Extracorporeal Shock Wave Therapy (ESWT) has emerged as a promising treatment modality in dentistry, offering non-invasive and effective solutions for various dental conditions. This review article aims to provide an overview of the current state of research on ESWT in dentistry, focusing on its applications, mechanisms of action and clinical outcomes. ESWT utilizes high-energy acoustic waves to stimulate biological tissues, promoting tissue regeneration, angiogenesis and pain relief. In dentistry, ESWT has been explored for the management of conditions such as periodontitis, peri-implantitis, Temporomandibular Joint Disorders (TMDs) and orofacial pain syndromes. Studies have demonstrated the efficacy of ESWT in reducing inflammation, promoting wound healing and improving clinical outcomes in these conditions. Furthermore, ESWT has shown promise in enhancing the outcomes of dental implant therapy by improving osseointegration and reducing implant failure rates. The non-invasive nature of ESWT, along with its minimal side effects and high patient acceptance, makes it a valuable adjunctive therapy in dental practice. ESWT thus represents a novel and effective approach in the management of various dental conditions. Further research is warranted to explore its full potential and establish standardized protocols for its use in dentistry.

As an emerging therapeutic option for erectile dysfunction (ED), low-intensity pulsed ultrasound (LIPUS) has attracted increasing attention. The therapeutic effect of LIPUS is comparable to low-intensity extracorporeal shockwave therapy. However, the underlying mechanism of LIPUS remains unclear. We summarized the current literature to assess the efficacy of LIPUS for ED and elucidate the biological effects caused by LIPUS in different ED models. Preliminary clinical studies demonstrate that LIPUS is beneficial for ED with varying degrees of severity, and its therapeutic effect can be enhanced when combined with phosphodiesterase 5 inhibitors. Basic researches have shown that LIPUS can treat ED resulting from type 1 diabetes mellitus, cavernous nerve injury, or cavernosa injury. The underlying mechanisms involve upregulating endothelial and neuronal nitric oxide synthase expression, increasing smooth muscle and endothelium content, inhibiting cavernosal fibrosis mediated by the transforming growth factor-β1/drosophila mothers against decapentaplegic protein/connective tissue growth factor (TGF-β1/Smad/CTGF) pathway, and ameliorating oxidative stress via microtubule-associated protein 1 light chain 3 (LC3)- and Parkin-dependent mitophagy in type 1 diabetic ED. Yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ), activated by LIPUS, contribute to the recovery of neurogenic ED. Furthermore, the survival and secretion function of Schwann cells are improved by LIPUS through activating tropomyosin receptor kinase B/protein kinase B/cyclic adenosine monophosphate-response element-binding protein (TrkB/Akt/CREB) pathway, thereby accelerating cavernous nerve repair. LIPUS is a safe and effective treatment modality for ED, which can restore the pathological changes in corpus cavernosum via multiple pathways. The long-term efficacy of LIPUS needs further investigation.

Pediatric nephrolithiasis continues to pose a substantial clinical challenge in pediatric urology because of its elevated recurrence rate and elevated morbidity with risk of end-stage renal failure. The management of pediatric nephrolithiasis involves dietary modification, pharmacological therapy, and urological intervention, with the choice of treatment guided by stone size, location, and composition. To evaluate the efficacy and safety of mini-percutaneous nephrolithotomy (mini-PCNL) and extracorporeal shock wave lithotripsy (SWL) for the management of renal stones measuring 1-2 cm in pediatrics. This prospective, randomized comparative research was conducted at the Department of Urology, Al-Azhar University Hospital, Assiut, Egypt, between December 2022 and November 2024. Sixty children with single renal stones were enrolled, with 30 undergoing SWL and 30 receiving mini-PCNL. Mini-PCNL achieved a significantly elevated stone-free rate (SFR, 93.33%) in contrast with SWL (33.33%) (p < 0.001). The SWL group also showed a higher rate of auxiliary approaches and retreatment. Overall complication rates were comparable. Mini-PCNL is more effective than SWL for managing renal stones measuring 10-20 mm in children aged 6 months to 6 years. It provides an elevated SFR and lowers the likelihood of retreatment and hospital readmission, with a comparable safety profile.

