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Huang N, Qin Z, Sun W, Bao K, Zha J, Zhang P, Feng P, Zhao X, Liu M, Shi J, Ma M. Comparing the effectiveness of extracorporeal shockwave therapy and myofascial release therapy in chronic pelvic pain syndrome: study protocol for a randomized controlled trial. Trials 2023; 24:675. [PMID: 37853420 PMCID: PMC10583345 DOI: 10.1186/s13063-023-07633-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 09/08/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Chronic prostatitis/chronic pelvic pain syndrome is a highly prevalent syndrome. Previous studies showed that extracorporeal shockwave therapy and myofascial release therapy could improve the quality of life in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Theoretically, combined therapy with extracorporeal shockwave therapy and myofascial release therapy will likely have significant advantages in treating CP/CPPS. We, therefore, present a protocol for conducting a well-designed randomized controlled trial to compare the efficacy and safety of each therapy. METHODS The proposed study will be a three-group randomized control trial (RCT) design that includes 150 participants from Zhongda Hospital Affiliated to Southeast University, with equal allocation of participants to the three intervention groups. The study duration will be 8 weeks, which includes a 4-week treatment period and a 4-week follow-up period. The primary outcome will be the changes in surface electromyography (sEMG) assessment and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI). The secondary outcomes will include the changes in three-dimensional quantification, shear wave elastography (SWE), and sympathetic skin response (SSR) testing. Assessments will be conducted before the intervention (T0), before the 5th intervention (T1), immediately after the 8th intervention (T2), and the 4th week after the end of the 8th intervention (T3). DISCUSSION This trial will compare the differences in efficacy between single extracorporeal shockwave therapy, single myofascial release therapy, and combined therapy to select the most appropriate treatment option for patients with CP/CPPS. The possible pathogenesis of CP/CPPS would also be analyzed by comparing the intercorrelation between each objective and subjective measurement (NIH-CPSI score, sEMG, SWE, SSR). TRIAL REGISTRATION The name of the registry: Extracorporeal Shockwave and Myofascial Release Therapy in Chronic Pelvic Pain Syndrome. REGISTRATION NUMBER NCT05659199. Date of registration: December 2022.
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Affiliation(s)
- Ningqing Huang
- Department of Physical Medicine and Rehabilitation, Southeast University, Nanjing, Jiangsu Province, People's Republic of China
| | - Zhi Qin
- Department of Radiology, Southeast University Zhongda Hospital, Nanjing, Jiangsu Province, People's Republic of China
| | - Wudong Sun
- Department of Rehabilitation, Southeast University Zhongda Hospital, No. 87, Dingjiaqiao, Gulou District, Nanjing, Jiangsu Province, People's Republic of China
| | - Kaiming Bao
- Division of Biokinesiology and Physical Therapy, University of Southern California, Nanjing, Jiangsu Province, People's Republic of China
| | - Jingxian Zha
- Department of Obstetrics, Southeast University Zhongda Hospital, Nanjing, Jiangsu Province, People's Republic of China
| | - Peng Zhang
- Department of Rehabilitation, Southeast University Zhongda Hospital, No. 87, Dingjiaqiao, Gulou District, Nanjing, Jiangsu Province, People's Republic of China
| | - Panpan Feng
- Nanjing Institute of Physical Education, Nanjing, Jiangsu Province, People's Republic of China
| | - Xiaojun Zhao
- Nanjing Institute of Physical Education, Nanjing, Jiangsu Province, People's Republic of China
| | - Mengqian Liu
- Department of Physical Medicine and Rehabilitation, Southeast University, Nanjing, Jiangsu Province, People's Republic of China
| | - Jinjun Shi
- Southeast University Zhongda Hospital, Nanjing, Jiangsu Province, People's Republic of China
| | - Ming Ma
- Department of Rehabilitation, Southeast University Zhongda Hospital, No. 87, Dingjiaqiao, Gulou District, Nanjing, Jiangsu Province, People's Republic of China.
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Magistro G, Wagenlehner FME, Pilatz A. [Chronic prostatitis/chronic pelvic pain syndrome]. UROLOGIE (HEIDELBERG, GERMANY) 2023:10.1007/s00120-023-02089-2. [PMID: 37120786 DOI: 10.1007/s00120-023-02089-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 05/01/2023]
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is defined as chronic pain or discomfort in the pelvic region for at least 3 of the past 6 months. It is variably associated with lower urinary tract symptoms, psychosocial consequences, and sexual dysfunction. Specific test systems or biomarkers for a definitive diagnosis are still not available. The purposes of the basic diagnostic assessment are to determine the individual spectrum of symptoms and to rule out differential diagnoses of pelvic pain. Patient-reported outcome measures (PROMs) like the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) are valuable instruments for the initial diagnostic assessment and to evaluate treatment response. Classification systems like UPOINTS (urinary, psychosocial, organ specific, infection, neurologic/systemic, tenderness of skeletal muscles, sexual dysfunction) are valuable tools to determine the individual spectrum of symptoms, to guide the adapted diagnostic assessment, and to identify relevant targets for a multimodal and tailored treatment. Close urological monitoring of CP/CPPS patients is usually necessary, especially to minimize the unwarranted use of antibiotics in the case of undulating complaints.
