What are prostatic calculi (prostate stones)? Do they affect sexual function?

What are prostatic calculi (prostate stones)? Do they affect sexual function?

Prostatic calculi (also called prostate stones) are small brownish-gray stones that form in the prostate. Each stone, or calculus, is roughly the size of a poppy seed. A man may have one calculus, or he could have hundreds of calculi.
Most of the time, prostatic calculi themselves don’t cause any symptoms, and they often aren’t found during routine medical exams.
However, prostatic calculi can become infected and, in turn, lead to urinary tract infections and prostatitis (inflammation of the prostate gland).
Some men with prostate stones experience pain in the lower back, penis, or perineum (the area between the anus and the scrotum). They might also have trouble urinating.
Prostate stones are more common in men who are middle-aged or older, and especially in men with an enlarged prostate, prostate cancer, chronic prostatitis/chronic pelvic pain syndrome.
Prostatic calculi that don’t cause symptoms usually don’t require treatment. Sometimes, they pass on their own in a man’s urine.
If stones are causing symptoms or contributing to other prostate conditions, they might be treated with antibiotics. In more severe cases, they can be removed surgically.
The direct effects of prostatic calculi on a man’s sexual function have not been widely researched. Some studies have suggested that ejaculatory pain and erectile dysfunction (ED) might be associated with prostatic calculi, but more information is needed.
Men who have questions about prostatic calculi are encouraged to see their andrologist.

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What is chronic prostatitischronic pelvic pain syndrome (CPCPPS)?

What is chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)?

Prostatitis is inflammation of the prostate gland, the walnut-sized gland located below a man’s bladder. The prostate gland secretes fluid that, along with sperm, forms semen.

There are different types of prostatitis, one of which is chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This is the most common type. Young and middle-aged men are more likely to develop CP/CPPS, but it can happen at any age.

CP/CPPS may be classified as inflammatory or non-inflammatory.

In inflammatory cases, urine, semen, and fluid secreted by the prostate contain infection-fighting cells. But these fluids don’t contain bacteria.

When CP/CPPS is non-inflammatory, no infection-fighting cells and no bacteria are found in the fluid.

Men with CP/CPPS can experience chronic discomfort or pain in the groin, genitals, perineum (the area between the anus and the genitals), or bladder. They may have pain with urination and ejaculation as well. Many feel anxious about the situation.

But symptoms don’t happen to every man with CP/CPPS. Also, symptoms may come and go on their own.

CP/CPPS can be hard to diagnose because its symptoms are similar to other medical conditions, like kidney and bladder problems. Also, some researchers believe that CP/CPPS is not related to the prostate gland but may be caused by pelvic floor muscle strain instead.

Men usually undergo a digital rectal exam, during which their doctor inserts a lubricated, gloved finger into the rectum. By doing this, the doctor can feel any abnormalities in the prostate gland.

Doctors may also analyze urine and prostatic fluid. In some cases, blood tests, ultrasounds, MRIs, or biopsies are ordered to rule out other conditions.

CP/CPPS can also be difficult to treat and, unfortunately, it cannot always be cured. It can also take some time to find what best relieves a man’s symptoms. Some strategies for treating CP/CPPS symptoms include the following:


Anti-inflammatory, pain medications, and muscle relaxants may be recommended. Alpha-blockers, which help relax muscles around the prostate, may also help. Some doctors prescribe antibiotics for CP/CPPS, but this treatment option is controversial.


Some men find relief by taking a hot bath or by applying a heating pad or hot water bottle to the affected area.

Changes in diet.

Spicy foods and caffeinated or acidic drinks can aggravate symptoms for some men.

Lifestyle changes.

Activities that make symptoms worse, like bicycle riding, may need to be avoided.


Experimenting with different pillows or cushions may help a man who is uncomfortable while seated.

 Prostatic massages.

These massages can help release some pressure around the prostate.


Psychological issues among men with CP/CPPS are common. Men with the condition have considerably higher levels of anxiety than those without it. Some experts believe that psychological problems are part of the cause of CP/CPPS. Such problems could also develop as a result. In either case, talking to a counselor may help men cope with this aspect of CP/CPPS.

Men with severe CP/CPPS may require surgery.

Sometimes, CP/CPPS gets better on its own.

Most men with CP/CPPS can have sex as they did before. However, it may be uncomfortable at times, especially during a pain flare-up. Couples may need to take a break from sex until the discomfort passes.

