The effect of extracorporeal shock wave therapy for chronic prostatitis

Epifanova M1, Kostin A1, Gameeva E2, Artemenko S3, Epifanov A4, Baranov V5

Research Type

Clinical

Abstract Category

Prostate Clinical / Surgical

Abstract 499
On Demand Prostate Clinical / Surgical
Scientific Open Discussion Session 32
On-Demand
Clinical Trial Male Painful Bladder Syndrome/Interstitial Cystitis (IC)
1. Department of Urology and Operative Nephrology with Oncourology course of the Medical Institute of Peoples’ Friendship University (RUDN University), Moscow, Russia, 2. P. Hertsen Moscow Oncology Research Institute — Branch of the National Medical Research Radiological Centre, Moscow, Russia, 3. Central State Medical Academy of the Business Administration of the President of the Russian Federation, Moscow, Russia, 4. A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia, 5. Medical Institute of Peoples’ Friendship University (RUDN University), Moscow, Russia
Presenter
M

Maya Epifanova
Links

Abstract

Hypothesis / aims of study 
The purpose of this research was to investigate the effectiveness of low-intensity extracorporeal shockwave therapy (LI-ESWT) in the treatment of chronic prostatitis (CP).
Study design, materials and methods 
This research included 33 patients with chronic prostatitis. The patient's mean age was 38±9.8 (27-65). The mean CP duration was 13.5 months (3-24). 33 patients were divided into 3 groups based on ultrasound investigation. Group 1 had fibrotic changes in the prostate (n=15). Group 2 had prostate calcifications (n=5). Group 3 had fibrotic changes and calcifications in the prostate (n=13). All patients receive LI-ESWT (Dornier Aries) twice a week for 6 weeks. Each ESWT session was comprised 2000-3500 pulses (0.05-0.062mJ/mm2) and 8-6 Hz of frequency. The subjects were examined on 0 and 60 days of the research using the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) , International Prostate Symptom Score (IPSS), TRUS of the prostate (mean (min&max), the culture of seminal fluid, serum PSA.
Results 
The patients over 45 years-old had total PSA less than 2 ng/ml. Bacterial growth was found in semen cultures of the 16 patients. They were additionally prescribed antibiotics according to antibiogram. All patients got the treatment well. Control study pointed at lower scores of NIH-CPSI – grade decreased from 14.06 (1-24) to 5.54 (0-10), IPSS decreased from 11.87 (0-17) to 4.45 (0-8). Prostate volume decreased from 24.72 cm3 (14.3-52.4) to 22.03 cm3 (13.6-46.1) according to TRUS. In the first group in 2 patients local fibrosis were completely resolved, fibrotic changes decreased from 5.25 mm (0-13) to 2.38 mm (0-6.6) in 13 cases. In the second group the number and the size of calcifications decreased from 8.06 mm (2-21) to 4 mm (0-20). In the third group calcifications were completely resolved, the volume of fibrosis decreased from 7.43 mm (3.2-15) to 4.9 mm (1-17), the calcification zone was replaced by  fibrosis (17 mm) in 1 case. Bacterial growth wasn’t found in 7 patients' seminal fluid, 9 patients had a decrease of the causative agent concentration on 60 day.
Interpretation of results 
LI-ESWT is an effective noninvasive medical treatment of chronic prostatitis. It helps to reduce the severity of dysuria. Causing microtrauma at the cellular level leads to resolution of infection, improves microcirculation, stimulates the lysis of the fibrosis zone and calcinates, improves the draining function of the gland, contributing to the accelerated elimination of microflora. At the moment a clinical trial continues on a larger sample size.
Concluding message 
We assume the proposed treatment method of chronic prostatitis should be widely used in medical practice.
Disclosures
Funding N/a Clinical Trial Yes Public Registry No RCT No Subjects Human Ethics Committee Ethics Committee of the Medical Institute of Peoples’ Friendship University Helsinki Yes Informed Consent Yes
17/04/2024 14:11:01