Therapeutic effects of Low intensity extracorporeal low energy shock wave therapy (LiESWT) on stress urinary incontinence

Long, Cheng‐Yu; Lin, Kun‐Ling; Chuang, Sung-Kiang; Lu, Jian‐He; Wu, Bin–Nan; Chueh, Kuang-Shun; Ker, Chin-Ru; Shen, Mei-Chen; Juan, Yung‐Shun

doi:10.1038/s41598-020-62471-4

Cited by 19 publications

(25 citation statements)

References 42 publications

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“…Our instrumentation was the DUOLITH SD1-TOP focused shock wave system (STORZ MEDICAL AG). The LiESWT was applied with 0.25 mJ/mm 2 of intensity, 3000 pulses of shock, and of 3 pulses/second of frequency on the middle urethra, including middle, left, and right side of the participant's labia 14 . The sham group used identical treatment without energy transmission to the tissue.…”

Section: Procedures and Medical Information Of Lieswtmentioning

confidence: 99%

“…The purpose of pad test in this study was to evaluate the effect of LiESWT on reducing urinary incontinence. The detailed steps were performed according to our previous study 14 . The percentage (%) of improvement was evaluated at 4-week (W4), 8-week (W8), and 1-month follow up (F1), 3-month follow up (F3), 6-month follow up (F6) after LiESWT treatment, and the results were normalized with pre-treatment baseline data (W0).…”

Section: Pad Test For the Evaluation Of Suimentioning

confidence: 99%

“…To analyze the effects of LiESWT, the primary endpoints were the changes in pad test and questionnaires (Overactive Bladder Symptom Score (OABSS), International Consultation on Incontinence Questionnaire short form (ICIQ-SF), Urinary Distress Inventory, Short Form (UDI-6), and Incontinence Impact Questionnaire, Short Form (IIQ-7)) 14 , and the secondary endpoints were the changes in 3-day urinary…”

Section: Outcomes Measures and Therapeutic E Cacy Assessment For Lieswtmentioning

confidence: 99%

“…A recent study using a SUI rat model induced by vaginal balloon dilation showed LiESWT ( 0.06 mJ/mm 2 , and 300 shocks at 3 Hz ) ameliorated SUI by promoting urethral sphincter regeneration, angiogenesis, and progenitor cell recruitment 7 . Recently, we published our preliminary results on human subjects to show that 8-week LiESWT attenuated SUI symptoms with short term follow up 14 . In the current study, we further evaluate the clinical application of LiESWT on SUI patients and its persistence e cacy, including attenuating bladder urine leaks, impacting on overactive bladder (OAB) symptoms, and promoting the quality of life.…”

Section: Introductionmentioning

confidence: 99%

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Low intensity extracorporeal shock wave therapy as a novel treatment for stress urinary incontinence: a randomized-controlled clinical study

Lin

Chueh

et al. 2021

Preprint

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Aims: To evaluate the effects of low intensity extracorporeal shock wave therapy (LiESWT) on stress urinary incontinence (SUI). Methods: This investigation was a multicenter, single-blind, randomized controlled trial study. 60 female SUI patients were randomly assigned to receive LiESWT with 0.25 mJ/mm2 intensity, 3000 pulses, and 3 pulses/second, once weekly for 4-week (W4) and 8-week (W8), or an identical sham LiESWT treatment without energy transmission. The primary endpoint was the changes in urine leakage as measured by pad test and validated standardized questionnaires. While the secondary endpoint was the changes in 3-day urinary diary among the baseline (W0), the W4 and the W8 of LiESWT, and 1-month (F1), 3-month (F3) and 6-month (F6) follow-up after LiESWT. Results: The results showed that 4-week LiESWT could significantly decrease urine leakage based on pad test and validated standardized questionnaire scores, as compared to the sham group. Moreover, 4-week LiESWT could significantly reduce urine leakage, but increase urine volume and attenuate urgency symptom, which showed meaningful and persistent improvement at W8, F1, F3 and F6. Furthermore, validated standardized questionnaire scores were significantly improved at W4, W8, F1, F3 and F6 as compared to the baseline (W0). Conclusions: 8-week LiESWT could attenuate SUI symptoms on physical activity, reduce urine leakage and ameliorate overactive bladder symptoms, which implied that LiESWT significantly improved the quality of life. Our findings suggested that LiESWT could serve as a potentially novel and non-invasive treatment for SUI.

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Section: Procedures and Medical Information Of Lieswtmentioning

confidence: 99%

Section: Pad Test For the Evaluation Of Suimentioning

confidence: 99%

Section: Outcomes Measures and Therapeutic E Cacy Assessment For Lieswtmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Low intensity extracorporeal shock wave therapy as a novel treatment for stress urinary incontinence: a randomized-controlled clinical study

Lin

Chueh

et al. 2021

Preprint

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“…Therefore, staged operation is a reasonable choice for women with POP and occult USI, and this option should also be provided to women with SUI. In addition, mild to moderate SUI can also be managed with conservative and noninvasive treatment, such as Kegel exercises, vaginal laser, bulky agent injection, or some novel treatments (e.g., intensity extracorporeal low energy shock wave therapy) 34 .…”

