Vahdatpour B et al, 2013: Efficacy of extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome: a randomized, controlled trial
Vahdatpour B, Alizadeh F, Moayednia A, Emadi M, Khorami MH, Haghdani S
Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
OBJECTIVES: To investigate the effectiveness of extracorporeal shock wave therapy (ESWT) for symptoms alleviation in chronic pelvic pain syndrome (CPPS).
MATERIALS AND METHODS: 40 patients with CPPS were randomly allocated into either the treatment or sham group. In the first group, patients were treated by ESWT once a week for 4 weeks by a defined protocol. In the sham group, the same protocol was applied but with the probe being turned off. The follow-up assessments were done at 1, 2, 3, and 12 weeks by Visual Analogue Scale (VAS) for pain and NIH-developed Chronic Prostatitis Symptom Index (NIH-CPSI).
RESULTS: Pain domain scores at follow-up points in both treatment and sham groups were reduced, more so in the treatment group, which were significant at weeks 2, 3, and 12. Urinary scores became significantly different at weeks 3 and 12. Also, quality of life (QOL) and total NIH-CPSI scores at all four follow-up time points reduced more significantly in the treatment group as compared to the sham group. Noticeably, at week 12 a slight deterioration in all variables was observed compared to the first 3 weeks of the treatment period.
CONCLUSIONS: our findings confirmed ESWT therapy as a safe and effective method in CPPS in short term.
ISRN Urol. 2013 Aug 28;2013:972601. doi: 10.1155/2013/972601. eCollection 2013
PMID:24000311 [PubMed]. PMCID:PMC3755541. FREE ARTICLE
For a medical condition that so far has defied most therapeutic efforts – and they are indeed numerous- it is promising to note that ESWT has least some positive short-term effect. Expressed in terms of VAS-score a reduction from 4.6 to 2.9 is in fact small and a difference between the ESWT and the control patients was only recorded at the higher energy levels (0.30 – 0.35 mJ/mm2). After two weeks (two treatments?) the pain scores were reduced by 1.4 and 1.0, respectively, in the two groups. But why are there no data after the 4 week session?
The important question is if this regimen did result in a long-term effect. The 12-week result cast some doubt about that inasmuch as the results showed increased levels compared with those recorded after 3 weeks. It would really have been of great interest to see how the effect was after for instance 24 weeks. Such measurements would not have required another study but just a new set of questionnaires sent to the 40 patients. And hopefully the authors will provide such long-term follow-up data later.