Extracorporeal Shock Wave Therapy for the Treatment of Chronic Pelvic Pain Syndrome in Males: A Randomised, Double-Blind, Placebo-Controlled Study. - Prostatitis Forum & Social Network2024-03-28T09:00:54Zhttps://prostatitis.ning.com/forum/topics/extracorporeal-shock-wave?groupUrl=chronicprostatitistreatment&commentId=2201951%3AComment%3A9074&groupId=2201951%3AGroup%3A7&feed=yes&xn_auth=noI have emailed the Dr and he…tag:prostatitis.ning.com,2010-11-04:2201951:Comment:91272010-11-04T08:42:02.000ZNikhttps://prostatitis.ning.com/profile/NikolasBartley
I have emailed the Dr and he plans on publishing the year follow up results "hopefully" this year.
I have emailed the Dr and he plans on publishing the year follow up results "hopefully" this year. Not that I am aware of, hence…tag:prostatitis.ning.com,2010-11-02:2201951:Comment:91212010-11-02T08:16:23.000ZNikhttps://prostatitis.ning.com/profile/NikolasBartley
Not that I am aware of, hence my comment above of "needing more detail"..!!!
Not that I am aware of, hence my comment above of "needing more detail"..!!! Leaving aside "extremely enco…tag:prostatitis.ning.com,2010-11-01:2201951:Comment:91202010-11-01T16:01:04.000ZArnon Krongrad, MDhttps://prostatitis.ning.com/profile/krongrad
Leaving aside "extremely encouraging," are there new data?
Leaving aside "extremely encouraging," are there new data? The attached study's & ot…tag:prostatitis.ning.com,2010-11-01:2201951:Comment:91192010-11-01T10:57:27.000ZNikhttps://prostatitis.ning.com/profile/NikolasBartley
The attached study's & others if you care to google, show that <b><i>"some"</i></b> bacteria are affected by shock wave therapy. I wonder if there is a link between this and the year long improvements implied in the above article, or if it is by some other mechanism, or even perhaps by multiple mechanisms? In theory at least, the shock waves could break up or disrupt long standing bio-films that had been resistant to antibiotics.
The attached study's & others if you care to google, show that <b><i>"some"</i></b> bacteria are affected by shock wave therapy. I wonder if there is a link between this and the year long improvements implied in the above article, or if it is by some other mechanism, or even perhaps by multiple mechanisms? In theory at least, the shock waves could break up or disrupt long standing bio-films that had been resistant to antibiotics. In this article he states "Re…tag:prostatitis.ning.com,2010-11-01:2201951:Comment:91142010-11-01T10:17:17.000ZNikhttps://prostatitis.ning.com/profile/NikolasBartley
In this article he states <b><i>"Recently, the one year FU (follow up) could be completed showing extremely encouraging results"</i></b>. I take this to mean that, for those who did find significant relief from shock wave therapy, that the effects were more than short term. Interesting. It would be nice to have a little more detail.
In this article he states <b><i>"Recently, the one year FU (follow up) could be completed showing extremely encouraging results"</i></b>. I take this to mean that, for those who did find significant relief from shock wave therapy, that the effects were more than short term. Interesting. It would be nice to have a little more detail. I have been tracking my CPSI…tag:prostatitis.ning.com,2010-10-19:2201951:Comment:90872010-10-19T02:30:52.000Zsilent.readerhttps://prostatitis.ning.com/profile/silentreader
I have been tracking my CPSI for over a year now every other week or so and my scores are ranging from 24 to 38. So 4 point drop means nothing to me. I would surely try to insert a couple of electrodes in my butt as long as I don't have to go to Sweden for that.
