Low-Energy Shock Wave Therapy for Overactive Bladder in Women With Metabolic Syndrome

Overactive bladder (OAB) is a prevalent urological condition characterized by urinary urgency, frequency, and nocturia, which significantly impairs quality of life. Emerging evidence suggests a strong association between OAB and metabolic syndrome, which is characterized by insulin resistance, hypertension, dyslipidemia, and central obesity. These metabolic abnormalities may contribute to endothelial dysfunction, chronic inflammation, and autonomic dysregulation, potentially affecting bladder function.

Low-energy extracorporeal shock wave therapy (LiESWT) is a novel, non-invasive therapeutic modality that has been shown to promote angiogenesis, improve tissue perfusion, and modulate inflammatory responses. Previous studies have demonstrated its potential benefits in various urological conditions.

This study is designed as a randomized, double-blind, sham-controlled trial to evaluate the efficacy and safety of LiESWT in women with metabolic syndrome-associated OAB. Participants are randomly assigned to receive either LiESWT treatment or a sham procedure.

Clinical outcomes are assessed using validated patient-reported outcome measures, including OABSS, ICIQ-SF, UDI-6, and IIQ-7, along with objective parameters such as uroflowmetry and post-void residual volume. Assessments are performed at baseline and at multiple follow-up time points after treatment.

This study aims to provide clinical evidence on the therapeutic role of LiESWT in improving symptoms and quality of life in this specific patient population.

Inclusion:

• Female participants aged 20 to 75 years
• Diagnosed with overactive bladder (OAB), defined as urinary frequency (≥8 times/day), nocturia (≥2 times/night), and urgency (≥2 episodes/week) for at least 3 months
• Diagnosed with metabolic syndrome, defined by the presence of at least three of the following criteria:
• Waist circumference ≥80 cm
• Blood pressure ≥130/85 mmHg or receiving antihypertensive treatment
• Fasting glucose ≥100 mg/dL or receiving treatment for diabetes
• Triglycerides ≥150 mg/dL or receiving lipid-lowering treatment
• High-density lipoprotein cholesterol <50 mg/dL
• No pharmacological or injection treatment for OAB within 3 months prior to enrollment
• Able to understand and comply with study procedures and questionnaires
• Willing to provide informed consent

Exclusion:

• History of kidney stones or bladder stones
• Urinary tract infection within 3 months prior to enrollment or recurrent urinary tract infections (≥3 episodes)
• Lower urinary tract surgery within 6 months prior to enrollment
• Known or suspected malignancy of the urinary tract
• Significant bladder outlet obstruction
• Severe coagulopathy, liver failure, or renal failure
• Prior pelvic malignancy or pelvic radiation therapy
• Intravesical injection or electrical stimulation therapy within the past year
• Substance abuse (drug or alcohol) within the past year
• Chronic pelvic pain due to other causes
• Inability to complete study questionnaires or procedures