男性慢性盆腔疼痛综合征患者会阴部的体外冲击波治疗：一项初步研究。
Extracorporeal shockwave therapy of the perineum for male patients with chronic pelvic pain syndrome: a pilot study.
作者信息
Lee Joe K C, Law Terence Y X, Shen Liang, Pek Gregory X W, Lim Qi Y, Tan Yi Q, Chia Jun Y, Li Man K
机构信息
Department of Urology, National University Hospital, Singapore, Singapore.
Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
出版信息
Prostate Int. 2024 Mar;12(1):27-34. doi: 10.1016/j.prnil.2023.11.001. Epub 2023 Nov 7.
BACKGROUND
Chronic pelvic pain syndrome (CPPS) is a complex condition that is often difficult to treat and may sometimes require a multidisciplinary team. Among the wide array of treatment options is extracorporeal shockwave therapy (ESWT). However, its role in CPPS remains controversial. The purpose of our study is to assess the efficacy and safety of ESWT of the perineum in male patients with CPPS.
METHODS
Fourteen patients aged between 21 and 85 years were recruited in this single-center, single-arm prospective trial from October 2018 to October 2020. ESWT was delivered to the perineum weekly for up to 8 weeks. Assessment was done via International Index for Erectile Function, International Prostate Symptom Score, King's Health Questionnaire, National Institutes of Health - Chronic Prostatitis Symptom Index, Visual Analogue Scale, Analgesic Questionnaire, and UPOINT (urinary symptoms [U], psychosocial dysfunction [P], organ-specific symptoms [O], infection-related symptoms [I], neurological/systemic conditions [N], tenderness of skeletal muscles [T]) phenotype system. The parameters are assessed before the start and end of treatment as well as at regular time points on follow-up appointments up to 20 weeks.
RESULTS
Thirteen patients completed the study. There was improvement in the Visual Analogue Scale pain score, Tenderness domain on UPOINT, King's Health Questionnaire, and National Institutes of Health - Chronic Prostatitis Symptom Index scores. In terms of erectile function, improvement in the erectile function domain of International Index for Erectile Function was observed. There was also significant improvement in lower urinary tract symptoms assessed on International Prostate Symptom Score. There were no adverse events reported post treatment and during the follow-up period.
CONCLUSIONS
ESWT improved pain and quality of life of male patients with CPPS. It can be a safe and effective treatment modality in the armamentarium of CPPS.
背景
慢性盆腔疼痛综合征（CPPS）是一种复杂的病症，通常难以治疗，有时可能需要多学科团队参与。众多治疗选择中包括体外冲击波疗法（ESWT）。然而，其在CPPS中的作用仍存在争议。我们研究的目的是评估会阴区ESWT治疗男性CPPS患者的疗效和安全性。
方法
2018年10月至2020年10月，在这项单中心、单臂前瞻性试验中招募了14名年龄在21至85岁之间的患者。每周对会阴区进行ESWT治疗，最长持续8周。通过国际勃起功能指数、国际前列腺症状评分、国王健康问卷、美国国立卫生研究院慢性前列腺炎症状指数、视觉模拟量表、镇痛问卷以及UPOINT（泌尿系统症状[U]、心理社会功能障碍[P]、器官特异性症状[O]、感染相关症状[I]、神经/全身状况[N]、骨骼肌压痛[T]）表型系统进行评估。在治疗开始和结束时以及随访预约的常规时间点（最长至20周）对各项参数进行评估。
结果
13名患者完成了研究。视觉模拟量表疼痛评分、UPOINT的压痛领域、国王健康问卷以及美国国立卫生研究院慢性前列腺炎症状指数评分均有改善。在勃起功能方面，观察到国际勃起功能指数的勃起功能领域有所改善。国际前列腺症状评分评估的下尿路症状也有显著改善。治疗后及随访期间均未报告不良事件。
结论
ESWT改善了男性CPPS患者的疼痛和生活质量。它可以成为CPPS治疗手段中的一种安全有效的治疗方式。
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