I have been tracking my CPSI for over a year now every other week or so and my scores are ranging from 24 to 38. So 4 point drop means nothing to me. I would surely try to insert a couple of electrodes in my butt as long as I don't have to go to Sweden for that. These are the central paramet…tag:prostatitis.ning.com,2010-10-18:2201951:Comment:90842010-10-18T16:39:09.000ZArnon Krongrad, MDhttps://prostatitis.ning.com/profile/krongrad
These are the central parameters of informed treatment decision:<br></br>
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<b>- <i>Probability</i> of effect<br></br>
- <i>Degree</i> of effect<br></br>
- <i>Durability</i> of effect<br></br>
- <i>Safety</i> of treatment</b><br></br>
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As we all hear about the one patient who did great -- "uncle John had metastatic lung cancer but green tea cured him" -- an informed decision rests upon not anecdote, but research. Sure, Lyrica and shock waves and Mother Time are associated with symptomatic remission in…
These are the central parameters of informed treatment decision:<br/>
<br/>
<b>- <i>Probability</i> of effect<br/>
- <i>Degree</i> of effect<br/>
- <i>Durability</i> of effect<br/>
- <i>Safety</i> of treatment</b><br/>
<br/>
As we all hear about the one patient who did great -- "uncle John had metastatic lung cancer but green tea cured him" -- an informed decision rests upon not anecdote, but research. Sure, Lyrica and shock waves and Mother Time are associated with symptomatic remission in <b><i>individual</i></b> cases. And individual cases (<a href="http://prostatitis.ning.com/video/after-surgery-for-chronic">Dave Radford</a>) are critical in helping us to generate hypotheses regarding treatment effect that can be tested in clinical trials (<a href="http://clinicaltrials.gov/ct2/show/NCT00775515" target="_blank">LRP for severe, treatment-resistant chronic prostatitis</a>). Individual cases do not test these hypotheses.<br/>
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An individual patient seeking informed decisions must go back to the medical literature. Which in this case shows that <a href="http://prostatitissurgery.com/Lyrica_pregabalin.html" target="_blank">Lyrica is ineffective for chronic pelvic pain</a> and that shock waves offer a short-term, 4-point average symptom score reduction in men who probably had mild disease. So this discussion has nicely helped us to differentiate a <b>potentially idiosyncratic individual response</b> from <b>probability of response as measured in a population</b> of pateints.<br/>
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This discussion also has helped to differentiate <b>mild illness</b> from <b>severe illness</b>. Consider a man with 3 months of blood pressure of 135/95. And contrast him with a man with a 20-year history of blood pressure of 170/110. The men share the hypertension diagnosis, but the severity of their illnesses are different, the treatments are different, and the responses to treatment are different. We should not lump these two patients, just as we should not lump the shock-wave patients and the prostatectomy patients. Exactly what I thought Jon. I…tag:prostatitis.ning.com,2010-10-18:2201951:Comment:90832010-10-18T09:10:56.000ZNikhttps://prostatitis.ning.com/profile/NikolasBartley
Exactly what I thought Jon. I tend to think of anyone who has trouble sitting as a reasonably severe case. It would be nice to hear how he is doing though, as his last post was a few months ago.<br></br>
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Interestingly I started Lyrica after talking to a guy who had success with it (maybe the same guy you spoke to) and it was quite effective in the beginning. As the months went by though, its effects wore off. Perhaps my body, like that of an alcoholic with alcohol, started to build a…
Exactly what I thought Jon. I tend to think of anyone who has trouble sitting as a reasonably severe case. It would be nice to hear how he is doing though, as his last post was a few months ago.<br/>
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Interestingly I started Lyrica after talking to a guy who had success with it (maybe the same guy you spoke to) and it was quite effective in the beginning. As the months went by though, its effects wore off. Perhaps my body, like that of an alcoholic with alcohol, started to build a tolerance to it!! It was already causing short term memory loss at the dose I started on so I did not want to increase the dosage.<br/>
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Reinhold has offered to treat me in Austria where he works as per the trial, or there is an ESWT therapist in London who is looking at the trial at the moment to see if its something he is willing to try on me. As Dr K quite rightly notes, there are a lucky few who sometimes respond significantly above the average trial results, like the Swedish guy. In treatments where the side effects have shown minimal or absent, and the therapy is affordable and available, it seems worth a try.<br />
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I certainly wont be getting too exited about it though, and will report back anything of significance. Hi, Nik.
