Li G. et al., 2021: Low-intensity extracorporeal shock wave therapy for male chronic pelvic pain syndrome: a systematic review and meta-analysis.
Li G., Man L.
Department of Urology, Beijing Jishuitan Hospital, Beijing, China.
Background: A systematic review of the evidence was conducted to evaluate the efficacy of low-intensity extracorporeal shock wave therapy (LI-ESWT) for patients with chronic pelvic pain syndrome (CPPS). Methods: A comprehensive search was undertaken of the Cochrane Register, PubMed, and Embase databases for controlled trials that evaluated patients with CPPS who were treated with LI-ESWT and that were published before August 2019. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was the most frequently used tool to evaluate the treatment efficacy of LI-ESWT. The NIHCPSI comprises subscales for pain [using a visual analog scale (VAS)], urinary function, and quality of life (QoL). Results: Six studies analyzing 317 patients were published from 2009 to 2019. The overall meta-analysis of the data indicated that LI-ESWT demonstrated efficacy in the treatment of CPPS at 12 weeks [risk difference (RD): 0.46; 95% confidence interval (CI), 0.28–0.63; P0.05). Conclusions: Based on these studies, LI-ESWT may transiently improve the total NIH-CPSI scores, QoL, pain scores, and urinary symptom scores of patients with CPPS. Future research may elucidate the mechanisms underlying the effects of LI-ESWT on CPPS. Well-designed and long-term multicenter randomized controlled trials are urgently needed to estimate the real potential and ultimate use of these devices in patients with CPPS.
Man L.Transl Androl Urol. 2021 Mar;10(3):1202-1211. doi: 10.21037/tau-20-1423. PMID: 33850755. FREE ARTICLE
This is another “systematic review and meta-analysis” (PRISMA), today increasingly common in urology.
It is well recognized that patients with chronic pelvic pain syndrome are difficult to treat and the urologist commonly is left without effective tools. For these patients Li-ESWT to some extent is a promising treatment alternative.
Information extracted from this report showed that the National Institutes of Health Chronic Prostatitis Syndrome Index (NIH-CPSI) score and urinary symptoms improved for up to 12 weeks after Li-ESWT. Treatments were carried out with energy flux densities 0.05-0.06 mJ/mm2 and 0.25 mJ/mm2.
The conclusion was that it cannot be decided which energy that is required and, unfortunately, that there is only a limited duration of the effect; less than 12 weeks.
It seems necessary to find a therapeutic regimen that is clinically feasible, but the observed improvement nevertheless is an opening in a field with so far little clinical progress.