Efficacy of adjuvant extracorporeal shock wave treatment for typeIIIprostatitis

Abstract

Objective To evaluate the clinical efficacy of adjuvant extracorporeal shock wave therapy (ESWT) for typeⅢprostatitis. Methods One hundred and twenty-five patients with typeⅢ prostatitis diagnosed at Department of Urology of North Sichuan Medical College from September 2015 to December 2016 were sequentially collected. These patients initially received guideline recommended standard drug treatment for 4 weeks. After that, the cured patients (76 cases) were excluded from clinical observation, and the remaining uncured 49 patients continued to receive treatment, of whom 36 received drug treatment and adjuvant ESWT and 13 continued to receive drug therapy alone. NIH-CPSI, IPSS, and NRS-11 scales were used to evaluate the prostatitis-related symptoms before and after treatment. The t-test was used to compare the differences between groups. The difference in cure rates between groups was compared using the chi-square test. Results After treatment, CPSI, IPSS, and NRS-11 scores in the ESWT-treated group were significantly lower than the scores before treatment [(11.25±5.82) vs (29.17±4.29), (5.75±3.95) vs (13.69± 3.47), (2.19±1.58) vs (5.06±0.89); t=14.57, 9.46, 9.04, P<0.01 for all]; however, although CPSI, IPSS, and NRS-11 scores decreased in the drug treatment alone group compared with the values before treatment [(19.31±7.40) vs (28.85±4.02), (8.54±3.84) vs (11.69±2.50), (4.08 ± 1.98) vs (4.77 ± 0.93)], only CPSI scores were statistically different (t=5.06, P<0.01) and there was no significant difference in IPSS or NRS-11 scores (t=1.99, P=0.07; t=1.24, P=0.24). Comprehensive evaluation of prostatitis-related symptoms using CPSI score<9 as a threshold showed that the cure rate in the drug treatment alone group was significantly lower than that in the adjuvant ESWT group (23.08% vs 80.56%), χ2=13.93, P<0.01). Using IPSS score<7 as the cure standard for patients with urinary symptoms, the cure rate was lower in the drug treatment alone group than in the adjuvant ESWT group (61.54% vs 69.44%), but there was no significant difference between the two groups (χ2=0.27, P=0.60). When using NRS-11 score<3 as the cure standard for patients with pain symptoms, the cure rate was significantly lower in the drug treatment alone group than in the adjuvant ESWT group (30.77% vs 72.22%, χ2=6.91, P=0.01). There were no significant difference in complications between the two groups. Conclusion Adjuvant ESWT for type Ⅲ prostatitis can significantly improve the cure rate and have a synergistic effect with drug therapy, especially for the relief of pain symptoms. Key words: Extracorporeal shock wave treatment; Chronic prostatitis; Chronic pelvic pain syndrome