Efficacy and safety evaluation of low‐intensity extracorporeal shock wave therapy on prostatitis‐like symptoms: An open‐label, single‐arm trial

Jin, Chen; Zhang, Song; Mo, Fan; Zhang, Meng; Meng, Jialin; Bian, Zichen; Fu, Ziyue; Fang, Qiaozhou; Kong, Xiangbin; Feng, Bin; Wang, Zhiping; Jiang, Zhancheng; Chen, Ming; Zhang, Li; Song, Zhengyao; Hao, Zongyao; Liang, Chaozhao

doi:10.1111/and.14260

Cited by 7 publications

(7 citation statements)

References 35 publications

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“…LESW has also been used to treat male patients with prostatitis-like symptoms without remarkable adverse effects [ 83 ]. In a recent prospective, randomized clinical trial, patients with OAB symptoms who received LESW (0.25 mJ/mm 2 , 3000 pulses, three pulses/s) once a week for 8 weeks exhibited significant symptom improvement in comparison with sham controls, and the therapeutic effect lasted up to 6 months [ 84 ].…”

Section: Lesw Reduces Tissue Inflammation and Attenuates Pain And Bla...mentioning

confidence: 99%

Low-Energy Shock Wave Plus Intravesical Instillation of Botulinum Toxin A for Interstitial Cystitis/Bladder Pain Syndrome: Pathophysiology and Preliminary Result of a Novel Minimally Invasive Treatment

2022

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Low-energy shock wave (LESW) therapy is known to facilitate tissue regeneration with analgesic and anti-inflammatory effects. LESW treatment has been demonstrated to be effective in treating chronic prostatitis and pelvic pain syndrome as well as overactive bladder, and it has a potential effect on interstitial cystitis/bladder pain syndrome (IC/BPS) in humans. LESW reduces pain behavior, downregulates nerve growth factor expression, and suppresses bladder overactivity by decreasing the expression of inflammatory proteins. Previous rat IC models have shown that LESW can increase urothelial permeability, facilitate intravesical delivery of botulinum toxin A (BoNT-A), and block acetic acid-induced hyperactive bladder, suggesting that LESW might be a potential therapeutic module for relieving bladder inflammatory conditions, such as bladder oversensitivity, IC/BPS, and overactive bladder. A recent clinical trial showed that LESW monotherapy was associated with a significant reduction in pain scores and IC symptoms. BoNT-A detrusor injection or liposome-encapsulated BoNT-A instillation could also inhibit inflammation and improve IC symptoms. However, BoNT-A injection requires anesthesia and certain complications might occur. Our preliminary study using LESW plus intravesical BoNT-A instillation every week demonstrated an improvement in global response assessment without any adverse events. Moreover, an immunohistochemistry study revealed the presence of cleaved SNAP25 protein in the suburothelium of IC bladder tissue, indicating that BoNT-A could penetrate across the urothelial barrier after application of LESW. These results provide evidence for the efficacy and safety of this novel IC/BPS treatment by LESW plus BoNT-A instillation, without anesthesia, and no bladder injection. This article reviews the current evidence on LESW and LESW plus intravesical therapeutic agents on bladder disorders and the pathophysiology and pharmacological mechanism of this novel, minimally invasive treatment model for IC/BPS.

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Section: Lesw Reduces Tissue Inflammation and Attenuates Pain And Bla...mentioning

confidence: 99%

Low-Energy Shock Wave Plus Intravesical Instillation of Botulinum Toxin A for Interstitial Cystitis/Bladder Pain Syndrome: Pathophysiology and Preliminary Result of a Novel Minimally Invasive Treatment

2022

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“…ESWT is an emerging and promising CP/CPPS treatment modality [ 17 ]. Most studies of ESWT effectiveness among CP/CPPS patients had short term follow up of 8–12 weeks post treatment [ 10 , 11 , 15 ]. Long-term studies of the effectiveness of ESWT (6–12 months) had small samples of up to 31 patients [ 12–14 ].…”

Section: Discussionmentioning

confidence: 99%

Short and long-term effectiveness of external shock wave therapy for chronic pelvic pain syndrome in men

