Prostatic calcification is a common finding, especially after the age of 50. They may be solitary but usually occur in clusters 7.
They are rare in children, infrequent below 40, and common in those over 50. Their number and size increase with age 8.
Prostatic calcification is most often an incidental, asymptomatic finding but it can cause symptoms such as dysuria, infection, haemautira, obstruction or pelvic/perineal pain. Occassionaly calcifcations can be passed via the urethra 1-2.
One of the key machanisms are thought to be calcification of corpora amylacea and simple precipitation of prostatic secretions 9.
Prostatic calcification may be either primary (idiopathic) or secondary to 2,6 :
- diabetes mellitus
- infections - e.g. tuberculosis or bacterial prostatitis
- benign prostatic hypertrophy - calcification occurs in 10%
- prostate cancer
- radiation therapy
- iatrogenic - urethral stents or surgery
- chronic pelvic pain syndrome 4-5
- large prostatic volume 10
Most commonly is bilateral and found in the posterior and lateral lobes although unilateral calcification can be seen.
Variable appearnace from fine granules to irregular lumps and can range in size from 1 to 40 mm. If there is significant prostatic hypertrophy the calcifications can project well above the pubic symphysis 1-2.
Calcifications appear as brightly echogenic foci that may or may not show posterior shadowing 3.
Calcifcations appear as hyper-attenuating foci of variable thickness 3.
SWI sequences may be used to identify calcifications.
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