Low intensity extracorporeal shockwave therapy for chronic pelvic pain syndrome: Long-term follow-up

Abstract

Chronic prostatitis (CP) is one of the diseases that reduce the quality of life (QoL) of young men. To date, there is no consensus on the management of these patients. It is essential to continue research into the treatment of CP, despite the use of various therapies, including low-energy extracorporeal shockwave therapy (ESWT). The main objective of this study is to observe and record the clinical symptomatology of patients during a 48-week follow-up period after ESWT treatment. Between 2019 and 2021, 28 patients with type IIIB CP/chronic pelvic pain syndrome were enrolled. Patients underwent ESWT once weekly for 4 weeks (3,000 individual sessions, maximum total energy flux density 0.25 mJ/mm2, frequency 3 Hz). Participants were assessed at 0, 4, 12, 24, 36 and 48 weeks post-treatment using the visual analogue scale (VAS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and International Index of Erectile Function (IIEF)-5. The mean age of patients was 47.1 ± 13.7 years (range 28–4 years). The positive effect of LI-ESWT was reflected in improvements in VAS, NIH-CPSI, and IIEF-5 scores. Regression of patients’ symptoms was observed as early as 4 weeks after treatment. The greatest progress was achieved at week 24. In addition, a slight worsening was observed at week 36 and 48, with stable progress. The treatment significantly improved the QoL of the patients, with the most significant improvement in the VAS score. In conclusion, this treatment approach is safe, most effective in the first 6 months. Thereafter, the efficacy of the treatment diminishes, but is sustained over a longer period.

Molecular mechanism and promising treatments of chronic prostatitis/chronic pelvic pain syndrome: An exploratory bibliometric analysis and literature review of preclinical studies

“…Although these mechanisms were widely used in preclinical studies to explore some interventions for the treatment of CP/CPPS, such as electroacupuncture might regulate TLR4/NF‐κB signaling pathway to relieve pelvic pain and attenuate prostatic inflammation in estradiol‐induced CNP rats [ 60 ] , Poria cocos polysaccharides could alleviate CNP by regulating the gut microbiota [ 70 ] , and low‐intensity extracorporeal shock wave therapy might reduce inflammation and pain in EAP rats via PI3K/AKT/FOXO1 pathway [ 51 ] , translational studies based on these mechanisms were actually quite rare. In fact, treatments such as acupuncture and low‐energy shock waves had already been used clinically [ 76,77 ] , and these mechanisms were used only to explain the biological basis behind their clinical efficacy. However, it is undeniable that more targeted therapies based on these mechanisms might be needed to better control the symptoms of CP/CPPS in the future.…”