Long CY. et al., 2026: . Effect of combining low intensity-extracorporeal shockwave therapy with platelet-rich plasma among female patients with interstitial cystitis: a prospective single-arm pilot study.

Long CY, Chang CY, Sung IC, Ke LY, Chuang HY.
Front Bioeng Biotechnol. 2026 May 28;14:1801578. doi: 10.3389/fbioe.2026.1801578

Abstract

Background: Interstitial cystitis (IC) is a disease comprised of multiple symptoms, included persistent bladder pain syndrome (BPS), frequent urination, and urgency without getting infection or other identifiable causes.

Methods: In our study, 25 female patients diagnosed with IC/BPS, the patients were performed low-intensity extracorporeal shockwave therapy (LI-ESWT) once a week for 8 weeks. The application sites for LI-ESWT are located above the pubic bone, in the middle and on both sides, with each session lasting about 20-30 min. High dosage of platelet-rich plasma (PRP) injections were administered in weeks 1, 5, and 9. All subjects had a baseline, 1-month and 6-month post-treatment assessment that included validated questionnaires and voiding diaries. Urodynamic studies were conducted at baseline and the 6-month follow-up after treatment.

Results: We observed an 80% efficacy rate. Then, we showed significant improvements in VAS, OABSS, UDI-6, IIQ-7, and POP at the 1-month follow-up. However, only the ICIQ showed significant improvement at the 6-month follow-up. We further examined the urodynamic parameters and MCC revealed significant difference at 6-month follow-up. The voiding diaries, which tracks the number of urinations, voided volume, maximum volume, and nocturia significant improved at 1-month follow-up while only maximum volume showed improvement at the 6-month follow-up. Finally, ICSI, ICPI, and OSS, all showed significant differences at both the 1-month and 6-month follow-ups.

Conclusion: The results of our study suggested that the combination treatment of PRP and LI-ESWT might show a therapeutic efficacy to IC/BPS patients, However, the follow-ups at 1 month and 6 months post-treatment suggested that the treatment needs to be administered again over time to maintain its effectiveness.

Comment Hans-Göran Tiselius

Patients with interstitial cystitis bladder pain syndrome comprise a group of patients difficult to treat. Some of these patients suffer extensively by awful pain. Unfortunately, effective treatment has been absent.

In the current report the authors have combined intravesical instillation of thrombocyte rich plasma and low-intensity SWL. The treatment that was given once a week for 8 weeks had a positive effect on the bladder urodynamic parameters ICSI, ICPI and OSS. The intention with the treatment was to affect the inflammatory process that causes interstitial cystitis,

The overall effects of this combined treatment is summarized in a graph showing that VAS was positively affected, so were also OABSS, UTDI-6, ILQ-9, POP and ICIQ. Most importantly was it that MCC (maximum cystometric capacity) was positively affected and also, as already mentioned, ICSI, ICPI and OSS.

The duration of the therapeutic effect, however, was limited to about six months, but given the therapeutic difficulties met in these patients, the authors conclusion was that the combined treatment might be worthwhile to repeat twice a year.

For the reader with particular interest in this disease, the report contains valuable information on the mechanisms underlying interstitial cystitis.

Hans-Göran Tiselius