The role of short-term low-intensity shock wave therapy to revitalize bladder function after partial bladder outlet obstruction

Purpose: This study aims to investigate the therapeutic efficacy of low-intensity shock wave therapy (LiESWT) on bladder dysfunction resulting from bladder outlet obstruction in a rat model. Materials and methods: We employed cystometrograms to trace and analyze the 24-hour voiding patterns using metabolic cages. To assess the severity of fibrosis, we utilized Masson trichrome staining. Western blotting was performed to investigate the protein levels related to angiogenesis, specifically vimentin, α-smooth muscle actin, and laminin. Furthermore, immunofluorescence staining was applied to evaluate the distribution of these proteins within the bladder wall. Results: The rat bladder weight significantly increased after partial bladder outlet obstruction (PBOO) surgery, exacerbating overactive bladder (OAB) symptoms with increased urinary frequency and decreased voided volume. The morphology study showed ischemic damage and enhanced interstitial fibrosis in the PBOO group, which were restored after shockwave therapy. LiESWT also augmented angiogenesis in the bladder wall. Treatment with LiESWT resulted in notable improvements in bladder capacity, contractility, and symptoms of OAB. Conclusion: Our findings from the animal model demonstrate that LiESWT is an effective treatment for PBOO-induced OAB. Short-term application of shock wave therapy has the potential to rejuvenate bladder function and alleviate associated symptoms.