The beneficial effect of low intensity extracorporeal low energy shock wave therapy on overactivity bladder
Dr YUNG-SHUN JUAN (1), PhD Shu-Mien Chuang (2), Dr Yung-Chin Lee(3), Professor Cheng-Yu Long(4), Dr. Kun-Ling Lin(5)
(1) Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan, (2) Department of Urology, College of Medicine, Kaohsiung Medical University, , Kaohsiung, Taiwan, (3) Department of Obstetrics and Gynecology, Kaohsiung Municipal Hsiao-Kang Hospital, , Taiwan, (4) Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital,, Kaohsiung, Taiwan, (5) Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
Extracorporeal low intensity shock wave therapy (LiESWT) has been used clinically to improve tendonitis, ischemic cardiovascular disorders, skin wound healing and erectile dysfunction. We hypothesize that clinical application of LiESWT on overactivity bladder (OAB) patients could attenuate inflammatory responses, increase angiogenesis, improve bladder overactivity and promote the quality of life (QoL). Our aim is to evaluate the effects of LiESWT on OAB syndrome, including urinary frequency, urgency, urge incontinence, and nocturia.
Our instrumentation is extracorporeal shock wave therapy system, the STORZ MEDICAL EvoTronTM (DUOLITH SD1, GA) shock wave (focused). The LiESWT was applied once weekly for 8 weeks. Eligible subjects include female outpatients aged 20~75 years who have been diagnosed with OAB symptoms for at least 3 months. The participants will complete the validated questionnaire of pre-treatment versus post-treatment of LiESWT to assess the change in overactive bladder questionnaire short form [Overactive Bladder Symptom Scores (OABSS), International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF); Urogenital Distress Inventory (UDI-6)-Short Form and incontinence impact questionnaire-7 (IIQ-7) score, uroflowmetry and measurement of post void residual urine volume, and three-day voiding diary.
A total of 60 patients with a mean age 55.90±9.19 years were enrolled. Changes in clinical symptoms at W8 of LiESWT showed the mean values of functional bladder capacity increased from 338.06±28.93 to 356.80±24.43 (ml), while the urgency decreased from 4.45±0.73 to 2.78±0.59 (times/ 24hrs). The mean values of nocturia also decreased from 1.72±0.17 to 1.18±0.24 (times). Moreover, OABSS, ICIQ-SF, UDI-6 and IIQ-7 scores also showed a significant improvement compared with the baseline level.
LiESWT ameliorated bladder hyperactivity, improved OAB syndrome, including urinary urgency, urinary frequency, and nocturia, and promotes the quality of life.