A Rare Adverse Event of Pancreatic Extracorporeal Shock Wave Lithotripsy for Pancreatic Stones.

Do symptom duration and body mass index influence clinical outcome following proximal medial gastrocnemius release for recalcitrant plantar fasciitis?

Background Chronic back pain is a common adult musculoskeletal disorder globally, causing lumbar dysfunction, sleep issues, and psychological anxiety. Yet current single-treatment plans have many limitations. Objective This study aimed to evaluate the efficacy of extracorporeal shock wave-based combined therapy for chronic back pain, analyze its impact on pain and lumbar function, and provide clinical evidence for multimodal treatment. Method This retrospective controlled study (September 2023–September 2025) enrolled 200 chronic low back pain (CLBP) patients from the Hospital, divided into two groups ( n = 100 each). The combined group received extracorporeal shock wave + core stability training + anti-inflammatory drugs, whereas the control group received exercise + anti-inflammatory drugs. The main indicators include Visual Analog Scale (VAS) (pain) and Oswestry Disability Index (ODI) (lumbar function), and the secondary indicators include Short Form 36 (SF-36) (quality of life), Berg Balance Scale (BBS) (posture control), Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) (anxiety and sleep), serum IL-6, and TNF-α. Data were collected pretreatment and 4 and 12 weeks posttreatment, and a 12-week recurrence rate was recorded. Result No significant variations were observed in the baseline data of the two patient groups ( P &gt; 0.05). Following 4 and 12 weeks of treatment, two key differences emerged: First, the combined group had significantly lower values in VAS/ODI/HADS/PSQI scores and serum inflammatory factors (IL-6, TNF-α) than those of the control group ( P &lt; 0.05); second, the combined group's SF-36 and BBS scores were significantly higher than those of the control group ( P &lt; 0.05). Additionally, after 12 weeks of follow-up, the pain recurrence rate in the combined therapy group was significantly lower than that in the control group ( P &lt; 0.05). Conclusion The combination of extracorporeal shock wave therapy, core stability training, and anti-inflammatory drugs significantly alleviates pain, improves lumbar function/quality of life, reduces inflammation, and lowers long-term pain recurrence in CLBP treatment.

Health-related quality of life in patients with plantar fasciopathy: Comparison to the general population of the United Kingdom.

The development of effective medical expulsive therapy (MET) following extracorporeal shock wave lithotripsy (ESWL) for pediatric urolithiasis is crucial for enhancing stone fragment clearance. This study aimed to evaluate the efficacy and safety of alpha-1 adrenergic blockers (tamsulosin and silodosin) in children after ESWL. A prospective randomized comparative study was conducted involving 200 patients (aged 2-18 years) who underwent ESWL. Participants were allocated to a study group (n = 50, receiving α1-blockers: tamsulosin 0.2mg/day for ages 2-5, silodosin 4mg/day for ages > 5) or a control group (n = 150, receiving standard therapy). Primary endpoints were stone-free rate (SFR) and stone expulsion time. Secondary endpoints included pain dynamics (visual analog scale, VAS), analgesic requirements, and adverse events. Statistical analysis was performed using StatTech v.4.8.3. The odds of being stone-free were 2.11 times higher with α1-blocker therapy (OR = 2.11; 95% CI: 1.02-4.37). The median expulsion time was reduced from 7 [5-9] days in the control group to 5 [4-7] days in the study group (p = 0.010). ROC analysis identified a 6-day threshold for stone passage (sensitivity 63.6%, specificity 72.1%, AUC = 0.627; p = 0.010). Pain intensity was significantly lower in the study group on postoperative day 1 (3 [0-4] vs. 6 [5-8] points, p < 0.001), with reduced analgesic requirements (1 [0-2] vs. 2 [1-4] doses/day, p = 0.003). Adverse events were mild and infrequent (5 cases of nasal congestion, 2 of nausea). Adjunctive therapy with α1-blockers after ESWL in children with urolithiasis improves treatment efficacy, shortens stone expulsion time, reduces pain, and demonstrates a favorable safety profile. An optimal timeframe for efficacy assessment is 6 days post-ESWL.

