The Effect of Extracorporeal Shock Wave Therapy in Male Patients with Chronic Pelvic Pain Syndrome

Aim of the study: To evaluate the effect of Low-Intensity Extracorporeal Shock Wave Therapy in patients with Chronic Pelvic Pain Syndrome Objectives: 1. To compare the pain of the patients with CPPS before and after LI-ESWT. 2. To compare urinary symptoms of the patients with CPPS before and after LI-ESWT. 3. To compare erectile function of the patients with CPPS before and after LI-ESWT. Methods: This retrospective study was performed at the Hospital of LUHS Kaunas Clinics, Department of Urology. The data were collected from the Department of Urology ambulatory patients’ case histories. Male patients with CPPS received 4 sessions of focal LI-ESWT (3000 impulses, 0,2mJ/mm2, 3Hz each session) in the period of 4 weeks. CPPS symptoms before and after LI-ESWT were evaluated using the VAS pain scale, NIH-CPSI and IIEF-5 questionnaires. Statistical analysis was performed using SPSS 23.0 software. The results were considered statistically significant when p<0,05. Results: After 4 sessions of LI-ESWT all 28 patients completed the follow-up of 24 weeks, mean age of these patients was 47,11 (±SD 13,68) years. Before LI-ESWT the average VAS pain score was 3,89 (±SD 1,77), 2,61 (±SD 1,40) after LI-ESWT, 1,79 (±SD 1,07) 12 weeks after LI-ESWT and 1,14 (±SD 0,75) 24 weeks after LI-ESWT (p<0,01). Comparing the mean VAS scores before and after LI-ESWT we observed 32,90% reduction in pain right after the treatment, 53,98% reduction in pain after 12 weeks and 70,69% reduction in pain after 24 weeks of follow-up. Mean NIH-CPSI total score before LI-ESWT was 18,07 (±SD 5,31), 13,89 (±SD 4,51) after LI-ESWT, 10,25 (±SD 3,70) 12 weeks after LI-ESWT, and 8,29 (±SD 2,14) 24 weeks after LI-ESWT (p<0,001). The treatment was considered effective if decrease in NIH-CPSI total score was ≥6. After 24 weeks we observed 25 (89,29%) patients who had a response to LI-ESWT. Before LI-ESWT mean score of urinary domain of NIH-CPSI score was 4,32 (±SD 1,91), 3,25 (±SD 1,74) after LI-ESWT, 2,61 (±SD 1,32) 12 weeks after LI-ESWT and 2,11 (±SD 0,83) 24 weeks after LI-ESWT (p<0,001). Before LI-ESWT mean IIEF-5 score was 19,68 (±SD 2,37), 19,89 (±SD 2,11) after LI-ESWT, 20,61 (±SD 1,77) 12 weeks after LI-ESWT, 20,75 (±SD 1,86) 24 weeks after LI-ESWT (p