Long term efficacy of extracorporeal shock wave therapy [ESWT] for treatment of refractory chronic abacterial prostatitis

Abstract

ObjectiveTo evaluate the effect and safety of extracorporeal shockwave therapy (ESWT) on chronic pelvic pain syndrome (CPPS)/chronic abacterial prostatitis after failure of most other modalities of treatment, the maintenance of the treatment effect for up to one year post treatment and whether the patients are in need for further sessions.Materials and methodsIn a follow-up survey of 41 patients, the study inclusion criteria were CPPS patients who failed at least previously 3 modalities of treatment other than ESWT, who were treated by ESWT once a week for one month with a protocol of 2500 pulses at 1 bar over 13 min, Nonaddiction to drugs and narcotics. The exclusion criteria included being under treatment by another method another diagnosis such as prostate cancer, therapy plan alteration, and noninclination to continue this treatment. Then the patients were followed up at 2 weeks, 6 months and 12 months after finishing the course of ESWT. The study was designed as an open-label uncontrolled therapeutic clinical trial which was conducted in Jordan university hospital through the period 2015–2016. Data were compared using paired samples t-test.ResultsOf our total 55 patients 8 of them did not complete the study protocol, 6 of them had missed follow up over the whole follow up period and 41 patients were evaluated. The patient's age group ranged between 18 and 78 years with a mean age of 42 and a median age of 43. The mean of National Institutes of Health -Chronic Prostatitis Symptom Index (NIH-CPSI), the International Prostate Symptom Score (IPSS), American Urological Association Quality of Life Due to Urinary Symptoms (AUA QOL_US) and International Index of Erectile Function (IIEF) were evaluated pre and post ESWT at 2 weeks, 6 months and 12 months and it showed statistically significant improvement in all parameters with maintenance of the effect without any significant side-effect of the treatment over the 12 months.ConclusionsThe evidence in this study would support the safety and efficacy of ESWT in refractory cases of CPPS at least for one year post treatment.

Therapeutic effects of Low intensity extracorporeal low energy shock wave therapy (LiESWT) on stress urinary incontinence

“…Clinical trials on the safety and efficacy profile of LiESWT in treating female SUI are still not completely clear. Clinically, LiESWT has emerged in recent years to treat (1) chronic pelvic pain syndrome (CPPS) (0.10-0.25 mJ/ mm 2 , 3000 pulses, once/week, 4 weeks) to improve pain, bladder voiding and QoL 17,[24][25][26][27] ; (2) erectile dysfunction (ED) (0.10-0.25 mJ/mm 2 , 3000-6000 pulses, once/week, 4-8 weeks) to increase penile hemodynamics and induce penile tissue regeneration 18,28,29 . In this study, the recruited subjects had normal BMI, blood pressure, renal function, liver function, blood sugar level, and lipid profiles, thus eliminating the potential confounding factors ( Table 1).…”

Effect of radial shock wave on chronic pelvic pain syndrome/chronic prostatitis

“…Recently, ESWT has been investigated in CPPS due to its anti-inflammatory, analgesic, and anti-spastic effects. The previous studies showed that ESWT is an effective modality and is safe for the treatment of CPPS 12 , 13 , 14 , 15 , 16 , 17 ) .…”

Potential applications of low‐energy shock waves in functional urology

“…80 Previous studies have shown that LESW has protective effects on inflammatory reaction, by lowering the expression of NGF, IL-6, IL-12, TNF-a, COX-2 and iNOS. 67 82 There were no significant side-effects in these studies (Table 1). However, more trials with different protocols to maximize the short-and long-term outcome are required before LESW can be widely applied in non-bacterial prostatitis/CPPS.…”

“…Al Edwan et al . further demonstrated the maximal effects of LESW (ESWT once a week for 1 month, with a protocol of 2500 pulses on the perineum with total energy flow density 0.25 mJ/mm 2 over 13 min) on the IPSS, NIH‐CPSI and the American Urological Association Quality of Life due to Urinary Symptoms scale at 2 weeks; the effect was stabilized until 12 months . There were no significant side‐effects in these studies (Table ).…”