Background: One in 5 men experiences erectile dysfunction, and with the aging population and comorbid diseases becoming increasingly common, this number is likely to continue to rise. Low-intensity extracorporeal shockwave therapy may cause structural changes that repair penile tissue. This study aimed to examine the available information regarding the effectiveness of low-intensity extracorporeal shockwave therapy for the treatment of erectile dysfunction. Materials and methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Fourteen studies involving 861 patients were included in this review. Results: Meta-analysis of data revealed that extracorporeal shockwave therapy significantly increased the International Index of Erectile Function across all treatment groups (mean difference, 3.60; 95% confidence interval, 0.59–6.61; p = 0.02). Conclusions: Improvement in International Index of Erectile Function–Erectile Function domain scores after low-intensity extracorporeal shockwave therapy was significantly greater than after sham therapy.

Peyronie's disease (PD) is a connective tissue disorder of the penis that causes pain, curvature, and erectile dysfunction. Methods: A prospective study was conducted on 112 patientstreated with ESWT. Each received three sessions of 3,000 shockwaves at 0.11-0.17 mJ/mm2. Pain, curvature, and erectile function were assessed. Pain relief occurred in 90% of patients (mean VASreduction: 3, p<0.00001); 57.1% had curvature improvement (mean 30°, p<0.001); 26.2% of ED patients improved ≥ 4 points in IIEF. ESWT appears safe and effective in improvingpain and curvature in PD patients.

Low-intensity extracorporeal shock wave therapy (Li-ESWT) has emerged as a promising treatment for vasculogenic erectile dysfunction (ED), particularly in men who do not respond to phosphodiesterase type-5 inhibitors (PDE5-Is). To evaluate the feasibility, safety, and clinical effectiveness of Li-ESWT in men with vasculogenic ED through a prospective 12- and 18-month follow-up. A prospective observational study was conducted on 188 patients with vasculogenic ED and inadequate response to PDE5-Is. Patients underwent 6 weekly sessions of Li-ESWT. Erectile function was assessed using the international index of erectile function (IIEF) and erection hardness score (EHS). Responders were defined as those achieving ≥ 3-point improvement on IIEF-EF and/or EHS ≥3. Mean age was 66.6 years; mean ED duration was 24 months. IIEF-EF improved from 11 at baseline to 21 at 12 months and 18 at 18 months. At 12 months, 71% of patients showed improvement in EHS. Younger age (<45 years), shorter ED duration (<12 months), and moderate baseline severity predicted better response (p<0.05). Sustained improvement was observed in 65% of patients at 12 months and 54% at 18 months. No adverse events were reported. Li-ESWT is a safe and effective treatment for vasculogenic ED unresponsive to PDE5-Is, with maximum benefit observed within 12 months. Efficacy tends to decline at 18 months. Larger controlled studies are needed to define long-term outcomes.