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Affiliation(s)
- G Magistro
- Urologische Klinik, Asklepios Westklinikum Hamburg, Suurheid 20, 22559, Hamburg, Deutschland.
| | - F M E Wagenlehner
- Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Justus-Liebig-Universität Giessen, Gießen, Deutschland
| | - A Pilatz
- Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Justus-Liebig-Universität Giessen, Gießen, Deutschland
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Ge Q, Lou J. Clinical Application of Prostatic Exosomal Protein and Prostate-Specific Antigen Levels in the Detection of Prostate-Related Diseases. Lab Med 2023; 54:212-214. [PMID: 36214593 DOI: 10.1093/labmed/lmac103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Our aim was to study the use of prostatic exosomal protein (PSEP) and prostate-specific antigen (PSA) in diagnosis of prostate-related diseases. METHODS A total of 54 cases of acute prostatitis (AP), 72 cases of chronic prostatitis (CP), and 36 cases of prostate cancer (PCa) were enrolled. Levels of PSEP and PSA were analyzed. RESULTS The positive rate and level of PSEP in CP was highest (both P < .05). The total PSA (tPSA) level in PCa was the highest (P < .05), followed by AP and CP. The free PSA (fPSA) level was lowest in CP (P < .05); fPSA/tPSA in AP was the highest (P < .05). The PSEP level in type II CP was higher than in type IIIa and type IIIb (both P < .05), and it was higher in type IIIa than in type IIIb (P < .05). The tPSA level in type IIIb was the lowest in the 3 types (both P < .05). The fPSA/tPSA in type IIIb was the highest in the 3 types (P < .05). CONCLUSION The PSEP combined with PSA better distinguishes prostate-related diseases.
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Affiliation(s)
- Qiuxia Ge
- Department of Laboratory Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jianfang Lou
- Department of Laboratory Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Wu WL, Bamodu OA, Wang YH, Hu SW, Tzou KY, Yeh CT, Wu CC. Extracorporeal Shockwave Therapy (ESWT) Alleviates Pain, Enhances Erectile Function and Improves Quality of Life in Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome. J Clin Med 2021; 10:3602. [PMID: 34441902 PMCID: PMC8396816 DOI: 10.3390/jcm10163602] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/03/2021] [Accepted: 08/10/2021] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), affecting over 90% of patients with symptomatic prostatitis, remains a therapeutic challenge and adversely affects patients' quality of life (QoL). This study probed for likely beneficial effects of ESWT, evaluating its extent and durability. PATIENTS AND METHODS Standardized indices, namely the pain, urinary, and QoL domains and total score of NIH-CPSI, IIEF-5, EHS, IPSS, and AUA QoL_US were employed in this study of patients with CP/CPPS who had been refractory to other prior treatments (n = 215; age range: 32-82 years; median age: 57.5 ± 12.4 years; modal age: 41 years). RESULTS For CP symptoms, the mean pre-ESWT NIH-CPSI total score of 27.1 ± 6.8 decreased by 31.3-53.6% over 12 months after ESWT. The mean pre-ESWT NIH-CPSI pain (12.5 ± 3.3), urinary (4.98 ± 2.7), and QoL (9.62 ± 2.1) domain scores improved by 2.3-fold, 2.2-fold, and 2.0-fold, respectively, by month 12 post-ESWT. Compared with the baseline IPSS of 13.9 ± 8.41, we recorded 27.1-50.9% amelioration of urinary symptoms during the 12 months post-ESWT. For erectile function, compared to pre-ESWT values, the IIEF-5 also improved by ~1.3-fold by month 12 after ESWT. This was corroborated by EHS of 3.11 ± 0.99, 3.37 ± 0.65, 3.42 ± 0.58, 3.75 ± 0.45, and 3.32 ± 0.85 at baseline, 1, 2, 6, and 12 months post-ESWT. Compared to the mean pre-ESWT QoL score (4.29 ± 1.54), the mean QoL values were 3.26 ± 1.93, 3.45 ± 2.34, 3.25 ± 1.69, and 2.6 ± 1.56 for months 1, 2, 6, and 12 after ESWT, respectively. CONCLUSIONS This study shows ESWT, an outpatient and easy-to-perform, minimally invasive procedure, effectively alleviates pain, improves erectile function, and ameliorates quality of life in patients with refractory CP/CPPS.
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Affiliation(s)
- Wen-Ling Wu
- Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan; (W.-L.W.); (O.A.B.); (S.-W.H.); (K.-Y.T.)
- TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei City 110, Taiwan
| | - Oluwaseun Adebayo Bamodu
- Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan; (W.-L.W.); (O.A.B.); (S.-W.H.); (K.-Y.T.)
- Department of Hematology and Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
- Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan; (Y.-H.W.); (C.-T.Y.)
| | - Yuan-Hung Wang
- Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan; (Y.-H.W.); (C.-T.Y.)
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Su-Wei Hu
- Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan; (W.-L.W.); (O.A.B.); (S.-W.H.); (K.-Y.T.)
- TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei City 110, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Kai-Yi Tzou
- Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan; (W.-L.W.); (O.A.B.); (S.-W.H.); (K.-Y.T.)
- TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei City 110, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 110, Taiwan
| | - Chi-Tai Yeh
- Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan; (Y.-H.W.); (C.-T.Y.)
- Department of Medical Laboratory Science and Biotechnology, Yuanpei University of Medical Technology, Hsinchu City 30015, Taiwan
| | - Chia-Chang Wu
- Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan; (W.-L.W.); (O.A.B.); (S.-W.H.); (K.-Y.T.)
- TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei City 110, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 110, Taiwan
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