Introduction and Objectives: Prostatic calculi are common but little is known about their relation with prostate cancer. Retrospectively, we investigated the association of prostatic calculi with prostate cancer.
Material and Methods: Between July 2004 and March 2005, 141 patients who underwent sextant core transrectal ultrasound (TRUS) guided prostate biopsy were enrolled. All patients had a suspicion of prostate cancer in the form of prostate specific antigen (PSA) ≥ 4 ng/ml and/or abnormal digital rectal examination (DRE). Total prostate volume and the echo-pattern of the prostate as well as the presence of prostatic calculi were determined by TRUS for all patients. The patients were divided into three groups according to their PSA values (PSA < 10 ng/ml, PSA 10-20 ng/ml, and PSA ≥ 20 ng/ml respectively) and were evaluated separately.
Results: Prostatic calculi were detected in 76 patients (53.9 %). Out of 141 patients, 29 had positive prostate biopsy (20.6%). Patients, with PSA ≥ 20 ng/ml, were found to have 50% chance of having positive biopsy. Prostate biopsy was positive in 10% in patients with PSA < 10 ng/ml. No significant difference was found between the presence of prostatic calculi in patients with benign prostatic hyperplasia (BPH) and prostate cancer (54.9%, 51.7% respectively; P = 0.56). Patients with prostate cancer and PSA < 10 ng/ml were associated with statistically insignificant higher incidence of prostate calculi compared to patients with BPH in the same group (83.33, 59.3% respectively; p = 0.2). Chronic prostatitis was detected in 17 patients (12.1%) and only one patient with prostate cancer was found to have chronic prostatitis.
Conclusion: Our study suggests that there is no association between the presence of prostatic calculi and prostate cancer. The prostatic calculi show similar distribution between patients with BPH and prostate cancer. Although, it is not significant, the presence of prostate calculi is seen more in patients who have prostate cancer than those with BPH who have PSA 4-10 ng/ml. However, further studies including a larger number of patients should be carried out to confirm these preliminary results.