Shen YC. et al., 2021: Improves symptoms and urinary biomarkers in refractory interstitial cystitis/bladder pain syndrome patients randomized to extracorporeal shock wave therapy versus placebo.
Shen YC, Tyagi P, Lee WC, Chancellor M, Chuang YC.
Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Song District, Kaohsiung, Taiwan.
The Center of Excellence in Shockwave Medicine and Tissue Regeneration, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Song District, Kaohsiung, Taiwan.
Department of Urology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Urology, Beaumont Health System, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA.
Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Song District, Kaohsiung, Taiwan.
The Center of Excellence in Shockwave Medicine and Tissue Regeneration, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Song District, Kaohsiung, Taiwan.
Abstract
Extracorporeal shock wave therapy (ESWT) has been shown to improve symptoms in patients with interstitial cystitis/bladder pain syndrome (IC/BPS); however, there is a lack of objective evidence. We measured change of urinary biomarker levels in 25 patients with IC/BPS received ESWT or placebo once a week for 4 weeks. Urines were collected from participants at baseline, 4 and 12 weeks post treatment. A representative 41 inflammatory growth factors, cytokines, and chemokines in urine were measured using a MILLIPLEX immunoassay kit. Symptom bother was assessed by O'Leary-Sant symptom scores (OSS), and visual analog scale (VAS) for pain. The ESWT group exhibited a significant reduction in the OSS and VAS compared to the placebo group 4 weeks post-treatment (P < 0.05), and the effects were persistent at 12 weeks. The difference in urinary markers change in ESWT versus placebo was P = 0.054 for IL4, P = 0.013 for VEGF, and P = 0.039 for IL9 at 4 weeks. The change of urine biomarker was not significant in other biomarkers or all the measured proteins at 12 weeks. The current data suggest that IL4, IL9, and VEGF mediation may be involved in its pathophysiologic mechanisms and response to LESW treatment.
Sci Rep. 2021 Apr 6;11(1):7558. doi: 10.1038/s41598-021-87040-1. PMID: 33824389. FREE ARTICLE
Comments 1
Pain caused by interstitial cystitis and bladder pain syndrome usually is a theraputic challenge for the urologist.
In this report the authors describe improvements in O’Leary-Sant symptom scores (OSS) and VAS-scores following treatment with Li-ESWT. Moreover, IL4, VEGF and IL9 were affected compared with measurements following placebo treatment, but the findings in these markers are more difficult to interpret. There were no differences in base-line biomarkers in placebo and treated patients.
Treatment strategy:
Energy flux 0.25 mJ/mm2
One treatment per week x 4
Shockwaves delivered with a frequency of 3/second, 2000 per session.
Application 2-4 cm above the symphysis.
Hans-Göran Tiselius