Efficacy and safety of extracorporeal shockwave therapy for the treatment of chronic non-bacterial prostatitis: A systematic review and meta-analysis

Abstract

Purpose Chronic pelvic pain syndrome (CPPS) is one of the most common outpatient urological diagnoses, and its incidence is increasing. Extracorporeal shockwave therapy (ESWT) has been suggested for relieving local perineal symptoms associated with chronic prostatitis/CPPS. Despite several treatment methods, no causal or standardized treatment is available for CPPS. This study aimed to investigate the efficacy and safety profile of ESWT for the treatment of chronic non-bacterial prostatitis. Materials and methods Studies were collected using four search engines (Pubmed, Cochrane, ScienceDirect, and EBSCOHost), on May 16, 2020; and assessed based on predetermined inclusion and exclusion criteria. Two reviewers performed study selection. Studies were then analyzed using Review Manager 5.3 for the meta-analysis. Results Seventy-four publications were initially retrieved, and three studies were considered for both qualitative and quantitative analyses. From these studies, we found that the use of ESWT was significantly associated with decreased pain domain (mean difference: -3.93; 95% confidence interval [CI] -5.13, -2.73; p<0.001), improved urinary score (mean difference: -1.79; 95% CI -2.38, -1.21; p<0.001), improved quality of life (mean difference: -1.71; 95% CI -2.12, -1.31; p<0.001), and improved National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) score (mean difference: -5.45; 95% CI -5.74, -5.16; p<0.001) after 12 weeks of treatment. Conclusion ESWT is efficacious and safe in reducing pain and improving urinary condition, NIH-CPSI score, and quality of life in patients with chronic non-bacterial prostatitis.

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

“…The device used for the study was a standard electromagnetic shock wave unit with a focused shock wave source (P100, Wikkon Precision Technologies). Referring to the previous literature (Mykoniatis et al., 2021; Yuan et al., 2019), the Li‐ESWT regimen was designed as follows: once in a week for four weeks without anaesthesia at a frequency of 3 Hz and an energy flow density (EFD) from 0.20 mJ/mm 2 to 0.30 mJ/mm 2 (Birowo et al., 2020; Li & Man, 2021), which was adjusted according to patient tolerance and preferably 0.25 mJ/mm 2 based on our experience. The regimen was kept unchanged for as much as possible throughout the treatment.…”

“…The baseline clinical demographic information (age, height, weight, course and historical usage of medicines) was collected before commencing treatment (0 weeks), and the initial clinical condition was recorded by validated questionnaires, including the National Institute of Health Chronic Prostatitis Symptoms Index (NIH‐CPSI), International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF‐5) and Visual Analogue Scale (VAS) (Birowo et al., 2020; Guu et al., 2017; Li & Man, 2021; Zimmermann et al., 2009). The professional training on filling in the questionnaire had been given to the patient in 0 weeks.…”

Chronic Prostatitis: Impact of Lifestyle, Infection, and Inflammation on Semen Parameters

“…Chronic prostatitis is a disease of young adults under 50 years [8], [40], [41] characterized by voiding symptoms, genitourinary pain, and often sexual dysfunction, that may lead to impaired sexual and reproductive health [7], [8], [42], [43], [44], such as erectile dysfunction and premature ejaculation [42], [45], [46], [47], [48]. Erectile dysfunction is 3.6 times more common in men with chronic prostatitis symptoms [49], and up to 35% of patients with chronic prostatitis experience erectile dysfunction [48].…”

Effect of Xiaochaihu Decoction on Cytokines and MAO in Experimental Autoimmune Prostatitis Rats

“…Chronic prostatitis is a disease caused by a number of factors 5 that may lead to discomfort in the groin area, pelvic pain, irritable urination and sexual dysfunction 6 . Its histological characterization is the infiltration of multinucleate and mononuclear cells into interstitial connective tissues 7 .…”