Wu WL. et al., 2021: Extracorporeal Shockwave Therapy (ESWT) Alleviates Pain, Enhances Erectile Function and Improves Quality of Life in Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome.
Wu WL, Bamodu OA, Wang YH, Hu SW, Tzou KY, Yeh CT, Wu CC.
Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan.
TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei City 110, Taiwan.
Department of Hematology and Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan.
Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 110, Taiwan.
Department of Medical Laboratory Science and Biotechnology, Yuanpei University of Medical Technology, Hsinchu City 30015, Taiwan.
Abstract
Purpose: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), affecting over 90% of patients with symptomatic prostatitis, remains a therapeutic challenge and adversely affects patients' quality of life (QoL). This study probed for likely beneficial effects of ESWT, evaluating its extent and durability.
Patients and methods: Standardized indices, namely the pain, urinary, and QoL domains and total score of NIH-CPSI, IIEF-5, EHS, IPSS, and AUA QoL_US were employed in this study of patients with CP/CPPS who had been refractory to other prior treatments (n = 215; age range: 32-82 years; median age: 57.5 ± 12.4 years; modal age: 41 years).
Results: For CP symptoms, the mean pre-ESWT NIH-CPSI total score of 27.1 ± 6.8 decreased by 31.3-53.6% over 12 months after ESWT. The mean pre-ESWT NIH-CPSI pain (12.5 ± 3.3), urinary (4.98 ± 2.7), and QoL (9.62 ± 2.1) domain scores improved by 2.3-fold, 2.2-fold, and 2.0-fold, respectively, by month 12 post-ESWT. Compared with the baseline IPSS of 13.9 ± 8.41, we recorded 27.1-50.9% amelioration of urinary symptoms during the 12 months post-ESWT. For erectile function, compared to pre-ESWT values, the IIEF-5 also improved by ~1.3-fold by month 12 after ESWT. This was corroborated by EHS of 3.11 ± 0.99, 3.37 ± 0.65, 3.42 ± 0.58, 3.75 ± 0.45, and 3.32 ± 0.85 at baseline, 1, 2, 6, and 12 months post-ESWT. Compared to the mean pre-ESWT QoL score (4.29 ± 1.54), the mean QoL values were 3.26 ± 1.93, 3.45 ± 2.34, 3.25 ± 1.69, and 2.6 ± 1.56 for months 1, 2, 6, and 12 after ESWT, respectively.
Conclusions: This study shows ESWT, an outpatient and easy-to-perform, minimally invasive procedure, effectively alleviates pain, improves erectile function, and ameliorates quality of life in patients with refractory CP/CPPS.
.J Clin Med. 2021 Aug 16;10(16):3602. doi: 10.3390/jcm10163602. PMID: 34441902. FREE ARTICLE
Comments 1
The mean prevalence of CP/CPPS is given as 8 % (1). However, “it ranged from 2% to 9.7%. …. Possible reasons for this almost five-fold variation in prevalence include differences: in study design, selection of populations for investigation, cultural factors, variations in practice patterns, genetic differences or exposure to undefined risk factors”(1).
Most studies evaluated in that review were ~ 20 years old and are outdated. A more recent review by multiple authors is freely available (2). The present study also gives detailed information on the subject, however unfortunately the present study is again just a single-arm cohort study. It is a large study with 215 patients obviously well examined before the treatment. The treatment was 1 session per week during 6 weeks and the follow up was 12 months.
Patients were thoroughly examined before the procedure, but no details are reported. It seems that only 12 patients got an additional therapy with antibiotics. It is not clear if there was any self-medication and there is no information about a dropout rate. 40 references accompany the paper.
Peter Alken
1 Krieger JN, Lee SW, Jeon J, Cheah PY, Liong ML, Riley DE. Epidemiology of prostatitis. Int J Antimicrob Agents. 2008 Feb;31 Suppl 1(Suppl 1):S85-90. doi: 10.1016/j.ijantimicag.2007.08.028. Epub 2007 Dec 31. PMID: 18164907; PMCID: PMC2292121. Free PMC article
2 Magri V, et al. Multidisciplinary approach to prostatitis. Arch Ital Urol Androl. 2019 Jan 18;90(4):227-248. doi: 10.4081/aiua.2018.4.227. PMID: 30655633.