Kang Y. et al., 2021: The Efficacy and Safety of Extracorporeal Shockwave Therapy versus Acupuncture in the Management of Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Evidence Based on a Network Meta-analysis
Kang Y, Song P, Cao D, Di X, Lu Y, Liu P, Dong Q.
Department of Urology, Suining Central Hospital, Suining, Sichuan Province, China.
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
The Clinical Medical College of Lanzhou University, Lanzhou, Gansu Province, China.
The aim of this study was to evaluate the efficacy and safety of extracorporeal shockwave therapy (ESWT) and acupuncture therapy for patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). We searched electronic databases including PubMed, Cochrane Library, Embase and web of science from its inception to June 1, 2021. The randomized controlled trials (RCTs) that compared ESWT and acupuncture in the management of CP/CPPS were identified. A network meta-analysis was conducted with the software of STATA 14.0. Nine RCTs with 525 patients were enrolled in our analysis. The results revealed that both ESWT and acupuncture were significantly better than the sham procedure in the outcomes of total score of NIH-CPSI, pain subscore, urinary symptoms subscore, QoL subscore, IPSS score, the IIEF score and response rates (p < .05). Both ESWT and acupuncture were well-tolerated and had no obviously increased adverse events. Compared with acupuncture, ESWT was associated with better short term (24 w) efficacy than acupuncture.
Am J Mens Health. 2021 Nov-Dec;15(6):15579883211057998. doi: 10.1177/15579883211057998. PMID: 34911370. FREE ARTICLE
Given the problems with the clinically therapy-resistant urological conditions chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS), it is reassuring from this meta-analysis that both ESWT and acopuncture can be applied with positive effects. Unfortunately, the effect of ESWT was most pronounced only during first 12 weeks after treatment. For longer follow-up periods it was not possible to demonstrate differences between the two methods.
It is of importance to note, however, that all groups of patients included in the study were treated differently. For more reliable and solid conclusions it seems essential to formulate standardized treatment strategies which possibly should include treatment periods for ESWT beyond 4 weeks. It is of note that acopuncture was applied for periods up to 8-10 weeks.
My conclusion is that ESWT is an interesting therapeutic alternative for this clinically difficult group of patients, but the treatment strategy obviously needs to be refined.