madman
Super Moderator
Purpose: To assess the safety and effect of the multifocal low-intensity extracorporeal shockwave therapy (MESWT) in the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
Materials and Methods: We randomly separated 30 patients with CP/CPPS into a MESWT and placebo group of the same number using a prospective-randomized, double-blind design. The participants’ National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total and subdomain scores, International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), and visual analog scale (VAS) were assessed and compared at baseline and at finishing immediately and 4 weeks after the procedure and also were compared between MESWT and placebo groups.
Results: A total of 30 participants were randomized to a MESWT or placebo group. Twenty of thirty participants completed this trial. NIH-CPSI total and subdomain scores, IPSS, IIEF-5, and VAS had significantly ameliorated compared with baseline in the MESWT group at 4 weeks assessment. Furthermore, a comparison of the results from MESWT and placebo groups represented statistically significant differences in NIH-CPSI total and subdomain scores, IPSS, IIEF-5, and VAS. No side effects or events have occurred in both groups of the participants during study periods.
Conclusions: MESWT can be an effective treatment modality in patients with CP/CPPS as it improves pain and QoL.
Chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS) is a frequent urologic disease in male [1,2]. National Institutes of Health (NIH) category III CP/CPPS is the most common subtype of prostatitis, with heterogeneous and mainly uncertain causes. Inflammatory and non-inflammatory CP/CPPS is distinguished according to the clinical presentation of patients, the absence or presence of white blood cells or bacteria in the expressed prostate secretion (EPS), post prostatic massage urine or seminal fluid [3,4]. The major symptoms of this disease contain persistent and recurrent pelvic floor, lower abdomen, perineum, scrotum, and penis pain and discomfort, various degrees of lower urinary tract symptoms such as dysuria, frequency, urgency and sense of incomplete urination.
Many studies represented that CP/CPPS III patients have been suffered for a long time without treatment. Furthermore, there is no standard therapy of CP/CPPS until a recent date [5,6]. Various treatment options are suggested, like antibiotics, non-steroidal anti-inflammatory agents, α-blocker, and non-medical modalities (electromagnetic therapy, physiotherapy, neuromodulatory therapy, intraprostatic injection, and transcutaneous electrical nerve stimulation). However, any of these therapy modalities did not reveal a significant success rate [2,7,8].
Several studies have recently reported the effectiveness and safety of low-intensity extracorporeal shock wave therapy (Li-ESWT) for patients with CP/CPPS [9-12]. However, these studies almost utilized uni-focal ESWT for the treatment of CP/CPPS. Recently, multifocal low-intensity extracorporeal shock wave therapy (MESWT) was invented and manufactured in Korea. The main feature of MESWT is that the treatment effect can be increased by expanding the shockwave therapy zone. To our knowledge, there was no study to evaluate the efficacy and safety MESWT for the treatment of CP/CPPS. This present study uses randomized controlled design in order to assess the exact effect of MESWT on the clinical effectiveness and safety of CP/ CPPS.
CONCLUSIONS
Our study results confirmed the efficacy and safety of MESWT in cases of CP/CPPS in the short term. MESWT is cost-effective, easy to conduct, and prevents side effects. MESWT is a local treatment with the opportunity of repeating the treatment at all times. It is mandatory to perform large-number and long-term follow-up studies comparing the effectiveness of unifocal ESWT to that of MESWT.
Materials and Methods: We randomly separated 30 patients with CP/CPPS into a MESWT and placebo group of the same number using a prospective-randomized, double-blind design. The participants’ National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total and subdomain scores, International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), and visual analog scale (VAS) were assessed and compared at baseline and at finishing immediately and 4 weeks after the procedure and also were compared between MESWT and placebo groups.
Results: A total of 30 participants were randomized to a MESWT or placebo group. Twenty of thirty participants completed this trial. NIH-CPSI total and subdomain scores, IPSS, IIEF-5, and VAS had significantly ameliorated compared with baseline in the MESWT group at 4 weeks assessment. Furthermore, a comparison of the results from MESWT and placebo groups represented statistically significant differences in NIH-CPSI total and subdomain scores, IPSS, IIEF-5, and VAS. No side effects or events have occurred in both groups of the participants during study periods.
Conclusions: MESWT can be an effective treatment modality in patients with CP/CPPS as it improves pain and QoL.
Chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS) is a frequent urologic disease in male [1,2]. National Institutes of Health (NIH) category III CP/CPPS is the most common subtype of prostatitis, with heterogeneous and mainly uncertain causes. Inflammatory and non-inflammatory CP/CPPS is distinguished according to the clinical presentation of patients, the absence or presence of white blood cells or bacteria in the expressed prostate secretion (EPS), post prostatic massage urine or seminal fluid [3,4]. The major symptoms of this disease contain persistent and recurrent pelvic floor, lower abdomen, perineum, scrotum, and penis pain and discomfort, various degrees of lower urinary tract symptoms such as dysuria, frequency, urgency and sense of incomplete urination.
Many studies represented that CP/CPPS III patients have been suffered for a long time without treatment. Furthermore, there is no standard therapy of CP/CPPS until a recent date [5,6]. Various treatment options are suggested, like antibiotics, non-steroidal anti-inflammatory agents, α-blocker, and non-medical modalities (electromagnetic therapy, physiotherapy, neuromodulatory therapy, intraprostatic injection, and transcutaneous electrical nerve stimulation). However, any of these therapy modalities did not reveal a significant success rate [2,7,8].
Several studies have recently reported the effectiveness and safety of low-intensity extracorporeal shock wave therapy (Li-ESWT) for patients with CP/CPPS [9-12]. However, these studies almost utilized uni-focal ESWT for the treatment of CP/CPPS. Recently, multifocal low-intensity extracorporeal shock wave therapy (MESWT) was invented and manufactured in Korea. The main feature of MESWT is that the treatment effect can be increased by expanding the shockwave therapy zone. To our knowledge, there was no study to evaluate the efficacy and safety MESWT for the treatment of CP/CPPS. This present study uses randomized controlled design in order to assess the exact effect of MESWT on the clinical effectiveness and safety of CP/ CPPS.
CONCLUSIONS
Our study results confirmed the efficacy and safety of MESWT in cases of CP/CPPS in the short term. MESWT is cost-effective, easy to conduct, and prevents side effects. MESWT is a local treatment with the opportunity of repeating the treatment at all times. It is mandatory to perform large-number and long-term follow-up studies comparing the effectiveness of unifocal ESWT to that of MESWT.
