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Aging Male. 2019 Apr 4:1-8. doi: 10.1080/13685538.2019.1597341. [Epub ahead of print]

The 12-month follow-up of the low-intensity extracorporeal shockwave therapy in the treatment of patients with chronic pelvic pain syndrome refractory to 3-As medications.

Guu SJ1, Liu CC1,2,3, Juan YS1,3,4, Li CC1,3, Tsai CC1,4.

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a Department of Urology , Kaohsiung Medical University Hospital, Kaohsiung Medical University , Kaohsiung , Taiwan.
b Department of Urology , Pingtung Hospital, Ministry of Health and Welfare , Pingtung , Taiwan.
c Department of Urology, Faculty of Medicine , College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan.
d Department of Urology , Kaohsiung Municipal Ta-Tung Hospital , Kaohsiung , Taiwan.



Applying low-intensity extracorporeal shockwave therapy (LI-ESWT) has been reported to improve symptoms of refractory chronic pelvic pain syndrome (CPPS) in short-term follow-up. This study aims to demonstrate the effect of LI-ESWT on refractory CPPS over the span of a 12-month follow-up.


This was an open-label, single-arm prospective study. LI-ESWT consisted of 3000 shock waves once weekly for 4 weeks (Duolith SD1 T-Top) were applied. Clinical symptoms were re-assessed at 1, 3, 6, and 12 months using NIH-CPSI score, visual analog scale, 5-item version of the International Index of Erectile Function and International Prostate Symptom Score.


Thirty-one of the 43 patients enrolled had a successful response at the 1-month follow up after the treatment. Twenty-six of the 31 patients who responded successfully to LI-ESWT at the 1-month follow-up, maintained their response at the 6- and 12-month follow-up. The existence of psychosocial disorder at the baseline characteristics analysis was the only potential factor that may hinder the effectiveness of LI-ESWT.


LI-ESWT has shown to be a safe and effective therapy for CPPS patients at the long-term follow-up. History of psychological disorders might be a significant predictor of a successful response.


Chronic pelvic pain syndrome; long term; low-intensity extracorporeal shock wave therapy

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