STORZ MEDICAL – Literature Databases
STORZ MEDICAL – Literature Databases
Literature Databases
Literature Databases

Palmieri A. et al., 2022: Extracorporeal shock wave therapy in association with bromelain and escin for the management of patients affected by chronic prostatitis/chronic pelvic pain syndrome.

Palmieri A, Cai T, Di Luise L, D'Alterio C, La Cava G, Cirigliano L, Di Giovanni A, Gallelli L, Capece M.
Department of Neurosciences, Reproductive Sciences, Odontostomatology-Urology Unit, University of Naples 'Federico II', I-80100 Naples, Italy.
Department of Urology, Santa Chiara Regional Hospital, I-38123 Trento, Italy.
Institute of Clinical Medicine, University of Oslo, 0010 Oslo, Norway.
Department of Urology, A.s.p. Crotone, I-88900 Crotone, Italy.
Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini Hospital, I-88100 Catanzaro, Italy.
Department of Health Sciences, School of Medicine, University of Catanzaro, I-88100 Catanzaro, Italy.
Research Center, Department of Health Sciences, University of Catanzaro, I-88100 Catanzaro, Italy.

Abstract

Extracorporeal shock wave therapy (ESWT) has been purposed for the management of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with encouraging results. Phytotherapeutic compounds have been used in everyday clinical practice for patients with CP/CPSS due to their anti-inflammatory properties. The present study aimed to investigate the effects of ESWT in association with the use of bromelain and escin extracts in patients with CP/CPSS. For this purpose, 95 patients with a clinical diagnosis of CP/CPSS were enrolled in the study. The patients were randomly allocated to either the ESWT plus bromelain and escin group (group A; n=48) or the ESWT only group (group B; n=47). A total of five weekly ESWT treatment sessions were administered alone or in combination with bromelain and escin. Each session consisted of 3,000 focused shock waves. Doses of 160 and 500 mg/day bromelain and escin were administered respectively for 5 weeks. The changes in urinary symptoms, pain and quality of life were considered the main outcome measures and were assessed at baseline, and at 4, 12 and 24 weeks of follow-up. Urinary symptoms, pain and quality of life were evaluated using the international prostatic symptoms score (IPSS), visual analog scale (VAS) and the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI). After 4 weeks, the mean VAS score, mean IPSS and mean satisfaction rate score had significantly improved in patients receiving ESWT plus bromelain and escin. After 12 weeks, the mean IPSS and mean satisfaction rate score were stable in the ESWT plus bromelain and escin group, while the mean VAS score was significantly lower when compared with the baseline values in both groups. On the whole, the present study demonstrates that in patients affected by CP/CPPS, treatment with ESWT plus bromelain and escin leads to pain resolution, and both treatments improve the IPSS, VAS and NIH-CPSI results.
Biomed Rep. 2022 Nov 25;18(1):7. doi: 10.3892/br.2022.1589. eCollection 2023 Jan. PMID: 36544851. FREE ARTICLE

0
 

Comments 1

Jens Rassweiler on Monday, 06 March 2023 09:30

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a clinical syndrome characterized by pain in the perineum, pelvis, suprapubic area, or external genitalia, and variable degrees of voiding and ejaculatory disturbance, without evidence of a bacterial infection. Among all non‐drug‐based therapies, physical therapies [such as extracorporeal shock wave therapy (ESWT) and intrarectal digital massage of the pelvic floor, psychological therapies and acupuncture have exhibited notable results in terms of clinical efficacy and improving the quality of life of patients. Previous studies have demonstrated the use of escin and bromelin in the management of CP/CPPS due to its anti‐inflammatory properties.

In this study, 95 patients with a clinical diagnosis of CP/CPSS were enrolled in the study. The patients were randomly allocated to either the ESWT plus bromelain and escin group (group A; n=48) or the ESWT only group (group B; n=47). A total of five weekly ESWT treatment sessions were administered alone or in combination with bromelain and escin. Each session consisted of 3,000 focused shock waves using the Storz Duolith. Doses of 160 and 500 mg/day bromelain and escin were administered respectively for 5 weeks. The changes in urinary symptoms, pain and quality of life were considered the main outcome measures and were assessed at baseline, and at 4, 12 and 24 weeks of follow‐up.

The authors focus in Results mainly on the slightly better results of the combination of phytotherapy and Li-ESWT considering pain relief, however, I think the most importsnt message is the fact, that Li-ESWT with and without phytotherapy had a positive effect on all domains. The authors already mentioned a significant limitation oof the study, because there is no placebo-group.
Thus, either new studies with placebo-group should be initiated or further studies with Li-ESWT alone should follow.

Jens Rassweiler

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a clinical syndrome characterized by pain in the perineum, pelvis, suprapubic area, or external genitalia, and variable degrees of voiding and ejaculatory disturbance, without evidence of a bacterial infection. Among all non‐drug‐based therapies, physical therapies [such as extracorporeal shock wave therapy (ESWT) and intrarectal digital massage of the pelvic floor, psychological therapies and acupuncture have exhibited notable results in terms of clinical efficacy and improving the quality of life of patients. Previous studies have demonstrated the use of escin and bromelin in the management of CP/CPPS due to its anti‐inflammatory properties. In this study, 95 patients with a clinical diagnosis of CP/CPSS were enrolled in the study. The patients were randomly allocated to either the ESWT plus bromelain and escin group (group A; n=48) or the ESWT only group (group B; n=47). A total of five weekly ESWT treatment sessions were administered alone or in combination with bromelain and escin. Each session consisted of 3,000 focused shock waves using the Storz Duolith. Doses of 160 and 500 mg/day bromelain and escin were administered respectively for 5 weeks. The changes in urinary symptoms, pain and quality of life were considered the main outcome measures and were assessed at baseline, and at 4, 12 and 24 weeks of follow‐up. The authors focus in Results mainly on the slightly better results of the combination of phytotherapy and Li-ESWT considering pain relief, however, I think the most importsnt message is the fact, that Li-ESWT with and without phytotherapy had a positive effect on all domains. The authors already mentioned a significant limitation oof the study, because there is no placebo-group. Thus, either new studies with placebo-group should be initiated or further studies with Li-ESWT alone should follow. Jens Rassweiler
Friday, 12 July 2024