Low-intensity shockwave therapy for managing persistent storage symptoms following transurethral surgery for benign prostatic obstruction

A recent study demonstrated that low-intensity shockwave therapy (Li-SWT) improves long-lasting storage symptoms and enhances quality of life (QoL) following transurethral surgery (TUS) for benign prostatic obstruction (BPO), showing similar effectiveness and superior tolerability in comparison to solifenacin. The results of this study were published in the journal Prostate Cancer and Prostatic Diseases.

A total of 137 patients experiencing persistent storage symptoms, with urgency episodes of at least one per day and daytime frequency of at least eight for a period of at least three months after TUS for BPO were included. They were then randomized to receive Li-SWT, sham treatment, or solifenacin 10 mg/day in a ratio of 3:1:1. The primary endpoint of the study was the percentage reduction from baseline in overactive bladder symptom score (OABSS) at the three month follow-up. Changes in voiding diary parameters over three days, quality of life score, peak flow rate, and residual urine at three-and six-months were also compared. Treatment-related adverse effects were assessed as well.

The baseline data were similar across all groups. At the three-month follow-up, the reduction in OABSS from baseline was significantly greater in the Li-SWT group compared to the sham group (-55% vs. -11%), while it was similar between Li-SWT and solifenacin-10 (-55% vs. -60%). Similar to solifenacin-10, Li-SWT demonstrated a significant improvement in three-day voiding diary parameters and quality of life score at the three-month follow-up. This improvement was comparable between Li-SWT and solifenacin-10 at the six-month follow-up, with no adverse effects related to Li-SWT except for manageable pain during the procedure. However, solifenacin-10 was correlated with bothersome adverse effects in 73% of patients, leading to an 11.5% discontinuation rate.

The above study demonstrated that Li-SWT enhances QoL and improves long-term storage symptoms after TUS for BPO, showing comparable efficacy and better tolerability than solifenacin.