I guess my e-mail j…tag:prostatitis.ning.com,2010-10-18:2201951:Comment:90822010-10-18T03:57:44.000ZJonhttps://prostatitis.ning.com/profile/Jon
Hi, Nik.<br />
<br />
I guess my e-mail just went into his trash or something. It was kind of him to reply to you so quickly.<br />
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There will always be treatments which somehow match a particular patient's needs. I started to take Lyrica after contacting a guy whose life was completely transformed by it. For him it was just what he needed. Unfortunately, it's done nothing for me. But I would have been foolish not to try. Likewise with the shock wave therapy. It's easy to try and probably not damaging, so if it…
Hi, Nik.<br />
<br />
I guess my e-mail just went into his trash or something. It was kind of him to reply to you so quickly.<br />
<br />
There will always be treatments which somehow match a particular patient's needs. I started to take Lyrica after contacting a guy whose life was completely transformed by it. For him it was just what he needed. Unfortunately, it's done nothing for me. But I would have been foolish not to try. Likewise with the shock wave therapy. It's easy to try and probably not damaging, so if it becomes more widely available, I'll certainly give it a shot. In the case of the sufferer in Sweden, he got lucky and found something which was a perfect match for him. I'd like to know the severity of his condition, although the fact that he doesn't sit down at work may be an indication that it was quite severe. Thanks for sharing. It's alwa…tag:prostatitis.ning.com,2010-10-17:2201951:Comment:90812010-10-17T15:07:20.000ZArnon Krongrad, MDhttps://prostatitis.ning.com/profile/krongrad
Thanks for sharing. It's always nice to see individual response. It helps us to gauge potential to relieve or fail to relieve in a way that population averages do not.So as this patient apparently got complete relief on the one hand, we see other individuals who even after 60 hours of treatment have <a href="http://prostatitissurgery.com/Spinal_Cord_Stimulator.html" target="_blank">absolutely no response</a>. Individual patients looking at averages should remember just that: They are…
Thanks for sharing. It's always nice to see individual response. It helps us to gauge potential to relieve or fail to relieve in a way that population averages do not.So as this patient apparently got complete relief on the one hand, we see other individuals who even after 60 hours of treatment have <a href="http://prostatitissurgery.com/Spinal_Cord_Stimulator.html" target="_blank">absolutely no response</a>. Individual patients looking at averages should remember just that: They are individuals, not averages, and we do not have mathematical formulas to precisely predict <b><i>individual</i></b> <b><i>response</i></b>. The best we cann offer today are <b><i>probabilities</i></b>.<br/>
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It's interesting. He makes it sound like <a href="http://prostatitissurgery.com/Aerobic_Exercise.html" target="_blank">exercise</a> and trigger point release, which have been associated in othere studies with average CPSI changes of approximately 7 and 6 points. What's different is that exercise and trigger point release protocols as published are <b>multidimensional</b>, involving everything from relaxation to range-of-motion exercises. The shock waves, which appear less effective than physical therapy and trigger point release protocols as published, are apparently <b>uni-dimensional</b> interventions.<br/>
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It's important to keep in mind that there are <b>different classes of chronic prostatitis severity</b>. Shock waves therapy as publised in the paper linked above was <b><i>apparently</i></b> (see review of study weaknesses above) given to patients with <b><i>mild illness</i></b>: Short duration, average CPSI = 25, unknown number of treatment failures. Prostatectomy is a treatment offered as part of a clinical trial to patients with <b><i>severe illness</i></b>: Illness duration of up to 45 years, average CPSI = 35, up to 20 treatment failures. Let's not conflate <b><i>shock wave "apples"</i></b> with <b><i>prostatectomy "oranges."</i></b><br />
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Given how poorly shock waves worked in this study of relatively mildly ill patients, the progression is surely not shock wave therapy failure and then prostatectomy, which is for relatively severely ill patients. There are many other approaches that have been shown to on average work better than shock waves' 4-point drop. For mildly ill patients, these are the treatments patients can consider after failing shock waves.