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The efficacy and safety of low-intensity extracorporeal shock wave treatment combined with or without medications in Chronic prostatitis/chronic pelvic pain syndrome: a systematic review and meta-analysis

Prostate Cancer and Prostatic Diseases volume 26, pages 483–494 (2023)Cite this article

Subjects

Abstract

Background

We performed this systematic review and meta-analysis to investigate the efficacy and safety of Li-ESWT combined with or without medications for patients with Chronic prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS).

Methods

A comprehensive search was conducted of PUBMED, Cochrane Library, and Web of Science databases from inception to February 2022 for randomized controlled trials (RCTs) assessing the efficacy and safety of Li-ESWT with or without the combination of medications compared with the control group. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH‐CPSI), Visual Analogue Scale/Score (VAS), International Index of Erectile Function (IIEF), and International prostate symptom score (IPSS) were used to assess the improvements of symptoms in CP/CPPS patients.

Results

651 patients from 12 randomized controlled studies were included in this study. The total NIH-CPSI scores, pain domain scores, and quality of life (QOL) scores were significantly lower in the Li-ESWT group than those in the control group at the termination of treatment, and 1, 4, 12, and 24 weeks after treatment. And these scores were significantly reduced in the Li-ESWT group than in baselines. In the subgroup analysis, reductions of these scores lasted longer and were greater in Li-ESWT combined with medications than in Li-ESWT alone. In the Li-ESWT group, the VAS score; IIEF score; and IPSS score were significant improvements than those in control group at the termination of treatment, and 1, 4, and 12 weeks after treatment; 4, 12, and 24 weeks after treatment; and 1, 4, and 12 weeks after treatment, respectively.

Conclusions

Li-ESWT is a safe, non-invasive, and effective option for patients with CP/CPPS, whether combined with medications or not, should be recommended for widespread use in clinical practice.

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Fig. 1: Flow diagram of study selection.
Fig. 2: Forest plots of the total NIH‐CPSI scores in Li-ESWT group vs control group.
Fig. 3: Forest plots of the pain scores in Li-ESWT group vs control group.
Fig. 4: Forest plots of the urinary scores in Li-ESWT group vs control group.
Fig. 5: Forest plots of the QOL scores in Li-ESWT group vs control group.

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Data availability

The authors confirm that the data supporting the findings of this study are available within the results and supplementary materials of this article.

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Funding

This study was supported by the “Cuiying Science and Technology Innovation” Program (2020QN-15) of the Second Hospital of Lanzhou University, the Innovation Fund Project (2021B-042) of the Gansu Provincial Education Department, National Natural Science Foundation of China (PRO133011) and the Fundamental Research Funds for the Central Universities of Lanzhou University (lzujbky-2021-kb29).

Author information

Author notes

  1. These authors contributed equally: Xiangbin Kong, Weiwei Hu, Zhilong Dong

Authors and Affiliations

  1. Research Institute of Urology / Key Laboratory of Gansu Province for Urological Diseases / Clinical Center of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Lanzhou City, Gansu Province, China

    Xiangbin Kong, Zhilong Dong, Junqiang Tian, Yuhan Wang & Zhiping Wang

  2. Department of Nephrology, The Second Hospital of Lanzhou University, Lanzhou City, Gansu Province, China

    Weiwei Hu

  3. Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

    Chen Jin, Chaozhao Liang & Zongyao Hao

Authors
  1. Xiangbin Kong
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Contributions

Conceptualization: XBK, WWH, ZLD, ZPW, Data curation: XBK, WWH, ZLD, Formal analysis: XBK, WWH, ZLD, JQT, Funding acquisition: XBK, WWH, ZLD, ZPW, Investigation: XBK, WWH, ZLD, YHW, Methodology: XBK, WWH, ZLD, Project administration: ZPW, CCL, ZYH, Supervision: ZPW, JQT, CCL, ZYH, Validation: CJ, ZPW, CCL, ZYH, Writing: XBK.

Corresponding author

Correspondence to Zhiping Wang.

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The authors declare no competing interests.

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Supplementary information

Supplementary figure and table legends

Table S1 Additional information on the Li-ESWT protocols.

Table S2 Technical characteristics of different Li-ESW devices used in enrolled studies.

41391_2022_571_MOESM4_ESM.docx

Table S3 Mean differences of Li-ESWT group vs baseline at the termination of treatment, and 1, 4, 12, and 24 weeks after treatment.

41391_2022_571_MOESM5_ESM.docx

Table S4 Mean differences of control group vs baseline, at the termination of treatment, 1, 4, 12, and 24 weeks after treatment.

Fig. S1 Risk of bias graph.

Fig. S2 Risk of bias summary.

Fig. S3 Forest plots of the total NIH-CPSI scores in Li-ESWT group vs baseline.

Fig. S4 Forest plots of the total NIH-CPSI scores in Control group vs baseline.

Fig. S5 Forest plots of the pain scores in Li-ESWT group vs baseline.

Fig. S6 Forest plots of the pain scores in Control group vs baseline.

Fig. S7 Forest plots of the urinary scores in Li-ESWT group vs baseline.

Fig. S8 Forest plots of the urinary scores in Control group vs baseline.

Fig. S9 Forest plots of the QOL scores in Li-ESWT group vs baseline.

Fig. S10 Forest plots of the QOL scores in Control group vs baseline.

Fig. S11 Forest plots of the VAS scores in Li-ESWT group vs Control group.

Fig. S12 Forest plots of the IIEF scores in Li-ESWT group vs Control group.

Fig. S13 Forest plots of the IPSS scores in Li-ESWT group vs Control group.

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Kong, X., Hu, W., Dong, Z. et al. The efficacy and safety of low-intensity extracorporeal shock wave treatment combined with or without medications in Chronic prostatitis/chronic pelvic pain syndrome: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 26, 483–494 (2023). https://doi.org/10.1038/s41391-022-00571-0

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