Use of low‐intensity extracorporeal shock wave therapy in the management of interstitial cystitis/bladder pain syndrome patients: A thirty case study in a tertiary medical center

Abstract

Introduction Low‐energy extracorporeal shock wave therapy (LiESWT) is a new potential treatment for intractable interstitial cystitis/bladder pain syndrome (IC/BPS), and this paper will evaluate its therapeutic effects on IC/BPS. Materials and Methods This prospective clinical trial enrolled 30 women who have been diagnosed with IC/PBS to receive LiESWT treatment at an intensity of 0.25 mJ/mm2 and a frequency of 3 pulses/second, for a total of 3000 pulses within 8 weeks. And we assessed questionnaires (including O'Leary‐Sant Interstitial Cystitis Symptom Index (ICSI)), 3‐day voiding diary, and urodynamic study at the following intervals: 4 weeks of LiESWT (W4), 8 weeks of LiESWT (W8), 1‐month follow‐up (F1), 3‐month follow‐up (F3) after LiESWT, and 1 year follow‐up (F12). Results The primary outcome of questionnaires showed significant improvement of symptoms compared to baseline (W0), especially on ICSI(12.87 ± 3.44 before treatment and 7.87 ± 5.27 at F12, p < 0.05). 3‐day voiding diary also revealed significant decrease in daytime voiding frequency (15.57 ± 5.22 times before treatment and 10.70 ± 4.21 times at F1, p < 0.05) and significant increase on average voiding volume (95.85 ± 35.30 mL before treatment and 161.27 ± 74.21 mL at F1, p < 0.05). However, there were no significant differences in all parameters of the urodynamic study. Conclusion LiESWT can mitigate pain and lower urinary tract symptoms and improve the quality of life in IC/PBS patients, but does not increase the maximal cystometric capacity.

Multimodal therapies and strategies for the treatment of interstitial cystitis/bladder pain syndrome in Taiwan

“…100 Seven studies focused on treatment with oral medications, including Th2 cytokine inhibitor suplatast tosilate, 101 α1 adrenoceptor blocker silodosin, 102 SHIP1 of amino acid protein activator, 103 fatty acid amide hydrolase inhibitor ASP3652, 104 anti-TNF-α agent, 105 phosphodiesterase type 5 inhibitor tadalafil, 106 and pentosan polysulfate sodium. 107 Ten studies focused on the treatment of chronic inflammation and improvement of soft tissue regeneration such as low-energy shock wave (LESW), [108][109][110] hyperbaric oxygen therapy, 111 acupuncture, 112 and percutaneous tibial nerve stimulation or transcutaneous electrical nerve stimulation (PTNS/TENS). [113][114][115][116][117] The other two studies investigated the treatment of pelvic floor muscle myofascial pain (PFMP).…”

“…According to these studies, LESW and PTNS/TENS could improve bladder symptoms in most NHIC patients, 108–110,113,116,117 whereas education, CBT, and lifestyle modification might assist patients in coping with their symptoms regardless of their bladder condition 96,98,100 . PFMP may benefit from a combination of pelvic floor muscle treatment in patients who have pelvic floor myofascial pain 119 .…”