Khalafalla Kareim, Albakr Ahmed, El Ansari Walid, Majzoub Ahmad, Elbardisi Haitham, AlRumaihi Khalid, Arafa Mohamed
Department of Urology, Hamad General Hospital, Doha, Qatar.
Division of Urology, Department of Surgery, University of Texas McGovern Medical School, Houston, TX, USA.
Arab J Urol. 2023 May 14;21(3):162-169. doi: 10.1080/2090598X.2023.2207415. eCollection 2023.
Chronic pelvic pain syndrome (CPPS) is a frequent urological diagnosis that affects men's quality of life. Extracorporeal shockwave therapy (ESWT) is a recent treatment option for patients with CPPS. We evaluated ESWT's short and long - term efficacy in managing CPPS.
This prospective self-controlled study included 75 patients diagnosed with CPPS at our tertiary pelvic pain clinic between January 2017-June 2019. Patients were referred for ESWT and received four sessions one week apart. The National Institute for Health - Chronic Prostatitis Symptom Index (NIH - CPSI) questionnaire was used to assess patients' symptom severity before starting therapy and at 0, 12 and 26 weeks after completing ESWT. Demographics, clinical data and complications were also recorded.
Patients' mean age was 37.9 ± 8.6 years, and mean duration of symptoms was 5 ± 4.5 years. Compared to pre-treatment scores, all patients exhibited improvements across all NIH - CPSI domains directly after completing ESWT (week 0 post-treatment), with a mean difference improvement of 9.26 ± 5.7, 5.2 ± 3.4, 1.19 ± 2.18 and 2.88 ± 2.46 points in the total, pain, urinary symptoms, and quality-of-life scores respectively. At 12 weeks after completing ESWT, 80.9% of patients reported improvements, with mean difference improvement of 8.07 ± 7.56, 4.55 ± 4.6, 0.76 ± 2.48, 2.85 ± 2.78 in the total, pain, urinary symptoms, and quality-of-life scores respectively. Again, none of the patients developed any treatment-related complications. At 26 weeks after completing ESWT, 82.4% of patients reported improvements, with mean difference improvement of 8.29 ± 7.7%, 4.92 ± 4.69, 0.75 ± 2.96, 2.5 ± 3.0 in total, pain, urinary symptoms, and quality-of-life scores respectively. None of the patients developed treatment-related complications.
ESWT is a safe and effective treatment modality for patients with CPPS, with short-term improvement in total, pain, urinary symptom, and quality-of-life scores; and long-term improvement in total, pain, and quality-of-life scores.
慢性盆腔疼痛综合征（CPPS）是一种常见的泌尿外科诊断疾病，会影响男性的生活质量。体外冲击波疗法（ESWT）是最近针对CPPS患者的一种治疗选择。我们评估了ESWT在治疗CPPS方面的短期和长期疗效。
这项前瞻性自我对照研究纳入了2017年1月至2019年6月期间在我们的三级盆腔疼痛诊所被诊断为CPPS的75名患者。患者被转诊接受ESWT治疗，每周进行一次，共四次。在开始治疗前以及完成ESWT后的0、12和26周，使用美国国立卫生研究院慢性前列腺炎症状指数（NIH - CPSI）问卷来评估患者的症状严重程度。还记录了人口统计学、临床数据和并发症情况。
患者的平均年龄为37.9±8.6岁，平均症状持续时间为5±4.5年。与治疗前的评分相比，所有患者在完成ESWT后（治疗后第0周），NIH - CPSI所有领域的症状均有改善，总评分、疼痛评分、泌尿症状评分和生活质量评分的平均改善差值分别为9.26±5.7、5.2±3.4、1.19±2.18和2.88±2.46分。在完成ESWT后的12周，80.9%的患者报告症状有所改善，总评分、疼痛评分、泌尿症状评分和生活质量评分的平均改善差值分别为8.07±7.56、4.55±4.6、0.76±2.48和2.85±2.78。同样，没有患者出现任何与治疗相关的并发症。在完成ESWT后的2�周，82.4%的患者报告症状有所改善，总评分、疼痛评分、泌尿症状评分和生活质量评分的平均改善差值分别为8.29±7.7%、4.92±4.69、0.75±2.96和2.5±3.0。没有患者出现与治疗相关的并发症。
ESWT是一种治疗CPPS患者的安全有效的治疗方式，能在短期内改善总评分、疼痛评分、泌尿症状评分和生活质量评分；在长期内改善总评分、疼痛评分和生活质量评分。
