The article provides a comparative assessment of various methods of shock wave therapy used to treat patients with chronic calculous prostatitis and the presence of chronic pelvic pain syndrome. The mechanism of action of the radial pressure wave and focused shock wave therapy is analyzed in detail.
The treatment was carried out in 648 patients divided into 4 groups. In groups 1, 3 and 4, focused shock wave therapy was used using Piezo Wave devices from Richard Wolf of various generations with a piezoelectric generator G-4 (the source of shock waves is a piezoelectric self focusing hemisphere with an energy flux density in the focus area of up to 0,4 mJ/mm2 and pressure up to 82,2 mPa, shock wave pulsation frequency of 8 Hz) and G-10 (the source of shock waves is a piezoelectric self-focusing hemisphere with an energy flux density in the focus area of up to 0,6–2 mJ/mm2 and a pressure of up to 100,0 mPa, shock wave pulsation frequency 8 Hz).
The second group used a BTL-6000 SWT Topline radial pressure wave apparatus with a pressure of up to 5 bar and a frequency of up to 20 Hz. The treatment was carried out according to the method developed on the basis of the Research Institute of Urology of the National Academy of Medical Sciences of Ukraine. The technique includes: the use of shock wave therapy, transrectal photo-electrostimulation and electrophoresis of the rectal preparation fermencol. The technique has long established itself as an effective way to combat chronic pelvic pain syndrome.
The study was conducted in order to establish the most effective method of shock wave therapy and the optimal number and power of impulses per session, as well as the required number of sessions to achieve the maximum effect in relation to pain and in relation to a decrease in the area of prostate gland lesions by secondary changes: fibrosis and calculi, in order to further improve the technique, in connection with the emergence of new models of shock wave therapy devices with improved characteristics on the medical equipment market, article provides a comparative assessment of various methods of shock wave therapy used to treat patients with chronic calculous prostatitis and the presence of chronic pelvic pain syndrome. The mechanism of action of the radial pressure wave and focused shock wave therapy is analyzed in detail.
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Nickel JC. Classification and diagnosis of prostatitis: a gold standard? Andrologia. 2003;35(3):160–167.
Shoskes DA, Berger R, Elmi A, Landis JR, Propert KJ, Zeitlin S. Muscle tenderness in men with chronic prostatitis/chronic pelvic pain syndrome: the chronic prostatitis cohort study. Journal of Urology. 2008;179(2):556–560.
Marszalek M, Berger I, Madersbacher S. Low-energy extracorporeal shock wave therapy for chronic pelvic pain syndrome: finally, the magic bullet? European Urology. 2009;56(3):425–426.
Mehik A, Hellström P, Lukkarinen O, Sarpola A, Järvelin M-R. Epidemiology of prostatitis in Finnish men: a population-based cross-sectional study. British Journal of Urology International. 2000;86(4):443–448.
Nickel JC, Schaeffer AJ, Fowler JE, Jr., et al. Clinical evaluation of the man with chronic prostatitis/chronic pelvic pain syndrome. Urology. 2002;60(6, supplement): 20–23.
Zimmermann R, Cumpanas A, Hoeltl L, Janetschek G, Stenzl A, Miclea F. Extracorporeal shock-wave therapy for treating chronic pelvic pain syndrome: a feasibility study and the first clinical results. British Journal of Urology International. 2008;102(8):976–980.
Anothaisintawee T, Attia J, Nickel JC, et al. Management of chronic prostatitis/chronic pelvic pain syndrome: a systematic review and network meta-analysis. Journal of the American Medical Association. 2011;305(1):78–86.
Schaeffer AJ. Epidemiology and evaluation of chronic pelvic pain syndrome in men. International Journal of Antimicrobial Agents. 2008;31(1):S108–S111.
Walz J, Perrotte P, Hutterer G, et al. Impact of chronic prostatitis-like symptoms on the quality of life in a large group of men. British Journal of Urology International. 2007;100(6):1307–1311.
Turner JA, Hauge S, Von Korff M, Saunders K, Lowe M, Berger R. Primary care and urology patients with the male pelvic pain syndrome: symptoms and quality of life. Journal of Urology. 2002;167(4I):1768–1773.
Tripp DA, Nickel JC, Landis JR, Yan LW, Knauss JS. Predictors of quality of life and pain in chronic prostatitis/chronic pelvic pain syndrome: findings from the National Institutes of Health Chronic Prostatitis Cohort Study. British Journal of Urology International. 2004;94(9):1279–1282.
Pontari MA, Ruggieri MR. Mechanisms in prostatitis/chronic pelvic pain syndrome. Journal of Urology. 2004;172(3):839–845.
Marszalek M, Wehrberger C, Temml C, Ponholzer A, Berger I, Madersbacher S. Chronic pelvic pain and lower urinary tract symptoms in both sexes: analysis of 2749 participants of an urban health screening project. European Urology. 2009;55(2):499–508.
Clemens JQ, Nadler RB, Schaeffer AJ, Belani J, Albaugh J, Bushman W. Biofeedback, pelvic floor re-education, and bladder training for male chronic pelvic pain syndrome. Urology. 2000;56(6):951–955.
Zermann D-H, Ishigooka M, Doggweiler R, Schmidt RA. Neurourological insights into the etiology of genitourinary pain in men. Journal of Urology. 1999;161(3):903–908.
Nickel JC, Downey J, Clark J, et al. Levofloxacin for chronic prostatitis/chronic pelvic pain syndrome in men: a randomized placebo-controlled multicenter trial. Urology. 2003;62(4):614–617.
Nickel JC, Krieger JN, Mc-Naughton-Collins M, et al. Alfuzosin and symptoms of chronic prostatitis-chronic pelvic pain syndrome. New England Journal of Medicine. 2008;359(25):2663–2673.
Giubilei G, Mondaini N, Minervini A, et al. Physical activity of men with chronic prostatitis/chronic pelvic pain syndrome not satisfied with conventional treatments – could it represent a valid option? The physical activity and male pelvic pain trial: a double-blind, randomized study. Journal of Urology. 2007;177(1):159–165.
Nickel JC, Sorensen R. Transurethral microwave thermotherapy for nonbacterial prostatitis: a randomized double-blind sham controlled study using new prostatitis specific assessment questionnaires. Journal of Urology. 1996;155(6):1950–1955.
Zimmermann R, Cumpanas A, Miclea F, Janetschek G. Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome in males: a randomised, double-blind, placebo-controlled study. European Urology. 2009;56(3):418–424.
Yan X, Yang G, Cheng L, et al. Effect of extracorporeal shock wave therapy on diabetic chronic wound healing and its histological features. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012;26(8):961–967.
Nickel JC, Nyberg LM, Hennenfent M. Research guidelines for chronic prostatitis: consensus report from the first National Institutes of Health International Prostatitis Collaborative Network. Urology. 1999;54(2):229–233.
Krieger JN, Nyberg L, Nickel JC. NIH consensus definition and classification of prostatitis. Journal of the American Medical Association. 1999;282(3):236–237.
Ogden JA, Alvarez RG, Levitt R, Marlow M. Shock wave therapy (Orthotripsy) in musculoskeletal disorders. Clinical Orthopaedics and Related Research. 2001;(387):22–40.
Ogden JA, Tóth-Kischkat A, Schultheiss R. Principles of shock wave therapy. Clinical Orthopaedics and Related Research. 2001;(387):8–17.
Krischek O, Hopf C, Nafe B, Rompe J-D. Shock-wave therapy for tennis and golfer’s elbow-1 year follow-up. Archives of Orthopaedic and Trauma Surgery. 1999;119(1-2):62–66.
Manganotti P, Amelio E. Long-term effect of shock wave therapy on upper limb hypertonia in patients affected by stroke. Stroke. 2005;36(9):1967–1971.
Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971–979.
Wang C-J, Wang F-S, Yang KD, et al. Shock wave therapy induces neovascularization at the tendon-bone junction. A study in rabbits. Journal of Orthopaedic Research. 2003;21(6):984–989.
Malay DS, Pressman MM, Assili A, et al. Extracorporeal shockwave therapy versus placebo for the treatment of chronic proximal plantar fasciitis: results of a randomized, placebo-controlled, double-blinded, multicenter intervention trial. Journal of Foot and Ankle Surgery. 2006;45(4):196–210.
Дзюрак В.С., Сажай В.И., Сажай А.В., Бойко А.И. Хронический простатит. – К., 2003. – 124 с.
Горпинченко И.И. Роль хронического простатита в этиологии мужского бесплодия // Журнал практического врача. – 1998. – № 2. – С. 13–16.
Извозчиков С.Б., Болотов А.В., Шарвадзе Г.Г., и др. Невоспалительный синдром хронической тазовой боли у мужчин (история вопроса) // Урология. – 2007. – № 3. – С. 111–114.
Переверзев А.С. Заболевания предстательной железы. – Харьков, 2005. – С. 257.
Горпинченко И.И. Современный взгляд на лечение хронического простатита // Здоров’я України. – 2003. – № 64.