Prostate Calcifications: What They Are and How to Manage Them

Prostate calcifications are calcium deposits that form within the prostate gland. Although they are often asymptomatic and discovered incidentally, it is important to understand their causes, consequences, symptoms, methods of diagnosis and treatment.

Prostate calcifications per se are generally not the cause of increased PSA. However, they may be associated with conditions that affect PSA levels, such as inflammation or infection of the prostate.

Causes of Prostate Calcifications

Calcifications can have different origins:

• Chronic Prostatitis: Long-term inflammation of the prostate can lead to the formation of calcified deposits.
• Incetions: Bacterial infections can cause an immune response that leads to calcification.
• Aging: As we age, changes in the prostate can promote the formation of calcifications.
• Injuries: Trauma to the pelvic area or prostate can cause tissue damage, leading to the formation of calcifications during healing.

Consequences and Symptoms

Prostate calcifications often cause no symptoms and are discovered during routine examinations. However, in some cases they can cause:

• Urinary difficulty: Weak or intermittent urinary flow, increased time required to start urination.
• Pelvic Pain: Discomfort or pain in the pelvic area.
• Painful ejaculation: Pain during ejaculation.

Diagnosis of prostate calcifications

Calcifications are generally detected by means of:

• Transrectal ultrasound: Examination that uses sound waves to create images of the prostate.
• Magnetic Resonance Imaging (MRI)It provides detailed images of the prostate and can detect calcifications.
• Computed Tomography (CT)Used to view calcifications in detail.

Diagnostic Problems

Calcifications can interfere with some diagnostic methods:

• Ultrasound: Calcifications can create acoustic shadows that make it difficult to visualise other parts of the prostate.
• Biopsy: The presence of calcifications can make tissue sampling more difficult.
• Magnetic Resonance Imaging (MRI): In some cases, a lesion classified as PIRADS 4 may actually be a calcification. The PIRADS system classifies suspicious lesions on a scale of 1 to 5, with PIRADS 4 indicating a moderate-to-high probability of malignancy. However, benign conditions such as prostate inflammation or calcification may appear similar to a malignant tumour on MRI images, leading to false positives, returning results false positives.

Treatments

The treatment of prostatic calcifications depends on the symptoms and severity of the case. If asymptomatic, they often do not require treatment and are simply monitored. In the case of infection or inflammation, an attempt can be made to address the cause, using antibiotics or anti-inflammatory drugs.

In rare cases, calcifications may need to be removed if they cause significant symptoms.

Prostate calcifications are generally harmless, but it is important to monitor and treat them if they cause symptoms. Seeing a doctor for an accurate diagnosis and appropriate treatment is crucial for the best management of prostate health.

Reference:
https://pubmed.ncbi.nlm.nih.gov/29076299/