Section: Complication N (%)mentioning

confidence: 99%

The clinical and urodynamic outcomes of single-incision mesh surgery using the Uphold system for the treatment of pelvic organ prolapse

Liu

Loo

et al. 2020

Sci Rep

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this retrospective cohort study aims to assess the clinical and urodynamic outcomes of single-incision mesh surgery with the Uphold system. The medical records of 140 women with anterior and/or apical compartment prolapse stage 2 or greater who underwent Uphold mesh surgeries were reviewed. the clinical evaluation included a pelvic examination, a urodynamic study (UDS), and a personal interview to evaluate lower urinary tract symptoms (LUTS). After a follow-up time of 12-30 months, the anatomical reduction rates were 100% and 96.4% for the apical and anterior compartments, respectively, and these rates were similar across women with or without hysterectomy. All of the LUTS and several UDS parameters improved significantly. The continence rate in women with stress urinary incontinence (SUi) was improved if they also underwent a mid-urethral sling (MUS) operation. However, the continence rate did not differ between women with and without occult urodynamic stress incontinence who did not undergo a concomitant MUS operation. the rate of vaginal mesh extrusion was 2.8%, and this complication rarely occurred beyond the learning curve. In conclusion, the anatomic correction of the Uphold system was satisfactory with a low rate of mesh extrusion. Women with SUI would benefit from a concomitant MUS operation. Apical prolapse is an important issue among pelvic organ prolapse (POP) 1 , and level 1 support (according to DeLancey's description) should be provided during repair 2. In native tissue reconstruction, the sacrospinous ligament is an important attachment point of apical compartment repair. With direct visualization, sacrospinous ligament perforation and retrieval can be aided with specific devices, such as Deschamps ligature carrier 3 , but it is not always easy to approach the ligament from the vagina. The anatomic outcomes of sacrospinous ligament fixation, which is usually performed unilaterally, are heterogenous 4. Additionally, a higher rate of apical compartment recurrence was reported in sacrospinous hysteropexy than in hysterectomy 5. Therefore, a more durable procedure suitable for either uterine preservation or hysterectomy is needed 6 , and various transvaginal mesh (TVM) kits have been developed in recent decades. TVM was once considered a breakthrough innovation in treating POP. Regardless of fair anatomic outcomes, reports about mesh extrusion raised concerns about its safety 7. Due to the lack of long-term evidence in safety, the US Food and Drug Administration (FDA) ordered all manufacturers to stop selling synthetic mesh intended for transvaginal repair of anterior compartment prolapse on April 16th, 2019 8. Although TVM surgery is performed less often since the order, a continuous follow-up of women who underwent TVM surgeries is necessary and can provide abundant information. Although numerous procedures regarding level 1 support have been described, fixation with grafts is still one of the options in the flowchart 9. It appears that TVM still plays a role in

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Microenergy acoustic pulse therapy restores urethral wall integrity and continence in a rat model of female stress incontinence

Tan

Reed‐Maldonado

Wang

et al. 2022

Neurourology and Urodynamics

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Objective To determine the outcomes and mechanisms of microenergy acoustic pulse (MAP) therapy in an irreversible rat model of female stress urinary incontinence. Materials and Methods Twenty‐four female Sprague–Dawley rats were randomly assigned into four groups: sham control (sham), vaginal balloon dilation and ovariectomy (VBDO), VBDO + β‐aminopropionitrile (BAPN), and VBDO + β‐aminopropionitrile treated with MAP (MAP). MAP therapy was administered twice per week for 4 weeks. After a 1‐week washout period, all 24 rats were evaluated with functional and histological studies. The urethral vascular plexus was examined by immunofluorescence staining with antibodies against collagen IV and von Willebrand factor (vWF). The urethral smooth muscle stem/progenitor cells (uSMPCs) were isolated and functionally studied in vivo and in vitro. Results Functional study with leak point pressure (LPP) measurement showed that the MAP group had significantly higher LPPs compared to VBDO and BAPN groups. MAP ameliorated the decline in urethral wall thickness and increased the amount of extracellular matrix within the urethral wall, especially in the urethral and vaginal elastic fibers. MAP also improved the disruption of the urethral vascular plexus in the treated animals. In addition, MAP enhanced the regeneration of urethral and vaginal smooth muscle, and uSMPCs could be induced by MAP to differentiate into smooth muscle and neuron‐like cells in vitro. Conclusion MAP appears to restore urethral wall integrity by increasing muscle content in the urethra and the vagina and by improving the urethral vascular plexus and the extracellular matrix.

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Therapeutic effects of Low intensity extracorporeal low energy shock wave therapy (LiESWT) on stress urinary incontinence

Cited by 19 publications

References 42 publications

Low intensity extracorporeal shock wave therapy as a novel treatment for stress urinary incontinence: a randomized-controlled clinical study

Low intensity extracorporeal shock wave therapy as a novel treatment for stress urinary incontinence: a randomized-controlled clinical study

The clinical and urodynamic outcomes of single-incision mesh surgery using the Uphold system for the treatment of pelvic organ prolapse

Microenergy acoustic pulse therapy restores urethral wall integrity and continence in a rat model of female stress incontinence

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