Shockwave therapy is a non-invasive treatment that applies low-intensity acoustic waves to the body. These sound waves stimulate blood flow and encourage the body’s natural healing processes. This technology is being explored for several urological conditions, including those affecting the prostate gland, as an alternative to medication or surgery.
The Science Behind Shockwave Therapy
The modality used for prostate conditions is Low-Intensity Extracorporeal Shockwave Therapy (Li-ESWT). This therapy works by delivering acoustic energy to targeted tissue, where the mechanical stress initiates biological responses without causing damage. This process stimulates the release of growth factors and other signaling molecules involved in tissue repair.
A primary mechanism of Li-ESWT is neovascularization, the formation of new blood vessels. The sound waves stimulate the production of vascular endothelial growth factor (VEGF), a protein that encourages new capillary growth. This enhanced blood supply improves the delivery of oxygen and nutrients to the prostate tissue, facilitating healing.
The therapy also has anti-inflammatory effects. By modulating cellular activity, the shockwaves help reduce inflammatory markers in the tissue. This can lead to a decrease in the chronic pain and discomfort associated with certain prostate conditions.
Li-ESWT is also associated with tissue regeneration. The controlled micro-trauma can activate progenitor cells and other healing mechanisms. This can lead to the repair of damaged tissue and the restoration of more normal function within the prostate and surrounding pelvic structures.
Prostate Conditions Treated
The most common application for shockwave therapy in prostate health is for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). This condition is characterized by persistent pain in the pelvic region that can be difficult to treat with conventional methods. Li-ESWT is used to address the inflammation and pain associated with CP/CPPS.
While not a prostate condition, erectile dysfunction (ED) is closely linked to prostate health and is a primary target for shockwave therapy. Many cases of ED are vascular in origin, caused by insufficient blood flow to the penis. Li-ESWT can improve penile blood flow, leading to sustained improvements in erectile function.
An emerging area of investigation is the use of shockwave therapy for Benign Prostatic Hyperplasia (BPH), or an enlarged prostate. Research suggests the therapy may help alleviate lower urinary tract symptoms (LUTS) associated with BPH. Its use for BPH is less established than for CP/CPPS and ED.
The Treatment Process
A consultation with a urologist is required to confirm the diagnosis and determine if shockwave therapy is an appropriate option.
The procedure is non-invasive, performed externally, and requires no anesthesia. A clinician applies a handheld probe (transducer) with gel to the skin of the perineum, the area between the scrotum and the anus. This position allows the sound waves to be precisely targeted at the prostate gland and surrounding pelvic floor.
Patients do not experience significant pain, with the sensation often described as a light tapping or tingling. The intensity of the shockwaves can be adjusted for comfort. A single treatment session is brief, lasting between 15 and 20 minutes.
A complete course of treatment involves a series of sessions. A common schedule is one to two sessions per week over four to six weeks, though this can vary based on the condition and patient response.
Patient Candidacy and Expected Outcomes
Ideal candidates include men with a confirmed diagnosis of CP/CPPS or mild-to-moderate ED, especially those who have not found relief with conventional treatments. Patients with BPH who are poor surgical candidates or have not responded well to medication may also be considered. It is an option for those seeking a non-invasive approach.
Shockwave therapy should not be used in certain situations. Contraindications include an active urinary tract infection, prostate cancer, or tumors in the treatment area. Men with blood clotting disorders or those taking oral anticoagulant medications are also not suitable candidates.
Side effects associated with Li-ESWT are mild and temporary. Patients may experience minor skin redness, slight bruising, or discomfort in the treated area, which resolves within a few days. Studies suggest the therapy does not cause significant damage to prostate tissue.
The results of shockwave therapy are not immediate and can take several weeks or months to become noticeable. While many patients report significant improvement in their symptoms, it is not a guaranteed cure, and the degree of success can vary.