[Extracorporeal shock wave therapy for chronic prostatitis / chronic pelvic pain syndrome: A meta-analysis]

To systematically evaluate the clinical efficacy of the extracorporeal shock wave therapy (ESWT) in the treatment of chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) and provide some evidence for the management of the disease.

We searched the PubMed, Cochrane Library, EMbase, CNKI, VIP, WanFang Data and CBM databases on the internet, as well as the Journal of Clinical Urology and Chinese Journal of Urology manually for randomized controlled trials (RCT) on the treatment of CP/CPPS by ESWT published from their establishment till February 1, 2019. Two reviewers independently screened the literature, extracted the data and assessed the risk of bias of the included studies, followed by a meta-analysis with the RevMan 5.3 software.

Totally 12 RCTs involving 838 CP/CPPS patients were included in this study. Compared with the controls, the patients treated by ESWT showed a significantly higher rate of overall effectiveness (OR = 8.75, 95% CI: 5.16 to 14.86, P < 0.000 01) and lower NIH-CPSI scores (MD = －5.10, 95% CI: －6.13 to －4.06, P < 0.000 01). Subgroup analyses manifested that a higher number of shock wave pulses (≥2 000) had a better therapeutic effect (MD = －4.99, 95% CI: －6.20 to －3.38, P < 0.000 01 in the >2 000-pulse group; MD = －5.76, 95% CI: －7.09 to －4.42, P < 0.000 01 in the 2 000-pulse group).

ESWT can raise the rate of overall clinical effectiveness and improve the symptoms of chronic prostatitis in the treatment of CP/CPPS. This conclusion, however, is to be further supported by more RCTs with higher quality, larger sample size and better design.