Prostate calcification is the formation of small, solid mineral deposits within the prostate gland, a condition that becomes increasingly common as men age. These deposits, sometimes referred to as prostate stones or calculi, are often discovered unexpectedly during medical imaging performed for unrelated reasons. While the term might sound concerning, the presence of these calcifications is frequently benign, meaning they do not cause direct health problems. Understanding the nature of these deposits helps clarify their significance in overall prostate health.
Understanding Prostate Calcifications
These deposits are small, hard concretions composed of calcium phosphate. Calcifications are categorized into two main types based on their origin. The first type is known as corpora amylacea, which are endogenous (internally formed) structures. These small protein bodies naturally form in the prostatic acini and ducts, calcifying over time as part of the normal aging process.
The second type is true calculi, which are generally larger and considered exogenous (inflammation-related) deposits. These calculi are found within the prostate’s duct system or the acini, the small sacs where prostatic fluid is produced. When the prostatic ducts become blocked or fluid stagnates, minerals precipitate and accumulate around a core of cellular debris. These calcified bodies can range in size from tiny grains up to several millimeters.
Common Causes for Their Formation
The primary mechanism for calcification involves chronic inflammation and the stagnation of prostatic fluid. Long-term inflammation of the prostate, known as chronic prostatitis, is a leading factor because the inflammatory process provides the organic matrix for mineral deposition. Proteins from inflammatory cells form the nidus, or core, of the developing stone.
Urinary tract infections (UTIs) or the reflux of urine into the prostatic ducts also contribute. Urine reflux introduces foreign substances, including calcium salts, increasing the likelihood of precipitation. Benign prostatic hyperplasia (BPH) is another common associated factor. The enlarged tissue can compress the prostatic ducts, causing obstruction and fluid retention that facilitates calcification. In many cases, calcifications are considered idiopathic, meaning no specific cause can be identified, and they are viewed as a consequence of aging.
Symptoms and Associated Conditions
Most prostate calcifications are entirely asymptomatic and are discovered incidentally during imaging. When symptoms occur, they relate to the size, number, or location of the deposits, especially if they cause obstruction or harbor bacteria. Symptomatic calcifications can lead to lower urinary tract symptoms (LUTS), including a weak or intermittent urinary stream, increased urinary frequency, and the sensation of incomplete bladder emptying.
Calcifications are frequently associated with chronic pelvic pain syndrome (CPPS), a long-term condition characterized by pelvic or perineal discomfort without bacterial infection. While calcifications do not directly cause CPPS, their coexistence suggests a shared underlying inflammatory origin. Pain can manifest as discomfort in the perineum or pain during or after ejaculation. Although calcifications are often found in prostates with cancer, there is no direct causal link between the two conditions.
Diagnosis and Treatment Approaches
Prostate calcifications are most commonly identified through imaging tests, such as transrectal ultrasound (TRUS) or computed tomography (CT) scans. On ultrasound, the calcifications appear as bright, highly echogenic foci, sometimes with a shadow behind them. CT scans are useful for accurately assessing the size, number, and precise location of the deposits within the prostate zones.
For men with asymptomatic calcifications, the standard approach involves monitoring rather than active intervention. Treatment is reserved for cases causing problematic symptoms or recurrent infections. Management focuses on addressing the associated underlying condition, such as chronic inflammation or BPH, using medications like alpha-blockers to improve LUTS, or antibiotics for bacterial infections. In rare instances where large calcifications cause significant urinary obstruction, surgical removal may be considered, often performed during transurethral resection of the prostate (TURP).