Clinical and Immunological Outcomes of Extracorporeal Shock Wave Therapy in Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Abstract

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.