Prostatic calculi: diagnostic and therapeutic aspects

Strength properties of prostatic calculi (PC) were studied by microhardness HV.
Fifteen calculi under study were divided into 3
groups by the size: 2-3 mm (group 1), 4-6 mm (group 2), > 6 mm
(group 3). The surface of the thin sections of the calculi appeared as
concentric, spherical layers of different size indicating formation of
the calculus from the center. In the latter one could see a pigmented
nucleus of organic nature. Some calculi had two nuclei under one
cover - attached calculi. Correlations between the structure, morphology
of prostatic calculi and their strength properties were established.
These correlations allowed one to characterize destruction features of
the calculi in different destructing impacts. We have designed and introduced
into practice a complex of local physiotherapy in prostatolithiasis.
This physiotherapy was conducted in combination with medicines
for chronic prostatitis and included exposure of the prostate to
ultrasound in impulse regime (4 mc, 0.4-1.0 W/cm2). The ultrasound
was delivered through the rectum (insertion of the setting IUT 2.264-7-2.09u
to the site of the concrements location) and alternated with
laser therapy (insertion of the radiator P-2 into the rectum and radiator
LOl to the perineal area (5 W, 80 Hz, 64-128 s) and introduction
of sulfide mud heated with the device PPK-01 Pra, electrostimulation
for better passage of the prostatic section. The above therapy destructed
the concrements which eliminated from the prostatic ducts as a
result of which prostatic function recovered. The complex produced
a good effect: 65% patients stated enhancement of the erectile function
after 3 days of the treatment. After 5-6 procedures pain syndrome
relieved in 40% patients, after 11-15 procedures - in 87%. Ultrasonic
investigation showed that posttreatment size of the prostate diminished
from 0.8 to 0.2 cm. The absence of the calcinates's shadows
were recorded in 87% patients, the symptoms of chronic prostatitis
disappeared. The results of the combined physiotherapy demonstrate
efficacy of the above method in true prostatoliths.