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What is a penile rehabilitation program (PRP)?

What is a penile rehabilitation program (PRP)?

The prostate gland is surrounded by nerves that are critical for a man’s ability to have an erection.

When a man has prostate cancer, he may have a procedure called a prostatectomy, which involves removing the prostate gland. During a prostatectomy, a surgeon tries to preserve the surrounding nerves as much as possible. However, many men still have problems with erections after surgery.

Penile rehabilitation programs (PRPs) are like a form of physical therapy. For example, if a man has knee surgery, he may go to physical therapy and do exercises to strengthen his knee and get it back into good condition. If he doesn’t do his exercises, his knee may get weaker.

PRPs work in a similar way. They can help men recover their erectile function by inducing erections to “exercise” the penis. This process keeps erectile tissue healthy while the remaining nerves heal from surgery. The erections may be induced through oral medication, injections into the penis, penile suppositories, or vacuum devices. Some men are advised to masturbate on a regular basis.

Through penile rehabilitation, it is hoped that the patient will eventually have satisfactory erections on his own or will respond well to oral medications for erectile dysfunction.

It should be noted that some experts do not think penile rehabilitation is a worthwhile strategy.

Penile rehabilitation can take time – sometimes up to four years. With patience and dedication, however, many men are able to again have erections suitable for sex.

What does a penile rehabilitation program (PRP) involve?

Penile rehabilitation programs vary from clinic to clinic and patient to patient, but some of the more common strategies include the following:

Oral medications. Phosphodiesterase type 5 inhibitors, such as Viagra®, Levitra®, and Cialis®, improve blood flow to the penis and help keep erectile tissue healthy.

Penile Injections. The patient is trained to inject medication into his penis to prompt an erection.

Suppositories (MUSE). Pellets of medicine are inserted into the urethra, the tube that allows urine and semen to exit the body.

Vacuum erection devices. A clear plastic cylinder is placed over the penis. The man then uses a pump to draw out the air, creating a vacuum. This leads to an erection.

How successful are penile rehabilitation programs (PRPs)?

Penile rehabilitation programs (PRPs) can help men restore their ability to have erections after prostatectomy (removal of the prostate gland). However, several factors affect the success rate of PRPs:

The man must consider how well he was able to have erections before surgery. Men who had good erectile function beforehand can often recover that good function after penile rehabilitation. Men who had poor function may not be as successful.

The man needs to be compliant with the program, following his doctor’s instructions. Men who stick with the program diligently tend to have greater success than men who are not as dedicated.

Nerve-sparing also plays a role in recovery. The prostate gland is surrounded by nerves that are important for erectile function. Surgeons try to preserve as many nerves as possible, but usually there is some degree of nerve damage. The success of penile rehabilitation may depend on how much nerve damage results from surgery.

Other factors to consider are age, weight, smoking status, and any medical conditions like diabetes. Having additional treatments for prostate cancer, such as radiation and/or hormonal therapy, can also affect the outcome of penile rehabilitation.

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Should men with an enlarged prostate avoid certain medications?

Should men with an enlarged prostate avoid certain medications ?

Men with an enlarged prostate should not take medications that contain antihistamines or decongestants. These agents are often found in over-the-counter cold, sinus, and allergy medications.

To understand why, it helps to review some prostate anatomy. The prostate is a walnut-sized gland that produces seminal fluid. This fluid mixes with sperm to form ejaculate – the semen that is expelled from the penis when a man reaches orgasm.

Running through the prostate is the urethra – the tube from which urine and semen exit the body.

As men get older, it’s common for the prostate gland to grow inward. This results in an enlarged prostate or benign prostatic hyperplasia (BPH). Scientists aren’t sure why this happens. In some cases, the prostate itself does not enlarge, but it undergoes changes which make it more sensitive to chemicals that your body naturally produces.

The prostate may also undergo other changes which may slow down the flow of urine or increase urinary symptoms such as frequency and urgency.

Because of these changes, many men experience trouble emptying the bladder, find that they have to use the bathroom more often (especially at night), or feel a greater urge to urinate.

Antihistamines and decongestants may add to the problem. These drugs can make it harder for the prostate and the bladder to relax, making it even more difficult for urine to flow.

Fortunately, there are other ways to treat colds and allergies. Men with BPH should talk to their doctors about the treatments that are right for them.

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