Shockwave therapy for Pelvic pain / chronic prostatitis
Chronic prostatitis (also called chronic pelvic pain syndrome – CPPS) is defined as a non-specific pain, not easily localized in the absence of a diagnosable underlying disease (e.g. bacterial infection, trauma) that lasts for more than 6 months.
Traditionally, the therapy of this syndrome is based on the use of antibiotics, anti-inflammatories and alpha-blockers, used individually or in combination. Other second-line therapies have been employed, with mediocre results.
Shockwaves have two main characteristics: they can propagate in a liquid medium (1500m / sec in water) or gaseous (in the air) or solid, compact (the tissues of the human body) and carry energy.
These waves are produced by a handpiece that is placed on the body and can be transmitted to a well-located point or region of the body. The energy of the waves is discharged only in the targeted area without involving the nearby tissues. The biological action mechanism is not yet well clarified. The cells of the tissue affected by the shock waves are thought to be first compressed, due to the positive pressure deriving from the energy carried by the shock wave, and then expand due to the intrinsic tension properties, almost like a balloon inflated, creating microscopic bubbles, which induce a stress, an opening, of the cell membrane with release of angiogenetic factors.
Shockwave therapy is non-invasive and has been applied to the treatment of chronic prostatitis since it induces an increase in vascularity, an increase in anti-inflammatory signals, an interruption of painful nerve impulses and a reduction in passive muscle tone.
A recently published study shows that 76% of patients with chronic prostatitis unresponsive to antibiotic, anti-inflammatory and alpha-blocker therapy 4 weeks after low intensity Shockwave therapy had a benefit that in the ‘82% of patients were over 3 months of follow-up.