So what are the various differences?
Ultrasound imaging findings of prostate calcification:
Prostate calcifications appear as echogenic foci within the prostate gland on ultrasound imaging.
They are usually round or oval-shaped and can vary in size and number.
Calcifications are often seen in the peripheral zone of the prostate gland and usually found in older men.
Often associated with benign prostatic hyperplasia (BPH) or chronic prostatitis.
How to distinguish prostate calcification from prostate calculus:
1. Symptoms: Prostate calcification is typically benign and asymptomatic, whereas prostate calculus can cause obstructive symptoms such as urinary retention, dysuria, and hematuria.
2. Prostate calculus is often larger in size and may have a smooth surface compared to calcifications.
3. Numbers: Calcifications are usually multiple, whereas a prostate calculus is a single, larger stone-like structure.
4. Acoustic shadow is usually seen in prostate calculus but less seen in calcification.
5. Prostate calculus is usually more brightly echogenic than prostate calcification.
It must be noted, that prostate calcifications can later become a calculus.
CT or MRI confirmation:
Ultrasound can help distinguish between the two, but other imaging modalities such as CT or MRI may be needed for confirmation.
Symptoms of prostate calcification:
Prostate calcification: is usually asymptomatic and does not require treatment. However, it can be associated with underlying conditions such as BPH or chronic prostatitis, which may cause symptoms such as:
Urinary frequency and urgency
Weak or interrupted urine flow
Pain or discomfort during urination
Pain or discomfort in the pelvic area or lower back
Blood in the urine or semen.
Usually in calcification, symptoms if present are of chronic nature.
Prostate calculus: can present acute symptoms of urinary obstruction and acute pain in pelvis and urethra.
Example of prostate calculus:
3D ultrasound images showing prostate calculus in prostatic urethra:👇👇
In some cases, the presence of a prostate calculus may also be associated with other conditions such as prostatitis, benign prostatic hyperplasia (BPH), or prostate cancer.
Important note: ultrasound imaging findings of prostate calculus can be similar to those of prostate calcifications. However, there are some key differences in symptoms and imaging characteristics that can help distinguish between the two, (see above description).
Management of prostate calculus:
Further diagnostic tests such as a digital rectal examination (DRE), prostate-specific antigen (PSA) blood test, and MRI imaging may be needed to differentiate between these conditions and confirm the diagnosis.
If the lesion is determined to be a prostate calculus, management options will depend on the size and location of the calculus, as well as the presence of associated symptoms. Small, asymptomatic calculi may not require treatment and can be monitored with observation. Larger calculi that are causing significant symptoms may require medications, surgical procedures such as transurethral resection of the prostate (TURP), or laser therapy to break up and remove the calculus.
Prostate calcification:
TRUS scan prostate:
Multiple fluffy echogenic foci are seen in bilateral regions of the prostate. 👇👇
A fluffy central area of prostate calcification is present. It mimics a prostate calculus, but is less echogenic than prostate calculus.
The patient is a middle aged male.
Management of prostate calcification:
Prostate calcification does not require treatment unless it is associated with underlying conditions such as BPH or chronic prostatitis. In these cases, treatment may be focused on managing the underlying condition. Management options may include:Medications: such as alpha-blockers, 5-alpha-reductase inhibitors, or antibiotics
Lifestyle modifications such as increasing fluid intake, avoiding caffeine and alcohol, and practicing pelvic floor exercises
Surgery or other procedures such as transurethral resection of the prostate (TURP) or laser therapy may be recommended for severe cases of BPH.
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