ABSTRACT Introduction Extracorporeal shock wave lithotripsy (ESWL) is currently the first-line treatment for pancreatic stones larger than 5 mm. However, it remains unclear whether the presence of a preexisting pancreatic stent during ESWL influences the procedure’s efficacy or complication rate. This study aims to evaluate whether the stent should be removed prior to ESWL. Methods All consecutive patients who underwent ESWL between March 2011 and March 2020, with a history of pancreatic stent placement within the two years preceding ESWL, were included in the study. Based on the presence or absence of an indwelling pancreatic stent during the ESWL procedure, the patients were categorized into two groups: the stent group and the non-stent group. The primary outcome assessed was the rate of spontaneous stone clearance following ESWL. The secondary outcome included number of ESWL shock waves and post-ESWL complications. Results A total of 704 patients were initially enrolled. After exclusions, 117 patients in the non-stent group and 200 in the stent group were included in the final analysis. The rate of spontaneous stone clearance was significantly higher in the non-stent group than in the stent group (64.1% vs. 28.5%; p < 0.001). However, no significant differences were observed between the two groups in the number of shock waves required for successful stone fragmentation (7475.0 ± 3508.7 vs. 7777.8 ± 3908.7; p = 0.478), nor in the overall incidence of post-ESWL complications (5.5% vs. 7.7%; p = 0.439). Conclusions The presence of a pancreatic stent is associated with reduced rates of spontaneous stone clearance but does not significantly affect the incidence of ESWL-related complications. Therefore, proactive removal of the stent prior to ESWL may be considered.

To investigate the efficacy of extracorporeal shock wave therapy (ESWT), high-intensity laser therapy (HILT), and exercise therapy in patients diagnosed with plantar fasciitis. A total of 84 patients diagnosed with plantar fasciitis were randomized into 3 groups: ESWT combined with a home exercise program (n = 28), HILT combined with a home exercise program (n = 30), and a home exercise program alone (control) (n = 26). The ESWT group underwent a total of 3 ESWT sessions, performed once a week, whereas the HILT group underwent a total of 15 HILT sessions over 3 weeks. All 3 groups were evaluated at the beginning of the treatment, at the end of the treatment (week 3), and at the 12th week for pain levels (measured using the visual analog scale [VAS]), plantar fascia thickness, and the Foot Function Index (FFI). Because of the nature of the interventions, participant masking was not possible; however, assessor masking was strictly adhered to. Eighty-four patients completed the study. Significant reductions in plantar fascia thickness, VAS scores, and FFI values were observed in all 3 groups (P < .05). However, baseline-adjusted analyses detected no meaningful between-group differences at 12 weeks (P > .05; small effect sizes). Our study demonstrated that ESWT, HILT, and exercise therapy each effectively reduced pain levels and improved functional capacity in the treatment of plantar fasciitis. Adding ESWT or HILT to a structured home exercise program did not provide an incremental clinical benefit during the follow-up period. The findings support exercise therapy as a practical first-line option.

Peripheral vascular disease (PVD) causes significant pain and disability in patients. Current conservative treatment for PVD is often limited to physical exercise. However, several recent studies have investigated the effects of physical therapy modalities in patients with PVD. This systematic review and network meta-analysis (NMA) aimed to compare the effects of different physical therapy modalities and physical exercise in improving the walking function of patients with PVD. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, NMA extension. We searched six databases for relevant randomized clinical trials (RCTs) published between 2013-2023. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials version 2 (RoB2). MetaInsight and R were used to conduct the NMA. We analyzed 21 studies in the NMA. The results showed that shockwave therapy (SMD = 1.41, 95%CI (0.58, 2.24)) and vacuum therapy (SMD = 0.72, 95%CI (0.16, 1.29)) were effective independently in improving the walking function of patients with PVD. Combined hydrotherapy and exercise programs also performed better than exercise-only programs (SMD = 0.74, 95%CI (0.38, 1.09)). While electrotherapy yielded a significant effect when performed independently (SMD = 1.43, 95%CI (0.53, 2.33)), but was not effective when combined with exercise. Our findings suggest that shockwave and vacuum therapy can be used as a treatment for patients with PVD who have difficulties participating in physical exercise. Hydrotherapy could assist patients participating in physical exercise programs to achieve better outcomes. This study was registered in the PROSPERO database CRD42023461442.

