2009 journal article on shockwave therapy for CPP

[Lernica]

Extracorporeal Shock Wave Therapy for the Treatment of Chronic Pelvic Pain Syndrome in Males: A Randomised, Double-Blind, Placebo-Controlled Study

Reinhold Zimmermann, Alin Cumpanas, Florin Miclea, Günter Janetschek. Accepted 11 March 2009, Published online 25 March 2009, pages 418 - 424. Full Text Full-Text PDF (308 KB)

Abstract

Background

There is no sufficiently validated therapy for chronic pelvic pain syndrome (CPPS).

Objective

To investigate the effects of extracorporeal shock wave therapy (ESWT) in 60 patients suffering from CPPS.

Design, setting, and participants

Sixty patients suffering from CPPS for at least 3 mo were investigated in two groups. Both groups were treated four times (once per week), each by 3000 impulses; group 2 was performed as a sham procedure. The investigation was designed as a placebo-controlled, prospectively randomised, double-blind phase 2 study. Standardised follow-up was performed 1, 4, and 12 wk after ESWT.

Interventions

Low-energy–density ESWT was performed using a perineal approach without anaesthesia. In the placebo group, the same setting was used without shock wave energy transmission.

Measurements

ESWT effects on pain, quality of life (QoL), erectile function (EF), and micturition were evaluated. The parameters were investigated using validated questionnaires (National Institutes of Health Chronic Prostatitis Symptom Index [NIH-CPSI], International Prostate Symptom Score [IPSS], International Index of Erectile Function [IIEF]) and the Visual Analog Scale (VAS) for pain evaluation.

Results and limitations

All patients completed outpatient treatments and follow-ups without any problems. All 30 patients in the verum group showed statistically (highly) significant improvement of pain, QoL, and voiding conditions following ESWT in comparison to the placebo group, which experienced a continuous deterioration of the same parameters during the follow-up period. Perineal ESWT was easy and safe to perform without anaesthesia or any side-effects.

Conclusions

This is the first prospectively randomised, double-blind study to reveal perineal ESWT as a therapy option for CPPS with statistically significant effects in comparison to placebo. ESWT may in particular be interesting because of its easy and inexpensive application, the lack of any side-effects, and the potential for repetition of the treatment at any time.

Take Home Message

With extracorporeal shock wave therapy, it has been possible for the first time to establish a rapid and financially appealing outpatient therapy option for patients with chronic pelvic pain syndrome that uses a standard unit, that does not have side-effects, and that can be repeated as often as required.



Lernica adds: I have the full-text version; contact me if you would like a copy.

[flyer28]

I stated it previously: I have wxperience with ESW therapy and it iflicted horrible 3months flare-up for me.
The pain changed its pattern and became cruel, pinching and truly debilitating.
Fortunately, after 3-4 months it got back to its baseline pattern and intensity (dull, constant ache, with some burning episodes).
I personally would never agree with that If I knew the brutal and devastating long term effects on the pelvic tissues.
I did it wthout agreement with my urologist who said that he would never recommend that.
The others might have different experiences, but mine is this.

[Lernica]

Flyer28,

I'm sorry about your experience with ESWT. The Cornwall team claims that none of their patients have gotten worse. Glenn Cameron, the RMT who administers the treatment, has a huge amount of experience with the machine. I believe that the manufacturer has told him that he is the most prolific user of the machine in Canada (or North America), I forget which. So maybe it's simply a question of the experience of the therapist?

Also, the Cornwall team has developed an expertise in PN which started with the treatment of Dr. Andrews himself. He is an athlete and was a heavy cyclist, and suffered from PN for ten years. Perhaps other ESWT practitioners haven't developed the same expertise with pudendal neuralgia as the Cornwall team has? Where did you go for your treatment?

All the best to you.