One of the explanations for lingering bacterial prostatitis may be the presence of infection in tiny stones, called calculi, in the prostate. Prostatic calculi (the prostate’s version of gallstones or kidney stones) are quite common—about 75 percent of middle-aged men and 100 percent of elderly men have them. They can be detected with an imaging process called transrectal ultrasound.
They’re usually small, found in grapelike clusters, and, most important, harmless. But when they get infected—as they often do in men with chronic bacterial prostatitis—prostatic calculi can cause an infection to persist, and symptoms of urinary tract infections and prostration to return again and again. (What causes calculi? Molecular analysis has shown that these stones contain ingredients generally found in urine but not prostatic secretions—which suggests they form when urine somehow “backs up,” or refluxes, into the prostate.)
When a man has both prostatic stones and a history of chronic bacterial prostatitis, it’s pretty safe to assume that the stones are infected. The significance of this is that infected calculi have never been cured by medication alone, although antibiotics can certainly treat the symptoms. The only way to cure infected prostatic stones permanently is to remove them surgically, by a procedure known as transurethral resection of the prostate.
When a man has both prostatic stones and a history of chronic bacterial prostatitis, it’s pretty safe to assume that the stones are infected. The significance of this is that infected calculi have never been cured by medication alone, although antibiotics can certainly treat the symptoms. The only way to cure infected prostatic stones permanently is to remove them surgically, by a procedure known as transurethral resection of the prostate.
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