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, haematuria, obstruction or pelvic/perineal pain. Occasionally calcifications can be passed via the urethra 1-2.
One of the key mechanisms is thought to be calcification of the 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 appearance 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.
Calcifications appear as hyperattenuating foci of variable thickness 3.
SWI sequences may be used to identify calcifications.
- 1. Yochum TR, Rowe LJ. Essentials of Skeletal Radiology. Lippincott Williams & Wilkins. (2005) ISBN:0781739462. Read it at Google Books - Find it at Amazon
- 2. Sahani D, Samir A. Abdominal Imaging: Expert Radiology Series Expert Consult- Online. Saunders. ISBN:B0076LOOHG. Read it at Google Books - Find it at Amazon
- 3. Lower Genitourinary radiology. Springer. ISBN:038794706X. Read it at Google Books - Find it at Amazon
- 4. Shoskes DA, Lee CT, Murphy D et-al. Incidence and significance of prostatic stones in men with chronic prostatitis/chronic pelvic pain syndrome. Urology. 2007;70 (2): 235-8. doi:10.1016/j.urology.2007.04.008 - Pubmed citation
- 5. Geramoutsos I, Gyftopoulos K, Perimenis P et-al. Clinical correlation of prostatic lithiasis with chronic pelvic pain syndromes in young adults. Eur. Urol. 2004;45 (3): 333-7. doi:10.1016/j.eururo.2003.09.020 - Pubmed citation
- 6. Hong CG, Yoon BI, Choe HS et-al. The Prevalence and Characteristic Differences in Prostatic Calcification between Health Promotion Center and Urology Department Outpatients. Korean J Urol. 2012;53 (5): 330-4. doi:10.4111/kju.2012.53.5.330 - Free text at pubmed - Pubmed citation
- 7. Klimas R, Bennett B, Gardner WA. Prostatic calculi: a review. Prostate. 1986;7 (1): 91-6. Pubmed citation
- 8. Søndergaard G, Vetner M, Christensen PO. Prostatic calculi. Acta Pathol Microbiol Immunol Scand A. 1987;95 (3): 141-5. Pubmed citation
- 9. Kim WB, Doo SW, Yang WJ et-al. Influence of prostatic calculi on lower urinary tract symptoms in middle-aged men. Urology. 2011;78 (2): 447-9. doi:10.1016/j.urology.2010.12.056 - Pubmed citation
- 10. Park SW, Nam JK, Lee SD et-al. Are prostatic calculi independent predictive factors of lower urinary tract symptoms?. Asian J. Androl. 2009;12 (2): 221-6. doi:10.1038/aja.2009.75 - Free text at pubmed - Pubmed citation