An Overlooked Complication of the Clean Intermittent Catheters: Prostate Calculi - Beyond the Abstract

Today, the prevalence of prostate calculi is increasing due to the increasing use of radiological imaging methods. Prostate calculi are mostly detected in X-RAY graphics, Transrectal ultrasonography, and Computed tomography (CT) imaging.

Although there are different factors in the etiology of prostate calculi, the most important ones are; Intraprostatic infection reflux in the urethra, bladder, and sphincter dysfunction, obstruction in the prostatic ducts, hypercalciuria, low urine pH, increased uric acid excretion.

The relationship between prostate calculi and prostatitis is still controversial, but it is reported that the prevalence of prostate calculi is high in patients with prostatitis. In addition, the fact that prostate calculi not only prolong the duration of lower urinary tract symptoms (LUTS) but also reduce the success of antibacterial therapy in patients suggests that long-term antibiotic therapy is required in patients with chronic prostatitis. LUTS is more severe in prostate calculi patients. However, some studies have reported that large prostate calculi constitute an independent risk factor for moderate or severe LUTS.

Processes that may cause an inflammatory response in the prostate may cause prostate calculi formation as a result of the accumulation of hydroxyapatite crystals in the intraprostatic channels and mineralization with calcium in the corpora amylacea due to factors such as intraprostatic reflux.

The Clean Intermittent Catheter (CIC) is the gold standard method for bladder rehabilitation and urinary drainage. In patients using CIC; Complications such as recurrent urinary tract infection, urethral trauma, bleeding, and fistula are reported. However, when we searched the literature, we could not find a study on prostate calculi formation in patients using CIC.

When we combined the etiology of prostate calculi with our previous clinical observations, we observed that prostate calculi were more common in male patients using CIC. We put forward this study, which we think is very valuable, by evaluating our observations on the patients in our clinic and their data.

While 60 of the 160 patients included in our study who used CIC had prostate calculi, 36 of the 154 patients who did not use CIC had prostate calculi. In addition, we also evaluated the patients in terms of parameters such as Mean stone size and density, Number of prostate calculi, Microorganism in urine culture, and prostate calculi type in our study.

Written by: Gökhan Ecer MD, Urology Department, Konya State Hospital and Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey

Reference:

  1. Balasar et al. Prostatıc Calculı: Etıologıcal Factors, Dıagnosıs And Treatment. Health Sciences. 301.
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