Xi T. et al., 2025: Efficacy of extracorporeal shock wave therapy for female stress urinary incontinence: a systematic review and meta-analysis.

Background Stress urinary incontinence (SUI) greatly diminishes the quality of life for affected women. Extracorporeal shock wave therapy (ESWT) has emerged as a potential non-invasive treatment option. This study aims to assess ESWT's effectiveness in treating female SUI. Methods The researchers conducted a systematic literature review, searching databases like PubMed, Embase, and others from their inception through January 2024. They focused on randomized controlled trials (RCTs) and clinical studies comparing ESWT with control groups for SUI. Primary outcomes were International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) scores and overall treatment efficacy, while secondary outcomes included scores from the Incontinence Impact Questionnaire-7 (IIQ-7), Overactive Bladder Symptom Score (OABSS), and Urogenital Distress Inventory (UDI). Results Out of the search, four studies involving a total of 287 patients met the inclusion criteria. The findings indicated that ESWT significantly improved ICIQ-SF scores, with a standardized mean difference (SMD) of -4.22, surpassing the minimal clinically important difference of 2.5 points—indicating a meaningful improvement. Additionally, ESWT demonstrated a superior treatment efficacy with a risk ratio of 0.30. Improvements were also observed in OABSS scores (SMD = -1.88). However, no significant differences were found in IIQ-7 and UDI scores. [img]https://www.storzmedical.com/images/blog/Xi.png[/img] Discussion In the context of the systematic review and meta-analysis you provided, stating that "no differences were found in IIQ-7" means that the study did not observe a statistically significant change in scores on the Incontinence Impact Questionnaire-7 (IIQ-7) for patients undergoing extracorporeal shock wave therapy (ESWT) compared to the control groups. Understanding the IIQ-7: The IIQ-7 is a questionnaire specifically designed to assess the impact of urinary incontinence on a person's quality of life. It focuses on how incontinence affects various aspects of daily living, including physical, social, and emotional well-being. Lower scores on the IIQ-7 indicate a lesser impact of incontinence on quality of life. Implications of No Significant Differences: When the meta-analysis reports that no significant differences were found in IIQ-7 scores, it suggests several things: Effect on Quality of Life: While ESWT appeared to improve symptoms of SUI as measured by other tools (like ICIQ-SF and OABSS), these improvements did not translate into a measurable change in the perceived impact of incontinence on the participants' quality of life according to the IIQ-7. Limitations in Treatment Effectiveness: This could indicate that while patients may experience fewer symptoms or greater control over their urination, the overall effect on their everyday functioning and well-being might not be sufficiently impacted to reflect a meaningful change in the IIQ-7. Need for Further Research: The lack of significant findings related to the IIQ-7 emphasizes the complexity of urinary incontinence treatment and the necessity for further exploration to fully understand how therapies like ESWT influence not just symptoms but overall quality of life for patients. In summary, while ESWT shows promise in improving certain measurable symptoms of SUI, its effect on the overall quality of life, as assessed by the IIQ-7, was not statistically significant, highlighting the multifaceted nature of treating this condition. Conclusions The meta-analysis concludes that ESWT is an effective treatment for SUI, showing significant improvements in symptoms and quality-of-life measures. It presents a promising non-invasive alternative for patients preferring non-surgical options. Nevertheless, the high heterogeneity among the studies signals the need for larger and better designed RCTs to confirm these findings. Jens Rassweiler