Low Intensity Extracorporeal Shock Wave Therapy for Male Pelvic Pain

Document Type

Conference Proceeding

Publication Date

5-2025

Publication Title

Journal of Urology

Abstract

INTRODUCTION AND OBJECTIVE: Treatment of male pelvic pain requires a multimodal approach. Low-intensity extracorporeal shock wave therapy (Li-ESWT) is said to decrease inflammation, promote angiogenesis, and recruit stem cells. It has been found to improve penile pain in patients with Peyronies. We investigate whether Li-ESWT is useful in the treatment of male pelvic pain. METHODS: Retrospective review of men who underwent Li-ESWT for pelvic pain was performed. Demographic data, diagnoses for which they underwent treatment, additional treatment modalities, details regarding Li-ESWT treatment, and visual analog scale (VAS) pain scores were collected. Patients underwent weekly Li-ESWT sessions for 4-6 weeks. RESULTS: Included were 19 patients with mean age of 45.6 (25-80) years. Patients were treated for pudendal neuralgia, pelvic, scrotal, and testicular pain. Regarding concomitant interventions, 9 underwent pelvic floor physical therapy (PFPT), 9 nerve blocks, 3 utilized rectal suppositories, and 1 pudendal neuromodulation. Li-ESWT treatment sites were perineum in all patients, groin in 9, perianal in 4, and base of penis in 5 patients. Power ranged from 0.06-0.14mJ based on patient tolerance, frequency ranged from 4-4.5Hz, with average number of shocks being 2000. After session 1, mean reduction in VAS pain scores was 2.4±2.2, with 79.0% of patients reporting improvement in overall pain. After session 2, mean VAS decrease was 2.3±2.0, after session 3 mean decrease was 1.2±1.2, session 4 mean decrease was 1.4±1.0, session 5 mean decrease was 1.2±0.9, and after session 6 mean decrease was 0.9±0.8 (Figure 1a). On average, 75.3% of patients reported improvement in overall pain scores after each session, 22.1% reported no change in overall pain scores and 6.3% reported worsening overall pain scores. Overall pre-treatment pain scores decreased with increasing number of sessions. Prior to the first session, mean pretreatment VAS was 4.8±1.7. Prior to the 6th session, mean pretreatment VAS was 2.7±1.8 (Figure 1b). CONCLUSIONS: Li-ESWT is a useful adjunct in the treatment of male pelvic pain. Further investigation into its utility is warranted.

Volume

213

Issue

5S

First Page

e552

Last Page

e552

Comments

American Urological Association Annual Meeting, April 26-29, 2025, Las Vegas, NV

DOI

10.1097/01.JU.0001109900.23127.a9.35

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