From the Guidelines
Dystrophic calcification of the prostate gland typically doesn't require specific treatment unless it causes symptoms, and when symptomatic, the most effective treatment approach is to address underlying conditions and manage symptoms with alpha-blockers such as tamsulosin (0.4 mg daily) or alfuzosin (10 mg daily) as recommended by the latest guidelines 1.
Treatment Approach
When symptoms are present, the focus should be on relieving urinary symptoms, managing pain or inflammation, and preventing recurrent urinary tract infections.
- Alpha-blockers like tamsulosin or alfuzosin can help relax smooth muscle in the prostate and bladder neck, thus relieving urinary symptoms.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (400-800 mg three times daily) can be used for pain or inflammation.
- In cases of recurrent urinary tract infections, antibiotics targeted to the specific pathogen should be prescribed.
Considerations for Severe Cases
For severe cases causing significant obstruction or persistent symptoms, transurethral resection of the prostate (TURP) may be considered to remove calcified tissue 1.
Importance of Underlying Cause Identification
Dystrophic calcification itself represents calcium deposition in damaged tissue rather than a primary disease, so identifying and treating the underlying cause—whether it's chronic inflammation, previous infection, or tissue damage—is essential for comprehensive management.
Follow-Up
Regular follow-up with urological evaluation is important to monitor progression and adjust treatment as needed, considering the latest guidelines for managing lower urinary tract symptoms attributed to benign prostatic hyperplasia 1.
From the Research
Dystrophic Calcification of the Prostate Gland
- Dystrophic calcification can be defined as a calcification that occurs in degenerated or necrotic tissue, often seen at sites of previous inflammation or damage 2.
- It is associated with multiple clinical conditions and involves the deposition of calcium in soft tissues despite no generalized disturbance in the calcium or phosphorus metabolism.
Treatment Options
- Transurethral resection of the prostate (TURP) and bladder neck with laser lithotripsy can be used to remove the calculus caused by dystrophic calcification 2, 3.
- In some cases, partial cystectomy may be necessary to resolve the issue, as seen in a case where a patient underwent photovaporization of the prostate with GreenLightTM Laser 180 W 4.
- Salvage cryoablation (SCA) is an accepted treatment for radio-recurrent prostate cancer, but it may lead to dystrophic calcifications (DC) of the prostate, causing severe bladder outlet obstruction 5.
Underlying Causes
- Dystrophic calcification of the prostate can occur after cryotherapy, potentially due to chronic inflammation and necrosis of the prostate 3, 5.
- It can also occur after photovaporization of the prostate with GreenLightTM Laser 180 W, possibly linked to a previous thermal lesion of the bladder during the procedure 4.
Medical Treatment
- Medical treatment of benign prostatic hyperplasia (BPH) includes 5 alpha-reductase inhibitors and alpha-adrenergic antagonists, which can decrease the size of the prostate and improve micturition 6.
- However, these treatments may not directly address dystrophic calcification of the prostate gland.