non-surgical means becomes available and it is demonstrably effective in reducing the pain in some men I will give it a try. I look forward to hearing more about the study.

[gifford]

Perhaps the upcoming study that Dr. Shoskes referred to will help.
I don't know how common calcifications are in the "normal" population. I also don't know how effective either medical or surgical treatment for calcifications is in reducing pain and symptoms for CPPS. I was hoping that there would be more folks on this site who tried these and found favorable results..

gifford

[dshoskes]

Perhaps the upcoming study that Dr. Shoskes referred to will help.
I don't know how common calcifications are in the "normal" population. I also don't know how effective either medical or surgical treatment for calcifications is in reducing pain and symptoms for CPPS. I was hoping that there would be more folks on this site who tried these and found favorable results..

gifford

In one study (European Urology 45:333, 2004) 101/1374 young adults screened with ultrasound had prostatic calcifications (7.3%). In my practice of chronic prostatitis / chronic pelvic pain syndrome patients less than 50 years old, 43% have calcification.

[webslave]

In one study (European Urology 45:333, 2004) 101/1374 young adults screened with ultrasound had prostatic calcifications (7.3%). In my practice of chronic prostatitis / chronic pelvic pain syndrome patients less than 50 years old, 43% have calcification.

43%? That's very close to the percentage of normal prostates with microcalcifications:

Arch Pathol Lab Med. 1998 Feb;122(2):152-5.

Distribution and significance of microcalcifications in the neoplastic and nonneoplastic prostate.

Woods JE, Soh S, Wheeler TM.
Department of Pathology, Baylor College of Medicine, and The Methodist Hospital, Houston, Tex, USA.

OBJECTIVE: To determine the distribution and significance of microcalcifications in histologic sections of the prostate.
DESIGN: Retrospective review of all histologic slides of completely embedded prostates from surgical specimens.
MATERIALS: Randomly selected material included 266 radical prostatectomy and 10 cystoprostatectomy prostates without prostate cancer. Nonrandomly selected specimens included 26 radical prostatectomy specimens with a Gleason pattern 5 component, 24 cases with collagenous micronodules, and 8 cases previously noted to have microcalcifications within foci of prostate cancer.
RESULTS: Four patterns of microcalcifications were noted in association with prostate cancer: (1) dystrophic calcification in the comedo-type necrosis of Gleason pattern 5, (2) intraluminal calcification in cribriform-type Gleason pattern 3 prostate cancer, (3) intraluminal calcification in small acinar adenocarcinoma, and (4) stromal calcification within collagenous micronodules associated with prostate cancer. Microcalcifications were noted in 32% of prostates without cancer; 1.9% of randomly selected prostates demonstrated microcalcifications associated with prostate cancer.
CONCLUSIONS: Microcalcifications are less common in association with prostate cancer than with benign prostatic ducts and acini. However, intraluminal microcalcifications associated with an atypical small glandular proliferation should not be taken as unequivocal evidence of a benign process.

PMID: 9499358 [PubMed - indexed for MEDLINE]

[webslave]

Acta Pathol Microbiol Immunol Scand [A]. 1987 May;95(3):141-5.

Prostatic calculi.

Sondergaard G, Vetner M, Christensen PO.

The presence of calculi in 300 whole prostates from consecutive autopsies were investigated by the Faxitron imaging technique. Calculi were found in 99% of the prostates, their number and size increasing with age. They were mainly localized in the ducts in the borderzone between the middle lobes and the periferal prostate posterolaterally, but often some were also found anteriorly in the centreline. Calculi were never seen in the middle lobes. We found no statistically significant relation between the number, size or localization of calculi and other morphological or pathological parameters. Prostatic calculi seem to be a part of the normal process of aging, and do in only exceedingly rare cases assume any clinical importance.

PMID: 2440234 [PubMed - indexed for MEDLINE

[webslave]

41% of men without chronic prostatitis / chronic pelvic pain syndrome have prostate stones.

J Urol. 2003 Sep;170(3):745-8. Links

Prostatic calculi do not influence the level of serum prostate specific antigen in men without clinically detectable prostate cancer or prostatitis.


Lee SE, Ku JH, Park HK, Jeong CK, Kim SH.
Department of Urology, Clinical Research Institute, Seoul National University Hospital, 28 Youngon Dong, Jongno Ku, 110-744 Seoul, Korea. [email protected]

PURPOSE: Prostatic calculi are common but little is known of their effect on serum prostate specific antigen (PSA). We investigated whether prostatic calculi might influence serum PSA in men with clinically undetectable prostatic cancer or prostatitis.

MATERIALS AND METHODS: Between November 1999 and November 2001, 581 consecutive patients underwent serum PSA determination and digital rectal examination. Of these patients 486 without detectable prostatic cancer, or a history or symptoms of prostatitis and with other specified exclusion criteria were included in the study. The detection and volume measurement of prostatic calculi, and the measurement of prostate volume were performed by transrectal ultrasonography.

RESULTS: Prostatic calculi were detected in 198 of the 486 men (40.7%). Mean patient age, prostate volume and serum PSA were not significantly different in men with and without prostatic calculi. Prostate volume was significantly greater in patients with abnormally elevated serum PSA than in those with normal levels. However, no significant difference was found between the percent of men with prostatic calculi or the volumes of prostatic calculi in the 2 groups. Univariate logistic regression analysis indicated that the presence or volume of prostatic calculi was not a risk factor for elevated PSA. Multivariate analysis showed that age and prostate volume were associated with elevated PSA.

CONCLUSIONS: The presence or volume of prostatic calculi had no significant effect on serum PSA. Our results suggest that the influence of prostatic calculi is irrelevant in men with elevated PSA.

PMID: 12913688 [PubMed - indexed for MEDLINE]

[gifford]

Not sure a distinction is made between calcifications and "micro-calcifications" here . I would assume the micro are much smaller and potentially less a problem. Obviously there is a controversy here as to whether they can be symptomatic of pain or not.

It would be good to hear from folks on this site who have experience with stone treatment and whether it has helped or not.

Without that, I guess we will just have to wait for the 2007 study if indeed it occurs.
gifford

[lasteve]

I've been a sufferer since '89. In the mid-90s my urologist uncovered prostate stones with an ultra-sound and I thought perhaps we had found an underlying cause, but he said nothing could be done. Two years ago I had a renewed flare-up that has been relentless. Current specialist finally did a cystoscopy two months ago and revealed massive calcification on the left side of the prostate. Looked like a cave on the tv screen. There were times a year before where I had described the pain as feeling like broken glass in the prostate - which was almost literally true.

Current urologist suggested doing a TURP to remove stones, which were on the surface. He was able to do a modified one that left me with no side effects as far as retrograde ejaculation. BUT after the first ejaculation, my pain symptoms returned back up and I've had no improvement. (Oddly, I was feeling better than I had for many months after the cystoscopy, which the urologist said possibly caused a beneficial dilation.)

[webslave]

lasteve, thank you for that post. Members should take note of your experience and learn from it.