Abstract
Background and Objectives: To evaluate the effects of low intensity extracorporeal shock wave therapy (LiESWT) on stress urinary incontinence (SUI). Materials and Methods: This investigation was a multicenter, single-blind, randomized-controlled trial study. Sixty female SUI patients were randomly assigned to receive LiESWT with 0.25 mJ/mm2 intensity, 3000 pulses, and 3 pulses/s, once weekly for a 4-week (W4) and 8-week (W8) period, or an identical sham LiESWT treatment without energy transmission. The primary endpoint was the changes in urine leakage as measured by a pad test and validated standardized questionnaires, while the secondary endpoint was the changes in a 3-day urinary diary among the baseline (W0), the W4 and W8 of LiESWT, and 1-month (F1), 3-month (F3), and 6-month (F6) follow-up after LiESWT. Results: The results showed that 4 weeks of LiESWT could significantly decrease urine leakage based on the pad test and validated standardized questionnaire scores, as compared to the sham group. Moreover, 8 weeks of LiESWT could significantly reduce urine leakage but increase urine volume and attenuate urgency symptoms, which showed meaningful and persistent improvement at W8, F1, F3, and F6. Furthermore, validated standardized questionnaire scores were significantly improved at W8, F1, F3, and F6 as compared to the baseline (W0). Conclusions: Eight weeks of LiESWT attenuated SUI symptoms upon physical activity, reduced urine leakage, and ameliorated 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.
Highlights
Stress urinary incontinence (SUI), according to the International Continence Society, is the involuntary leakage of urine upon physical exertion, effort, coughing, or sneezing [1].The global prevalence of urinary incontinence in the female population is approximately50% [2], which is a significant problem, namely the impairment of quality of life (QoL), such as reducing social interaction and physical activity, destroying sexual relationships, and worsening emotional and mental health.Excessive hypermobility of the urethra and/or bladder neck resulting from pelvic floor degeneration and internal sphincter deficiency are the two main mechanisms of stress urinary incontinence (SUI).Clinical managements of SUI are various, such as lifestyle changes, pelvic floor muscle training (PFMT), and medication, as well as surgery
We further evaluate the clinical application of low intensity extracorporeal shock wave therapy (LiESWT) on SUI patients and its persistence efficacy, including attenuating bladder urine leaks, impacting on overactive bladder (OAB) symptoms, and promoting quality of life
The results revealed that there were no significant differences in these parameters between the sham group and the LiESWT
Summary
Stress urinary incontinence (SUI), according to the International Continence Society, is the involuntary leakage of urine upon physical exertion, effort, coughing, or sneezing [1].The global prevalence of urinary incontinence in the female population is approximately50% [2], which is a significant problem, namely the impairment of quality of life (QoL), such as reducing social interaction and physical activity, destroying sexual relationships, and worsening emotional and mental health.Excessive hypermobility of the urethra and/or bladder neck resulting from pelvic floor degeneration and internal sphincter deficiency are the two main mechanisms of SUI.Clinical managements of SUI are various, such as lifestyle changes, pelvic floor muscle training (PFMT), and medication, as well as surgery. Stress urinary incontinence (SUI), according to the International Continence Society, is the involuntary leakage of urine upon physical exertion, effort, coughing, or sneezing [1]. The primary endpoint was the changes in urine leakage as measured by a pad test and validated standardized questionnaires, while the secondary endpoint was the changes in a 3-day urinary diary among the baseline (W0), the W4 and W8 of LiESWT, and 1-month (F1), 3-month (F3), and 6-month (F6) follow-up after LiESWT. Results: The results showed that 4 weeks of LiESWT could significantly decrease urine leakage based on the pad test and validated standardized questionnaire scores, as compared to the sham group. Conclusions: Eight weeks of LiESWT attenuated SUI symptoms upon physical activity, reduced urine leakage, and ameliorated overactive bladder symptoms, which implied that
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