Extracorporeal Shockwave Therapy (ESWT) Alleviates Pain, Enhances Erectile Function and Improves Quality of Life in Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome

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.

Extracorporeal shockwave therapy of the perineum for male patients with chronic pelvic pain syndrome: a pilot study

“…Wu's paper shows that a pre-ESWT IPSS of 13.9 recorded a 27.1%, 38.0%, 42.0%, and 50.9% time-dependent improvement up to 1 year of result collection. 20 This was also concordant with Zimmerman's findings, which reported a 25% decrease in IPSS 3 months after ESWT. 7 Our study also demonstrated significant improvements in the frequency, urgency, weak stream, straining, and total score domain of the IPSS.…”

Global Trends in Research on extracorporeal shock wave therapy(ESWT) from 2000 to 2021

“…In 3 months after treatment in patients with maximum urinary ow rate increases, the bladder residual urine volume decreases. In the CPPS study (72), the experimental group treated with perineal ESWT (3000 pulses, 0.25 mJ/mm 2 , 4Hz) weekly experienced a reduction in refractory pain and a signi cant improvement in quality of life after 6 weeks of treatment.…”

The use of extracorporeal shock wave therapy along with other non-drug methods in the treatment of chronic prostatitis from the standpoint of modern evidence-based medicine

“…Wu и соавт. (2021)[21] c целью оценки долгосрочного влияния ЭУВТ провели когортное проспективное исследование с участием 215 мужчин с ХП/СХТБ категории IIIВ, рефрактерных к медикаментозной терапии. Всем исследуемым выполнено ЭУВТ по протоколу, включающему 3000 ударов с энергией 0,25 мДж/мм 2 и частотой 4 Гц 1 раз в неделю в течение 6 нед с использованием аппарата DUOLITH ® SD1 (Storz Medical AG, Швейцария).…”

“…Оценивались общий балл по NIH-CPSI, IPSS, МИЭФ-5, качество жизни при урологических симптомах согласно Американской урологической ассоциации (AUA QOL_US), шкала твердости эрекции (Erection Hardness Score, EHS) до и сразу после курса терапии, а также через 1, 2, 6 и 12 мес после лечения. Результаты исследования продемонстрировали, что ЭУВТ статистически значимо улучшает качество жизни, облегчает боль, улучшает эректильную функцию и окончательный эффект проявляется через 12 мес после курса терапии[21].Е.В. Кульчавеня и соавт.…”