PD62-03 CASE SERIES OF LOW INTENSITY SHOCK WAVE THERAPY FOR MEN WITH CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia II1 Apr 2018PD62-03 CASE SERIES OF LOW INTENSITY SHOCK WAVE THERAPY FOR MEN WITH CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME Daniel Shoskes and Brandon Mooney Daniel ShoskesDaniel Shoskes More articles by this author and Brandon MooneyBrandon Mooney More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2839AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a heterogeneous syndrome that is often challenging to treat. Low Intensity Shock Wave (LiSW) has emerged as a potential therapy and several sham controlled studies have shown efficacy. We wished to study the efficacy and safety of LiSW in CP/CPPS patients with clinical phenotyping to better understand who may best respond. METHODS Men were enrolled in this IRB approved study provided they had a diagnosis of CP/CPPS for at least 6 months and were able to return for weekly treatments. Those on multi-modal therapy continued other therapies as long as the dose was stable. LiSW was delivered with the Urogold 100 machine (Tissue Regeneration Technologies, Woodstock, GA) using the standard probe. There were 4 treatment sites, 2 on each side of the perineum at 500 shocks each for a total of 2000 shocks. Symptom severity was measured with the National Institute of Health Chronic Prostatitis Symptom Index (CPSI) at baseline and 1 month following the last treatment. Patients also self reported a General Response Assessment (GRA) ranging from 1 (significantly improved) to 5 (significantly worse). Patients were clinically phenotyped by the UPOINT system. Pre and post values were compared with the paired t test with significance set at p<0.05. RESULTS 14 men enrolled with a mean age of 45.1 years (range 22-67) and median duration of 36 months (range 9-240). Men had a mean of 2.6 positive UPOINT domains (range 1-5) and all but 2 had pelvic floor tenderness (domain ″T″). Total CPSI improved from 27.7 +/- 5.4 to 19.4 +/- 7.5 (p=0.003). While the pain and quality of life scores improved significantly, there was no change in the urinary subscore. 9 patients (64.3%) had a >6 point drop in CPSI. By GRA, 7 patients said they were significantly improved, 2 was somewhat improved and 5 were unchanged. There were no significant differences in responders to non-responders for phenotype or symptom duration although responders had a higher starting pain score (14.0 vs 9.4, p=0.005) and both patients without pelvic floor spasm failed to improve. CONCLUSIONS LiSW with the Urogold 100 improved symptoms of CP/CPPS in the majority of patients. All responders had pelvic floor spasm, and shock wave therapy is well established in the treatment of pain from trigger points. While small numbers preclude meaningful subgroup analysis, there was no impact on urinary symptoms. In conclusion, once weekly low intensity shock wave lithotripsy improved the symptoms of CP/CPPS in the majority of patients without side effects. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1157-e1158 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Daniel Shoskes More articles by this author Brandon Mooney More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...