Khalafalla

Albakr

Ansari

et al. 2023

Arab Journal of Urology

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Introduction Chronic pelvic pain syndrome (CPPS) is a frequent urological diagnosis that affects men’s quality of life. Extracorporeal shockwave therapy (ESWT) is a recent treatment option for patients with CPPS. We evaluated ESWT’s short and long – term efficacy in managing CPPS. Methods This prospective self-controlled study included 75 patients diagnosed with CPPS at our tertiary pelvic pain clinic between January 2017-June 2019. Patients were referred for ESWT and received four sessions one week apart. The National Institute for Health – Chronic Prostatitis Symptom Index (NIH – CPSI) questionnaire was used to assess patients’ symptom severity before starting therapy and at 0, 12 and 26 weeks after completing ESWT. Demographics, clinical data and complications were also recorded. Results Patients’ mean age was 37.9 ± 8.6 years, and mean duration of symptoms was 5 ± 4.5 years. Compared to pre-treatment scores, all patients exhibited improvements across all NIH – CPSI domains directly after completing ESWT (week 0 post-treatment), with a mean difference improvement of 9.26 ± 5.7, 5.2 ± 3.4, 1.19 ± 2.18 and 2.88 ± 2.46 points in the total, pain, urinary symptoms, and quality-of-life scores respectively. At 12 weeks after completing ESWT, 80.9% of patients reported improvements, with mean difference improvement of 8.07 ± 7.56, 4.55 ± 4.6, 0.76 ± 2.48, 2.85 ± 2.78 in the total, pain, urinary symptoms, and quality-of-life scores respectively. Again, none of the patients developed any treatment-related complications. At 26 weeks after completing ESWT, 82.4% of patients reported improvements, with mean difference improvement of 8.29 ± 7.7%, 4.92 ± 4.69, 0.75 ± 2.96, 2.5 ± 3.0 in total, pain, urinary symptoms, and quality-of-life scores respectively. None of the patients developed treatment-related complications. Conclusions ESWT is a safe and effective treatment modality for patients with CPPS, with short-term improvement in total, pain, urinary symptom, and quality-of-life scores; and long-term improvement in total, pain, and quality-of-life scores.

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“…For the clinical LiST treatment, we chose a low-intensity shockwave with a frequency of 3 Hz and an energy density of 0.25 mJ/mm 2 based on prior studies ( 23 , 29 ). Patients received the treatment once a week over the course of four weeks.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, Mykoniatis et al (22) summarized the recent studies and highlighted the efficacy and safety of LiST to CP/CPPS patients clinical treatment, provided the high level of evidence about the effectiveness of LiST. Our team also assessed the treatment effectiveness of LiST in 91 patients with CP/CPPSlike symptoms in a prior study, the effective rate after 4 rounds of treatment was approximately 51.65%, which increased to 68.18% after 8 rounds of treatment (23).…”

Section: Introductionmentioning

confidence: 99%

Metabolomics Analysis Reveals the Differential Metabolites and Establishes the Therapeutic Effect Prediction Nomogram Among CP/CPPS Patients Who Respond or Do Not Respond to LiST

Meng

Jin

et al. 2022

Front. Immunol.

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ObjectiveLow-intensity shockwave therapy (LiST) has been applied in the clinical treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but few studies have focused on the prediction of its therapeutic effect before treatment.MethodsSeventy-five CP/CPPS patients from our institute between July 2020 and May 2021 were enrolled and received 3 Hz, 0.25 mJ/mm2 LiST once a week over the course of four weeks. The scores of the NIH-CPSI, IPSS questionnaire and demographic features before treatment were recorded. The plasma before LiST treatment was also collected, while liquid chromatography-tandem mass spectrometry was used to detect the metabolites. Least absolute shrinkage and selection operator (LASSO) regression analysis was employed to identify the prediction metabolites and generate the metabolism score. Receiver operating characteristic curves and calibration curves were drawn to assess the prediction accuracy of the nomogram.ResultsTwelve metabolites were identified at incomparable levels before and after LiST treatment. The metabolism score generated by LASSO analysis presented a perfect prediction value (AUC: 0.848, 95% CI: 0.719-0.940) in the training cohort and further increased to 0.892 (95% CI: 0.802-0.983) on the nomogram, which accompanied with the NIH-CPSI scores and age. Similar results of the metabolism score (AUC: 0.732, 95% CI: 0.516-0.889) and total nomogram (AUC: 0.968, 95% CI: 0.909-1.000) were obtained in the testing cohort. Further enrichment of the 12 metabolites indicated that the glycine and serine metabolism pathway was involved in the LiST treatment.ConclusionWe used our system to accurately and quantitatively measure plasma metabolites and establish a predictive model to identify suitable patients for LiST treatment.

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Efficacy and safety evaluation of low‐intensity extracorporeal shock wave therapy on prostatitis‐like symptoms: An open‐label, single‐arm trial

Cited by 7 publications

References 35 publications

Low-Energy Shock Wave Plus Intravesical Instillation of Botulinum Toxin A for Interstitial Cystitis/Bladder Pain Syndrome: Pathophysiology and Preliminary Result of a Novel Minimally Invasive Treatment

Low-Energy Shock Wave Plus Intravesical Instillation of Botulinum Toxin A for Interstitial Cystitis/Bladder Pain Syndrome: Pathophysiology and Preliminary Result of a Novel Minimally Invasive Treatment

Short and long-term effectiveness of external shock wave therapy for chronic pelvic pain syndrome in men

Metabolomics Analysis Reveals the Differential Metabolites and Establishes the Therapeutic Effect Prediction Nomogram Among CP/CPPS Patients Who Respond or Do Not Respond to LiST

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