Prostate Stones (Prostatic Calculi)

Prostate stones are small calcified deposits inside the ducts and glands of the prostate. They are extremely common, present in a large proportion of men over 50, and nearly always discovered by chance on an ultrasound, CT or MRI done for another reason. They are typically a few millimetres across and often multiple.

In most men they cause no symptoms, need no treatment and carry no danger. They are not the same as kidney or bladder stones and do not travel. They are not a sign of cancer. Their importance is limited to a few situations: they can harbour bacteria in chronic bacterial prostatitis, and large clusters may be associated with pelvic pain or urinary symptoms.

Symptoms

• Usually no symptoms
• Ache in the perineum, lower abdomen or penis in some men
• Pain on ejaculation or blood in the semen
• Urinary frequency, urgency or a slow stream, generally due to accompanying enlargement
• Recurrent urinary infections with the same organism
• Rarely, a small stone passed in the urine

Causes and risk factors

Most stones form when prostatic secretions stagnate in ducts and small protein bodies called corpora amylacea calcify with calcium phosphate. This becomes more likely with age, with benign enlargement that compresses the ducts, and with chronic inflammation. A second type forms when urine refluxes into prostate ducts during voiding, which is more likely with a urethral stricture or bladder outlet obstruction. Previous prostate surgery, radiotherapy, and rarely metabolic conditions such as alkaptonuria are other associations. Diet has no proven role.

How it is diagnosed

• Transrectal or abdominal ultrasound: Shows bright echoes with shadowing inside the gland. This is how most are found.
• CT or MRI: Show the stones incidentally; MRI is used when the actual concern is prostate cancer.
• Urine culture and two-glass test: Look for chronic bacterial prostatitis when there are recurrent infections or pelvic pain.
• PSA and rectal examination: Standard prostate assessment. Stones themselves do not significantly raise PSA, but can make the gland feel firm, which may prompt MRI.
• Flow test and residual urine: Assess whether there is obstruction that needs treating in its own right.

Treatment options

• No treatment: The right choice for stones without symptoms. No follow-up is required for the stones themselves.
• Treating associated prostatitis: A prolonged culture-guided antibiotic course. Stones can shelter bacteria, which is one reason infection may recur.
• Alpha blockers and anti-inflammatories: For urinary symptoms or pelvic discomfort.
• Treating enlargement: If obstruction is the real problem, TURP or laser enucleation removes the adenoma and most stones along with it.
• Transurethral removal: Reserved for the uncommon case of large stones with persistent infection or pain despite other treatment.

When it is urgent

Prostate stones do not cause emergencies by themselves. Seek local emergency care for fever and chills with pelvic or urinary pain, inability to pass urine, or heavy bleeding in the urine, all of which point to another problem such as acute prostatitis or retention.

Travelling to Türkiye for treatment

There is no reason to travel for prostate stones found by chance, and you should be cautious if anyone recommends surgery solely because they are present. If you are coming for a prostate assessment or for treatment of enlargement or recurrent prostatitis anyway, the stones will be taken into account as part of that. A second opinion on imaging can be given remotely from your ultrasound or MRI files.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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