This review provides a comprehensive overview of mid-substance Achilles tendinopathy (MAT), covering its aetiology, pathophysiology, diagnosis, and management strategies, both nonoperative and operative. A detailed literature analysis was conducted, focusing on MAT's epidemiology, clinical presentation, imaging methods, and treatment options. Key studies and meta-analyses were reviewed. This review synthesizes the current evidence on the assessment and management of MAT. It details the pathophysiology, epidemiology, and diagnostic process, including clinical evaluation, specific provocation tests, and the role of imaging. A comprehensive analysis of both conservative and surgical treatment options is presented, evaluating their efficacy based on the available literature. MAT presents bimodally, with a male predominance. Diagnosis is primarily clinical, supported by ultrasound and tools such as the Victorian Institute of Sport Assessment-Achilles score. Nonoperative management is the cornerstone, with eccentric exercise rehabilitation standing as the most evidence-based and effective intervention. For recalcitrant cases, high-volume image-guided injection (HVIGI) is a promising second-line option with a favourable safety profile. Extracorporeal shockwave therapy (ESWT) may be considered as an adjunct. Evidence for other adjuncts such as platelet-rich plasma and corticosteroids is weak, and their use is not recommended. Surgical intervention is reserved for the approximately 20% to 29% of patients who fail conservative treatment. Options include gastrocnemius recession, plantaris excision, and open or minimally invasive/endoscopic debridement, with tendon transfer indicated for large defects. While most techniques report high success rates, a lack of high-level comparative evidence precludes a definitive surgical algorithm. The management of MAT is fundamentally staged, beginning with a prolonged trial of eccentric exercises. HVIGI and ESWT are valuable next-step options. Surgery is considered for refractory cases, with a trend towards minimally invasive techniques owing to their lower complication profile. However, there is a paucity of randomized controlled trials, making surgeon preference and expertise a significant factor in choice of procedure. An evidence-based treatment algorithm is proposed to guide clinical decision-making.

A0032 A double-blind randomized controlled trial of low intensity extracorporeal shock wave therapy for overactive bladder in women with metabolic syndrome

A0717 Low-intensity extracorporeal shockwave therapy on penile rehabilitation after nerve sparing robot-assisted radical prostatectomy: Preliminary results from a randomized controlled trial

P0063 Low-dose ionizing radiation and low-intensity shock wave therapy as adjunctive promoters of buccal mucosa urethral graft take in a rat model.

Introduction. Effective evacuation of stone fragments is a critical stage determining the success of extracorporeal shock wave lithotripsy (ESWL) in children with urolithiasis. However, optimal approaches to postoperative lithokinetic therapy in pediatric practice remain a subject of debate. Objective:comparative analysis of the efficacy and safety profile of combined lithokinetic therapy, including alpha-1-adrenergic blockers and polychromatic polarized light, for improving the elimination of stone fragments after extracorporeal shock wave lithotripsy (ESWL) in children with urolithiasis. Methods.This prospective randomized study included 250 children aged 2 to 18 years who underwent ESWL. All patients were randomized into three groups: a control group (n=150) receiving standard postoperative therapy, Group 2 (n=50) receiving a course of PPL exposure, and Group 3 (n=50) receiving a combination of alpha-1-adrenergic blockers (tamsulosin/silodosin) and a course of PPL exposure. To assess efficacy, the following parameters were analyzed: stone-free rate (SFR), time to stone expulsion, level of pain, and frequency of postoperative complications. Results.Combined lithokinetic therapy resulted in the highest stone-free rate (88.0%), which was significantly higher than in the control group (60.0%; p0.001). The SFR in the PPL group was 76.0%. The dynamics of SFR achievement differed, occurring earlier in Groups 2 and 3. The lowest need for analgesia was noted in the combination therapy group (82.0% of patients required no pain relief). Dynamic ultrasound showed a significantly faster reduction in the size of residual fragments in the study groups. Postoperative complications were less frequent in Groups 2 and 3. No adverse effects from the use of alpha-1-adrenergic blockers were noted. Conclusion.Combined lithokinetic therapy with alpha-1-adrenergic blockers and PPL may be associated with a higher rate of complete stone fragment passage after ESWL in children compared with standard therapy, as well as with a reduced need for analgesics.

Radial Extracorporeal Shockwave Therapy as an acupuncture device to improve equine movement dynamics in the sport horse