Prostatic calculi are found within the prostate gland per se and are found uncommonly within the prostatic urethra.
They are thought to represent calcified corpora amylacea and are rarely found in boys. Usually small and numerous, they are noted to be tannish gray in color during transurethral resection of the prostate. They are commonly located at the margin of the surgically resected adenoma and are composed of calcium phosphate. Although usually of no clinical significance, rarely they are associated with chronic prostatitis. Large prostatic calculi may be misinterpreted as a carcinoma.
Figure 16–23. A: Plain abdominal radiograph demonstrating 2 bladder calculi. B: Gross picture of removed blad-
der calculi. Note the characteristic shape of jack-stones typically composed of uric acid.
The prostate is usually mobile, however, and a radiograph or transrectal ultrasound helps to confirm the diagnosis.
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Seminal vesicle stones are smooth and hard and are extremely rare. They may be associated with hematospermia. Physical examination reveals a stony hard gland, and when multiple stones are present, a crunching sensation may be noted. These stones occasionally are confused with tuberculosis of the seminal vesicle.
Figure 16–24. A: Scout abdominal radiograph demonstrating extraosseous calcification in the region of the blad-
der. B: Intravenous pyelogram demonstrates stone to be within a ureterocele.
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Marshall L. Stoller, MD
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REFERENCES
- Ackermann D et al: Influence of calcium content in mineral water on chemistry and crystallization conditions in urine of calcium stone formers. Eur Urol 1988;14:305.
- Allie-Hamdulay S et al: Prophylactic and therapeutic properties of a sodium citrate preparation in the management of calcium oxalate urolithiasis: Randomized, placebo-controlled trial. Urol Res 2005;33:116.
- Bilezikian JP et al: Primary hyperparathyroidism: New concepts in clinical, densitometric and biochemical features. J Intern Med 2005;257:6.
- Fellstrom B et al: Dietary habits in renal stone patients compared with healthy subjects. Br J Urol 1989;63:575.
- Gentle DL et al: Geriatric nephrolithiasis. J Urol 1997;158:2221.
- Heller HJ et al: Effect of dietary calcium on stone forming propensity. J Urol 2003;169:470.
- Langley SE, Fry CH: The influence of pH on urinary ionized [Ca2+]:
