Extracorporeal shock wave therapy (ESWT) is a non-pharmacological, non-invasive procedure for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
The objective: to evaluate the dynamics and relationship of clinical symptoms and ejaculate cytokine concentrations during the use of ESWT in the treatment of patients with CP/CPPS.
Materials and methods. The study included 37 patients aged 18–45 years with CP/CPPS who received ESWT in the projection of the prostate and seminal vesicles. Symptoms of prostatitis were assessed by the NIH-CPSI scale, and ejaculate cytokines were assessed by ELISA before and after treatment. To analyze the results of treatment, patients with a significant reduction in the activity of prostatitis symptoms (by 6 or more points on the NIH-CPSI scale) were grouped into subgroup A. Patients with insufficient efficacy were grouped into subgroup B.
Results. After treatment, 21 (57%) patients significantly reduced the intensity of prostatitis symptoms (subgroup A). Patients with insufficient efficacy were grouped into subgroup B. The content of proinflammatory cytokine – interleukin-1β ejaculate significantly (p<0.05) increased only in these patients. In subgroup A, a significant correlation was found between the assessment of prostatitis symptoms on the NIH-CPSI scale and the concentration of interleukin-1β ejaculate (Spearman’s r=0.650; p<0.001 and r=0.735; p<0.001 before and after treatment, respectively). The concentration of the anti-inflammatory cytokine ejaculate (interleukin-10) increased significantly only in subgroup A (p<0.05).
Conclusion. Extracorporeal shock wave therapy provides a significant reduction in the symptoms of prostatitis causing dosed minimal damage and inflammation of the prostate and seminal vesicles, associated with an increase in the level of interleukin-1β in the ejaculate.
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Krieger JN, Nyberg L Jr, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA. 1999 Jul 21;282(3):236-7. DOI: 10.1001/jama.282.3.236. PMID: 10422990.
EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2021. ISBN 978-94-92671-13-4.
Hausner T, Nógrádi A. The use of shock waves in peripheral nerve regeneration: new perspectives? Int Rev Neurobiol. 2013;109:85-98. DOI: 10.1016/B978-0-12-420045-6.00003-1
Schmitz C, Császár NB, Milz S, Schieker M, Maffulli N, Rompe JD, Furia JP. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database. Br Med Bull. 2015;116(1):115-38. DOI: 10.1093/bmb/ldv047. Epub 2015 Nov 18.
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. Eur Urol. 2009 Sep;56(3):418-24. DOI: 10.1016/j.eururo.2009.03.043. Epub 2009 Mar 25. Erratum in: Eur Urol. 2020 May;77(5):e140.
Pajovic B, Radojevic N, Dimitrovski A, Vukovic M. Comparison of the efficiency of combined extracorporeal shock-wave therapy and triple therapy versus triple therapy itself in Category III B chronic pelvic pain syndrome (CPPS). Aging Male. 2016 Sep;19(3):202-207. DOI: 10.1080/13685538.2016.1197899. Epub 2016 Jul 5.
Yuan P, Ma D, Zhang Y, Gao X, Liu Z, Li R, Wang T, Wang S, Liu J, Liu X. Efficacy of low-intensity extracorporeal shock wave therapy for the treatment of chronic prostatitis/chronic pelvic pain syndrome: A systematic review and meta-analysis. Neurourol Urodyn. 2019 Aug;38(6):1457-1466. DOI: 10.1002/nau.24017. Epub 2019 Apr 29.