Author: Shazia Qureshi
In a small, double-blinded randomised study of male patients with chronic pelvic pain syndrome (CPPS), 6 sessions of low-intensity shockwave therapy (LiST) applied to the perineum once per week led to improvements in pain and quality of life scores over 24 weeks, compared with sham therapy, according to a study presented at the Virtual 35th Annual Congress of the European Association of Urology (EAU).
Ioannis Mykoniatis, MD, Aristotle University, Thessaloniki, Greece, and colleagues enrolled a total of 45 men who had been diagnosed with non-bacterial CPPS, and randomised them 2:1 to undergo either LiST (n = 30) or sham treatment (n = 15) once a week for 6 weeks using a Dornier Aries 2 device. Patients were followed-up for 24 weeks.
Sham treatment consisted of 5,000 shockwaves that produced no energy transmission, while the active LiST treatment consisted of 5,000 shockwaves at an energy flux density of 0.1 mJ/mm2, in both cases applied at the perineum without anaesthesia.
On multiparametric magnetic resonance imaging of the prostate, the researchers did not see significant changes before and after treatment. National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was used to evaluate treatment efficacy during the study.
Patients who received active LiST treatment reported a better NIH-CPSI total score compared with patients who had received sham treatment, and this comparison was significant at week 4 (16.0 vs 21.7; P = .002), week 12 (16.5 vs 22.3; P = .003), and week 24 (18.0 vs 23.9; P = .003).
There was no difference between groups on the urinary domain of the NIH-CPSI, in levels of prostate-specific antigen, in International Prostate Symptom Scores, in Prostate Imaging Reporting and Data System scores, or in maximum urine flow rate.
On the erectile function domain of the International Index of Erectile Function, patients in the active treatment group reported a better score compared with the sham group at week 24 (27 vs 25; P = .043), but not at earlier time-points in the study.
For the domains of pain and quality of life on the NIH-CPSI score, active treatment bested sham treatment at all time-points.
“The lack of any side-effects and the potential for repetition make LiST a promising treatment choice for patients with chronic pelvic pain syndrome,” the authors concluded.