Clinical Efficacy of Low‐Intensity Extracorporeal Shock Wave Therapy for Male Lower Urinary Tract Symptoms: A Retrospective Pilot Study

OBJECTIVE: To evaluate the efficacy and safety of low-intensity extracorporeal shock wave therapy (Li-ESWT) using the Morenova system in men with lower urinary tract symptoms (LUTS), including chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and to identify pretreatment factors associated with post-treatment symptom severity. METHODS: This retrospective single-center study included 61 men treated with Li-ESWT. The treatment was administered once weekly for six consecutive weeks. Symptom severity was assessed before and one month after treatment using the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), Benign Prostatic Hyperplasia Impact Index (BII), and National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). Multivariable linear regression analysis was performed to identify pretreatment factors independently associated with the post-treatment NIH-CPSI total score after adjustment for baseline NIH-CPSI. RESULTS: Significant improvements were observed in total IPSS (from 11.1 to 7.3), OABSS (from 3.8 to 2.8), BII (from 4.9 to 2.7), and NIH-CPSI (from 11.8 to 7.0) (all p < 0.001). Notably, pain improved significantly in patients with baseline pain (from 4.1 to 1.8, p < 0.001). Post-micturition dribbling improved in approximately one-third of patients. Higher PSA and lower baseline OABSS were independently associated with lower post-treatment NIH-CPSI scores after adjustment for baseline NIH-CPSI. No adverse events were observed. CONCLUSIONS: Li-ESWT was associated with improvements across voiding, storage, pain, and QOL domains, with no adverse events observed. These findings suggest that Li-ESWT may have potential as a treatment option for male LUTS, although prospective controlled studies are needed to confirm its efficacy.