The therapeutic effect and safety profile of extracorporeal shockwave therapy in treatment of chronic prostatitis/chronic pelvic pain syndrome: a systematic review

Abstract

Background: Extracorporeal Shockwave Therapy (ESWT) has been indicated to relieve local perineal symptoms caused by Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). Current research has examined the efficacy of ESWT in CPPS patients. Different types of energy generators for ESWT lead to development of different clinical protocols for treatment of CP/CPPS. Therefore in this review, we aimed to compare the clinical protocol, efficacy and safety profile of all these different ESWT machines in CP/CPPS treatment. Methods: A systematic literature search of 3 search engines (PubMed, Scielo, and Science Directs) was undertaken using the following keywords: Chronic Prostatitis, Chronic Pelvic Pain Syndrome, and Extracorporeal Shockwave Therapy. A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. This review included original studies that evaluated the efficacy and clinical protocol of Extracorporeal Shockwave Therapy and Chronic prostatitis or Chronic Pelvic Pain Syndrome that are fully written in English with full-text articles readily available. This article excluded letters to the editor, reviews, and editorials about prostatitis other than CPPS. Results: The search strategy yielded 8 journals that meet the inclusion and exclusion criteria from all 3 search engines. These 8 studies included 3 different types of energy generators (Piezoelectric, Electropneumatic, and Electromagnetic) with different protocols applied. All 3 types of energy generators of ESWT can effectively decrease all domains of CPSI score within 12 months of follow-up (P-value 0,05). The limitations of this systematic review include the restricted variety of energy generators with the lack of openly registered protocols. Conclusions: In Conclusion, ESWT provides significant improvement in clinical symptoms as compared to oral medications alone. These therapeutic effects are also observed in all different types of energy generators with different clinical protocols with similar safety profiles.