Adjunct Low-Intensity Extracorporeal Shockwave Therapy for Acute and Chronic Epididymitis: A Case Series of 11 Patients.

INTRODUCTION: Acute and chronic epididymitis frequently present with significant morbidity due to severe pain and inflammation. Standard management includes antibiotics and analgesics, yet persistent symptoms and complications often occur, sometimes leading to orchiectomy. Low-intensity extracorporeal shockwave therapy (LiESWT), previously shown to modulate inflammation and promote tissue repair in other urological conditions, was explored as an adjunct treatment for epididymitis. Case Presentation(s): Eleven men with ultrasound-confirmed acute or chronic epididymitis were treated with adjunct LiESWT in addition to guideline-based antibiotic therapy. In this small, uncontrolled case series, most patients experienced rapid symptom relief, including marked pain reduction and improvement of inflammatory markers, and no LiESWT-related adverse events were observed. LiESWT was well tolerated, and analgesic requirements appeared lower than expected based on typical clinical courses; however, the specific contribution of LiESWT cannot be determined in the absence of a control group.

CONCLUSION: This initial clinical experience suggests that LiESWT may represent a promising and biologically plausible adjunct option for acute and chronic epididymitis, particularly in patients with persistent or recurrent scrotal pain. Larger, controlled studies, especially in chronic epididymal pain cohorts, are needed to confirm these preliminary findings and to define the potential role and optimal use of LiESWT in this setting.