Sokmen D. et al., 2023: Efficacy and Safety of Extracorporeal Shock Wave Therapy in the Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome and Acquired Premature Ejaculation Patients
Sokmen D, Comez YI.
Androexpertise Clinic, Istanbul, Turkey.
Department of Urology, Memorial Bahcelievler Hospital, Istanbul, Turkey.
Abstract
Introduction: The aim of this study was to evaluate the efficacy and safety of extracorporeal shock wave therapy (ESWT) in patients with acquired premature ejaculation (APE) due to chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
Method: Patients with APE due to CP/CPPS between January 2020 and June 2022 were included in the study. Demographic data of the patients were recorded, and the degree of their symptoms was evaluated with the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), premature ejaculation diagnostic tool (PEDT), and Premature Ejaculation Profile (PEP). The international prostate symptom index (IPSS) was also used for lower urinary tract symptoms (LUTS), and the international erectile function index-erectile function (IIEF-EF) was used to evaluate erectile functions. All patients received treatment with the Medispec Bold Li-ESWT device without using any anesthesia method (12 sessions). The changes in the symptom scores of the patients were evaluated before the treatment and at the 3rd month after the treatment.
Results: A total of 42 patients were included in the study. The mean age of the patients was 43.75 ± 12.03 (20-55), and the mean BMI was 23.58 ± 7.61 (18.03-35.98) kg/m2. The patients' estimated mean intravaginal ejaculation latency time (IELT) before ESWT was 37.98 ± 21.87 s. After a total of 12 sessions of ESWT, the IIEF-EF, IPSS, NIH-CPSI, and PEP index scores of the patients showed significant improvements (p < 0.001 for each). The IELT mean increased to 74.81 ± 46.79 s (p < 0.001). Posttreatment IELT fold increase was determined as 3.25 ± 1.72 fold. A highly significant positive correlation (p = 0.032; r = 0.839) was found between the CPSI score difference and the posttreatment PEP index score.
Conclusion: Li-ESWT treatment is an effective and safe treatment with positive effects on both LUTS and premature ejaculation in patients with APE symptoms due to CP/CPPS. Patients who benefit from CP treatment also have longer IELT times.
Urol Int. 2023 Aug 23:1-5. doi: 10.1159/000531623. Online ahead of print. PMID: 37611558.
Comments 1
This study aimed to assess the effectiveness and safety of extracorporeal shock wave therapy (ESWT) in patients with acquired premature ejaculation (APE) resulting from chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
Patients with APE due to CP/CPPS were treated with the Medispec Bold Li-ESW: 500 shock waves were applied to 6 perineal points (3,000 shock waves in total) in each session, from the penis to the prostate). The energy setting was 3 Hz frequency and the maximum total energy flow density was 0.25 mJ/mm2. The treatment responses of the patients who received a total of 12 sessions of 2 sessions per week were compared. Various symptom scores were recorded using standardized measures before and three months after treatment, including the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), premature ejaculation diagnostic tool (PEDT), Premature Ejaculation Profile (PEP), international prostate symptom index (IPSS), and international erectile function index-erectile function (IIEF-EF).
Forty-two patients participated, with a mean age of 43.75 years. Following 12 ESWT sessions, significant improvements were observed in IIEF-EF, IPSS, NIH-CPSI, and PEP index scores (p indings. The study opens avenues for further exploration into the use of ESWT in patients with PE and CP/CPPS, emphasizing the potential correlation between improvements in lower urinary tract symptoms and premature ejaculation symptoms.
Jens Rassweiler