Low-Energy Extracorporeal Shock Wave Therapy for Chronic Pelvic Pain Syndrome: Finally, the Magic Bullet?

Marszalek, Martin; Berger, Ingrid; Madersbacher, Stephan

doi:10.1016/j.eururo.2009.03.075

Cited by 29 publications

(28 citation statements)

References 13 publications

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“…Mariotto et al reported shock waves to induce nitric oxide (NO) synthesis, which is one of the mechanisms of the effectiveness of shock waves for inflammatory reaction, since NO is mediated in neuromuscular junction formation such as synaptic plasticity and neurotransmission in the peripheral nervous system. Besides, interrupting the ﬂow of nerve impulses by stimulation of nociceptive receptors and reduction in muscle tone are the potential mechanisms …”

Section: Discussionmentioning

confidence: 99%

“…According to national institutes of health, CP/CPPS belongs to type III prostatitis, which occurs frequently in men before the age of 50 . The growing prevalence rate affects about 50% of men at some point throughout their lives . Additionally, its notable morbidity is comparable to that of the condition after a heart attack and angina pectoris.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of low‐intensity extracorporeal shock wave therapy for the treatment of chronic prostatitis/chronic pelvic pain syndrome: A systematic review and meta‐analysis

Yuan

Zhang

et al. 2019

Neurourology and Urodynamics

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Aims Low‐intensity extracorporeal shock wave therapy (Li‐ESWT) has been applied in urolithiasis and some chronic diseases. We performed a systematic review and meta‐analysis to assess the efficacy of Li‐ESWT for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods A comprehensive search of MEDLINE, Web of Science, EMBASE, and the Cochrane Library to January 6, 2019 was performed for randomized controlled trials (RCTs) reporting on patients with CP/CPPS treated with Li‐ESWT compared with the sham group. Outcomes were evaluated based on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH‐CPSI). The quality assessment of included studies was performed by the Cochrane System. Results Six publications involving five RCTs with 280 patients were assessed in this review. NIH‐CPSI total score, pain domain and quality of life (QOL) were significantly better in the Li‐ESWT group than those in the control group at the endpoint (P < 0.00001, P = 0.003, and P < 0.00001), 4 weeks (P < 0.00001, P = 0.0002 and P < 0.00001) and 12 weeks (P < 0.00001, P < 0.00001, and P = 0.0002) after the treatment. For urinary score, significant difference existed at 12 weeks after the treatment (P = 0.006). At 24 weeks after treatment, there was no significant difference between the two groups in NIH‐CPSI total score (P = 0.26), pain domain (P = 0.32), urinary score (P = 0.07), and QOL (P = 0.29). Conclusions Li‐ESWT showed great efficacy for the treatment of CP/CPPS at the endpoint and during the follow‐up of 4 and 12 weeks, though the efficacy of 24‐week follow‐up was not significantly different due to insufficient data. Generally, Li‐ESWT is a promising minimal invasive method for the treatment of CP/CPPS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of low‐intensity extracorporeal shock wave therapy for the treatment of chronic prostatitis/chronic pelvic pain syndrome: A systematic review and meta‐analysis

Yuan

Zhang

et al. 2019

Neurourology and Urodynamics

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“…Proposed mechanisms include infection leading to pain via nociceptive nerve endings and receptors, pelvic floor hyperactivity, local chemical alterations, neurologic components, and perfusion disturbances [3, 12, 13]. The role of the prostate is challenging [13].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, effectiveness of perineal extracorporeal shock wave therapy (ESWT) has been investigated in CPPS patients [3, 6, 20, 21]. There are different mechanisms through which ESWT reduces pain: interrupting the flow of nerve impulses by hyperstimulation of nociceptors, healing tissue by revascularization processes, and reductions in muscle tone and spasticity [3, 20, 21].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Extracorporeal Shock Wave Therapy for the Treatment of Chronic Pelvic Pain Syndrome: A Randomized, Controlled Trial

et al. 2013

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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.

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Comparing two different low‐intensity shockwave therapy frequency protocols for nonbacterial chronic prostatitis/chronic pelvic pain syndrome: A two‐arm, parallel‐group randomized controlled trial

et al. 2021

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Background: Despite encouraging results, the optimal low-intensity shockwave therapy (LiST) protocol in patients with chronic prostatitis/chronic pelvic pain syndrome (CPPS) remains unknown. We conducted a two-arm, parallel-group, randomized controlled trial aiming to compare the efficacy and safety of six LiST sessions applied once or twice weekly.Methods: Fifty patients with CP/CPPS type IIIb were randomly assigned to six LiST sessions once (Group A, n = 25) or twice weekly (Group B, n = 25). Both groups followed the same treatment protocol in terms of LiST application, impulses (5000/ session), energy flux density (0.096 mJ/mm 2 ) and frequency (5 Hz). Subsequently, all participants were evaluated at 1 and 3 months after completion of LiST protocol.Results: At the follow-up evaluations, LiST significantly improved the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) total, pain and quality of life scores, as well as the International Index of Erectile Function-Erectile Domain (IIEF-ED) in both groups (p < .001 for all measures). Comparing between the two groups, no significant differences were demonstrated in the NIH-CPSI total, pain, urinary and quality of life scores, as well as in the International Prostate Symptom Score, IIEF-ED, and LiST-induced pain at both follow-up evaluations. Accordingly, no adverse events and no dropouts were observed in both groups. Conclusion:Six sessions of LiST applied once weekly for 6 weeks or twice weekly for 3 weeks seem to be equally safe and effective in patients with CP/CPPS. Nevertheless, further studies are necessary, since LiST gradually gains its place for the management of CP/CPPS.

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Low-Energy Extracorporeal Shock Wave Therapy for Chronic Pelvic Pain Syndrome: Finally, the Magic Bullet?

Cited by 29 publications

References 13 publications

Efficacy of low‐intensity extracorporeal shock wave therapy for the treatment of chronic prostatitis/chronic pelvic pain syndrome: A systematic review and meta‐analysis

Efficacy of low‐intensity extracorporeal shock wave therapy for the treatment of chronic prostatitis/chronic pelvic pain syndrome: A systematic review and meta‐analysis

Efficacy of Extracorporeal Shock Wave Therapy for the Treatment of Chronic Pelvic Pain Syndrome: A Randomized, Controlled Trial

Comparing two different low‐intensity shockwave therapy frequency protocols for nonbacterial chronic prostatitis/chronic pelvic pain syndrome: A two‐arm, parallel‐group randomized controlled trial

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