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Extracorporeal Shock Wave Treatment (ESWT)

Extracorporeal shock wave treatment (ESWT) was introduced about 40 years ago to break down kidney stones (lithotripsy).

Recently this technology has been applied to various fields of medicine, including urology and andrology, for regenerative purposes. In fact, the low intensity shock waves, through a biological mechanism only partially known, are able to increase the vascularization of the treated area and this consequently promotes its regeneration.

Extracorporeal Shock Wave Treatment (ESWT) in Urology

The main fields of use in uro-andrology are erectile dysfunction, induratio penis Plastica (IPP, also called Peyronie's disease) and chronic prostatitis (also called chronic pelvic pain syndrome - CPPS).

Shock waves have two main characteristics: they can propagate in a liquid medium (1500m / sec in water) or gaseous (in air) or solid, compact (the tissues of the human body) and they carry energy.

These waves are produced by a handpiece that is placed on the body and can be transmitted to a well localized point or region of the body. Wave energy is discharged only in the targeted area without involving nearby tissues. The biological mechanism of action is not yet well understood. It is thought that the cells of the tissue, affected by the shock waves, are first compressed, due to the positive pressure deriving from the energy carried by the shock wave, and then expand due to the intrinsic properties of tension, almost like a balloon. swollen, creating microscopic bubbles, which induce a stress, an opening, of the cell membrane with the release of angiogenic factors. These substances would induce the creation of new vascular structures (blood vessels).

CHRONIC PROSTATITIS - SHOCK WAVE THERAPY

Chronic prostatitis (also called chronic pelvic pain syndrome - CPPS) is defined as non-specific pain, not easily localized in the absence of a diagnosable underlying disease (e.g. bacterial infection, trauma) that lasts for more than 6 months.

Traditionally, the therapy of this syndrome is based on the use of anibiotics, anti-inflammatories and alpha-blockers, used individually or in combination. Other second-line therapies have been employed, with poor results.

Shock waves have two main characteristics: they can propagate in a liquid medium (1500m / sec in water) or gaseous (in air) or solid, compact (the tissues of the human body) and they carry energy.

These waves are produced by a handpiece that is placed on the body and can be transmitted to a well localized point or region of the body. Wave energy is discharged only in the targeted area without involving nearby tissues. The biological mechanism of action is not yet well understood. It is thought that the cells of the tissue, affected by the shock waves, are first compressed, due to the positive pressure deriving from the energy carried by the shock wave, and then expand due to the intrinsic properties of tension, almost like a balloon. swollen, creating microscopic bubbles, which induce a stress, an opening, of the cell membrane with the release of angiogenic factors.

Low-intensity shock wave therapy is non-invasive and has been applied to the treatment of chronic prostatitis as it induces an increase in vascularity, an increase in anti-inflammatory signals, an interruption of painful nerve impulses and a reduction in passive muscle tone.

A recently published study (Guu SJ, 2018) shows that 76% of patients with chronic prostatitis unresponsive to anibiotic, anti-inflammatory and alpha-blocker therapy 4 weeks after low-intensity shockwave therapy had a benefit that in 82% of patients were greater than 3 months of follow-up.