Chronic Prostatitis

ISRN Urol. 2013 Aug 28;2013:972601. doi: 10.1155/2013/972601. eCollection 2013.

Efficacy of extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome: a randomized, controlled trial.

Vahdatpour B1, Alizadeh F, Moayednia A, Emadi M, Khorami MH, Haghdani S.

1Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran.


Objectives. To investigate the effectiveness of extracorporeal shock wave therapy (ESWT) for symptoms alleviation in chronic pelvic pain syndrome (CPPS). Materials and Methods. 40 patients with CPPS were randomly allocated into either the treatment or sham group. In the first group, patients were treated by ESWT once a week for 4 weeks by a defined protocol. In the sham group, the same protocol was applied but with the probe being turned off. The follow-up assessments were done at 1, 2, 3, and 12 weeks by Visual Analogue Scale (VAS) for pain and NIH-developed Chronic Prostatitis Symptom Index (NIH-CPSI). Results. Pain domain scores at follow-up points in both treatment and sham groups were reduced, more so in the treatment group, which were significant at weeks 2, 3, and 12. Urinary scores became significantly different at weeks 3 and 12. Also, quality of life (QOL) and total NIH-CPSI scores at all four follow-up time points reduced more significantly in the treatment group as compared to the sham group. Noticeably, at week 12 a slight deterioration in all variables was observed compared to the first 3 weeks of the treatment period. Conclusions. our findings confirmed ESWT therapy as a safe and effective method in CPPS in short term.



Chin Med J (Engl). 2012 Jan;125(1):114-8.

Extracorporeal shock wave treatment for non-inflammatory chronic pelvic pain syndrome: a prospective, randomized and sham-controlled study.

Zeng XY1, Liang C, Ye ZQ.

1Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.



Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a clinical syndrome characterized by pain in the perineum, pelvis, suprapubic area, or external genitalia and variable degrees of voiding and ejaculatory disturbance. The analgesic effect of extracorporeal shock wave treatment (ESWT) was an interesting phenomenon with an unclear mechanism discovered by chance in the applications for urolithiasis, on which ESWT has become an increasingly popular therapeutic approach as an alternative option for the treatment of a number of soft tissue complaints. In this study, we aimed to evaluate the feasibility and efficacy of ESWT in non-inflammatory (IIIB) CP/CPPS.


Men diagnosed with IIIB CP/CPPS were randomized to either ESWT (group 1, n = 40) or the control (group 2, n = 40). Group 1 received 20 000 shock wave impulses in 10 sessions over a two-week period, whereas group 2 received only a sham procedure. The total scores and sub-domain scores of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) for both groups were assessed at baseline, mid-treatment, end-point, and 4-week and 12-week follow-up visits.


The mean total NIH-CPSI score of group 1 was significantly decreased from baseline at all post-treatment time points (P < 0.01 for all). Decreases in pain domain and quality of life (QOL) scores were also significant. In group 2, no significant decreases of total NIH-CPSI score and pain domain score were found at all post-treatment time points. At the end-point of treatment, 71.1% of group 1 exhibited perceptible improvement in total NIH-CPSI compared with 27.0% of group 2 (P < 0.001); additionally, 28.9% of group 1 exhibited clinically significant improvement compared with 10.8% of group 2 (P < 0.01). Moreover, a greater number of patients in group 1 at 4-week and 12-week follow-up were rated as responders (perceptible and clinically significant response) compared with group 2.


ESWT exhibits a potentially therapeutic role in the treatment of CP/CPPS.


Eur Urol. 2010 Mar;57(3):e24; author reply e25. doi: 10.1016/j.eururo.2009.10.017. Epub 2009 Oct 17.

Re: Reinhold Zimmermann, Alin Cumpanas, Florin Miclea, Günter Janetschek. Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome in males: a randomised, double-blind placebo-controlled study. Eur Urol 2009;56:418-24.

Cai T, Bartoletti R.

Comment on

Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome in males: a randomised, double-blind, placebo-controlled study. [Eur Urol. 2009]

PMID:19853372[PubMed – indexed for MEDLINE]

Eur Urol. 2009 Sep;56(3):425-6. doi: 10.1016/j.eururo.2009.03.075. Epub 2009 Apr 3.

Low-energy extracorporeal shock wave therapy for chronic pelvic pain syndrome: finally, the magic bullet?

Marszalek M, Berger I, Madersbacher S.

Comment on

Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome in males: a randomised, double-blind, placebo-controlled study. [Eur Urol. 2009]

PMID:19362412[PubMed – indexed for MEDLINE]


BJU Int. 2008 Sep;102(8):976-80. doi: 10.1111/j.1464-410X.2008.07742.x. Epub 2008 May 28.

Extracorporeal shock-wave therapy for treating chronic pelvic pain syndrome: a feasibility study and the first clinical results.

Zimmermann R1, Cumpanas A, Hoeltl L, Janetschek G, Stenzl A, Miclea F.

Author information

1Department of Urology, Elisabethinen Hospital, Linz, Austria.



To investigate the feasibility and clinical outcome of extracorporeal shock-wave therapy (ESWT) for patients suffering from chronic pelvic pain syndrome (CPPS).


The study included 34 patients who had had CPPS for >or=3 months, who were investigated in two subsequent studies. ESWT was administered using a perineal approach with two different standard ESWT devices with and without an ultrasonographic positioning system. The follow-up was at 1, 4 and 12 weeks after ESWT, to evaluate the effects on pain, quality of life and voiding. Imaging studies and changes in prostate-specific antigen (PSA) were used to investigate the safety and side-effects of ESWT.


All patients completed the treatments and follow-up; there were statistically significant improvements in pain and quality of life after ESWT. Voiding conditions were temporarily improved but with no statistical significance. Perineal ESWT was easy and safe to administer with no anaesthesia on an outpatient basis. Side-effects could be excluded clinically, by imaging studies and by changes in PSA level.


Perineal ESWT must be considered as a promising new therapy for CPPS, in particular as it is easy to apply and causes no side-effects.

PMID:18510660[PubMed – indexed for MEDLINE]