Choric Pelvic Pain Syndrome

ESWT Treatment protocol for Choric Pelvic Pain Syndrome (CPPS)

Contraindications
• Local infection at the area to be treated.
• Currently active sexually transmittable disease.
• Malignancy at the area to be treated.

Warnings and precautions
Patient has a bleeding tendency as a result of primary physiologic pathology in the coagulation system, or due to medications that enhance bleeding such as anticoagulants, etc.

Treatment protocol
Treatment will be applied twice a week for 3 consecutive weeks (Total of 6 treatment sessions) by a physician qualified/trained by Medispecas illustrated below. In each treatment session, the patient will receive 2400 shocks to cover the whole treatment area (The total number of shockwave pulses for the whole treatment course will be 14,400) during 2 treatment sessions per week over a 3 week period.

There are a total of 3 treatment locations during each treatment session which is designated by the laters A, B and C:

• Treatment locations A and B -Two locations over the penile crura (abdominal approach)
• Treatment location C-One location over the prostate through the mid-line of the perineal floor.

300 shockwaves will be applied to locations A and to B (300 shocks to each of those locations, total-600 shocks).

1800 shocks will be applied to location C (location C consists the perineal midline and will be divided to 1 cm sectors – the 1800 shocks will be divided by the number of sectors e.g. 1800/3=600 , therefore each of the three sectors will receive 600 shocks).
A total of 2400 shockwaves will be applied per treatment session.

Treatment procedure
Care must be taken to completely empty the bladder prior to SW treatment to enable the penetration of the SWs to the prostate:

• Subject will lie on his back on the treatment bed with his knees spread apart so that the perineum is exposed and ready for treatment.
• Generous amount of ultrasound gel will be spread on the silicone membrane of the shockwave applicator and on the areas to be treated.
• The shockwave applicator will be applied to the appropriate treatment areas (locations A, B, and C) and shockwaves will be applied according to the protocol.

Recovery procedure
Subject will be discharged immediately after treatment or remain under supervision for a duration which will be upon the physician’s consideration following each treatment session before discharge.