ArticleTranslational andrology and urology2026
Low-intensity extracorporeal shockwave therapy for chronic prostatitis/chronic pelvic pain syndrome: a retrospective single-center observational study in Japan.
Article in Translational andrology and urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a heterogeneous condition that can remain symptomatic despite conventional therapy. Low-intensity extracorporeal shock wave therapy (Li-ESWT) has shown symptomatic benefits in previous clinical studies; however, real-world evidence from Japanese clinical practice remains limited. This study aimed to evaluate the effectiveness and safety of a standardized four-session Li-ESWT protocol in patients with treatment-refractory CP/CPPS at a Japanese outpatient urology clinic. Methods: This retrospective, single-center observational study included 19 consecutive patients with CP/CPPS who underwent Li-ESWT between July 2023 and June 2025. Treatment was administered once weekly for four weeks using 3,000 pulses per session at an energy flux density of 0.25-0.35 mJ/mm Results: All 19 patients completed treatment. The mean NIH-CPSI total score decreased from 25.9±5.4 at baseline to 21.6±7.5 after treatment (mean change, -4.32±4.27; P<0.001). Six patients (31.6%) achieved a clinically meaningful improvement of at least 6 points, while 16 (84.2%) showed some overall symptom improvement. Significant improvements were observed in the pain domain (11.5±3.2 to 9.2±3.5, P<0.01) and QoL domain (10.1±1.4 to 8.5±2.7, P<0.01), whereas the urinary domain did not significantly improve (4.3±3.2 to 3.9±3.6, P=0.31). No serious adverse events were observed. Conclusions: In this small retrospective Japanese cohort with persistent symptoms despite conservative treatment, a standardized four-session Li-ESWT protocol was associated with improvement in overall NIH-CPSI scores, particularly in pain and QoL, and was well tolerated. Larger prospective controlled studies with longer follow-up are needed to confirm these findings.
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