| Objective: To investigate the effect and safety of extracorporeal shock wave (ESW) for treating the pain symptom ofⅢB prostatitis.Methods: Based on Chinese guideline of diagnosis and therapy of prostatitis (2009), the twenty five patients diagnosedⅢB prostatitis were given extracorporeal shock wave treatment from March,2010 to March,2011. In the process of treatment, the patient's horizontal position was opted, and passed over hypogastrium the target organ prostate was detected by B ultrasound and measured the volume,morphous and inside resonance. After that the second focal spot of extracorporeal shock wave producer focused on prostate tissue and the prostate tissue was given extracorporeal shock wave treatment (2500 times per time, energy ranged from 5.5-7.0KJ, frequency was 3HZ). The treatment was once a week, lasting for four weeks. The NIH-CPSI, VAS, IIEF-5, the volume and morphou of prostate, the urinary state, and the color of urine of each patient were recorded before and after the treatment. The sperm and EPS were obtained before the initial treatment and after the final treatment, and then a routine analysis was conducted over the sperm and a routine analysis and correlated measurement of cytokine (IL-6,TNF-α,IL-1β) was carried out. Making use of statistical software of SPSS17.0,we analyzed the sperm routine and the expressing level of cytokine (IL-6,TNF-α,IL-1β) in EPS before and after the treatment by t-test to research that the change was statistical significance or not. The NIH-CPSI, VAS and IIEF-5 were analyzed by analysis of variance of single factor repeated measurement design.Results: The twenty five patients ofⅢB prostatitis had completed the four treatments safely. Before treatment the pain scores was 14.32±1.93. The pain scores was 9.24±1.51 after treatment. The change was difference(P<0.01).Though the urinary symptoms scores decreased from 4.96±1.17 to 4.64±0.86,the change was no remarkable differenc(eP >0.05). The quality of life scores reduced from 6.44±1.04 to 4.66±1.00 and the change was significant difference(P<0.01). The NIH-CPSI before treatment was 25.73±1.86 and after treatment was 18.48±2.23. The change was marked difference(P<0.01). VAS scores put down from 6.64±1.03 to 3.12±1.05 ,the change was significance(P<0.01). The concentration of IL-6 increased from 55.32±6.58ng/ml to 86.64±4.32 ng/ml. The concentration of TNF-αreduced from 3.96±0.17 ng/ml to 3.21±0.26 ng/ml. The concentration of IL-1βdecreased from 3.2±1.10 ng/ml to 1.5±0.86 ng/ml. The result were significant difference(P<0.01). Before treatment the IIEF-5 scores was 18.24±2.09. After treatment the pain scores was 18.56±2.16. The change was no significance(P>0.05). Compared with before treatment , the elements of sperm were no marked difference after treatmen(tP>0.05).The twenty five patients can urinate immediately after each treatment. One patient discovered initial hematuria after first treatment which disappeared after three hours.Conclusion: After ESWT, the pain symptom of the patients ofⅢB chronic prostatitis had improved obviously without side-effects. Therefore ESW is an effective method for treating the pain symptom ofⅢB chronic. |
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