Improves symptoms and urinary biomarkers in refractory interstitial cystitis/bladder pain syndrome patients randomized to extracorporeal shock wave therapy versus placebo

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.

Use of the Shock Wave Therapy in Basic Research and Clinical Applications—From Bench to Bedsite

“…A decrease in the activity of inflammatory biomarkers seems to be a potential mechanism of action in observed in improvement in symptoms in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) in human [25,26]. These clinical findings have been confirmed in a recently published meta-analysis [27] regarding the therapy of patients with a chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).…”

Urinary Oxidative Stress Biomarker Levels Might Be Useful in Identifying Functional Bladder Disorders in Women with Frequency and Urgency Syndrome

“…Hence, urine biomarkers could represent the pathophysiological mechanism of bladder pathologies or bladder outlet dysfunctions, and these LUTDs could be identified by urine levels of different biomarkers [ 13 , 34 ]. Changes in urine biomarker levels can be also used to assess therapeutic outcomes after specific treatments [ 35 ]. However, different LUTDs might have the same elevated urine levels of a single urine biomarker, whereas an LUTD could have different urine biomarker levels due to varying disease severity.…”

Multimodal therapies and strategies for the treatment of interstitial cystitis/bladder pain syndrome in Taiwan

“…100 Seven studies focused on treatment with oral medications, including Th2 cytokine inhibitor suplatast tosilate, 101 α1 adrenoceptor blocker silodosin, 102 SHIP1 of amino acid protein activator, 103 fatty acid amide hydrolase inhibitor ASP3652, 104 anti-TNF-α agent, 105 phosphodiesterase type 5 inhibitor tadalafil, 106 and pentosan polysulfate sodium. 107 Ten studies focused on the treatment of chronic inflammation and improvement of soft tissue regeneration such as low-energy shock wave (LESW), [108][109][110] hyperbaric oxygen therapy, 111 acupuncture, 112 and percutaneous tibial nerve stimulation or transcutaneous electrical nerve stimulation (PTNS/TENS). [113][114][115][116][117] The other two studies investigated the treatment of pelvic floor muscle myofascial pain (PFMP).…”