Living with Overactive Bladder Syndrome (OAB) is like being held hostage by your own body. The constant urge to run to the bathroom, the anxiety of leaking at the wrong moment, and the restless nights can make daily life feel overwhelming. Millions of people, struggle with OAB, a condition that can disrupt work, social activities, and even sleep. While medications and invasive procedures offer some relief, they often come with frustrating side effects, leaving many feeling trapped between their symptoms and treatment burdens.
Overactive Bladder Syndrome
Overactive bladder syndrome is a common urinary condition that affects approximately 16-17% of adults worldwide, with its prevalence increasing as people age. This condition is characterized by a cluster of symptoms, with the primary one being urgency – a sudden, intense need to urinate that’s hard to control. OAB often goes hand in hand with increased frequency, where a person may find themselves using the bathroom more than eight times in a 24-hour period.
Nocturia, or waking up one or more times during the night to urinate, is another hallmark of this syndrome. In some cases, OAB can also involve urge incontinence, where the strong urge to urinate leads to involuntary leakage. While OAB affects both men and women, the specific symptoms and their intensity may vary slightly between genders. Despite its prevalence, it’s important to note that OAB is not a normal part of aging and can significantly impact quality of life if left untreated.
Management Options
Treating overactive bladder (OAB) typically involves a multi-faceted approach, starting with lifestyle modifications and progressing to more advanced therapies if needed. Initially, patients are often advised to make dietary changes, such as reducing caffeine and alcohol intake, and to practice bladder training techniques.
If these conservative measures aren’t sufficient, medications like anticholinergics or beta-3 adrenergic agonists may be prescribed to relax the bladder muscles. For more severe cases, advanced treatments such as Botox injections into the bladder or nerve stimulation therapies might be considered.
Can Focused Shockwave Therapy Help?
But what if there was a new way to manage OAB that didn’t involve pills, injections, or surgeries? Enter – focused shockwave therapy (fSWT), a non-invasive, painless treatment that could be a game-changer for OAB sufferers. Multiple studies have shown that fSWT may significantly reduce symptoms, improve bladder function, and enhance quality of life, offering new hope to those living with this often-debilitating condition.
In this post, we’ll dive into a prospective, randomised, single-blinded clinical trial, exploring the efficacy focused shockwave therapy as a treatment for Overactive Bladder Syndrome (OAB), focusing on both short-term and long-term benefits.
Access to full text, HERE
Overview of Study
Inclusion Criteria
- Female participants aged 20–75 years diagnosed with Overactive Bladder (OAB) for more than 3 months.
- OAB symptoms included daytime urination frequency of 8 or more times, and at least one instance of nocturia, urgency, or urgency incontinence.
- Participants who had previously used antimuscarinic or β3 agonist medications for OAB could participate after a 3-month withdrawal period.
Treatment Protocol
- Device used: DUOLITH SD1-TOP focused shockwave system (STORZ MEDICAL, AG, Switzerland)
- Treatment settings:
- Energy: 0.25 mJ/mm².
- Number of pulses: 3,000 pulses per session (1000 pulses directed at the bladder dome and bilateral walls).
- Treatment duration: Once a week for 8 weeks.
- Procedure:
- Participants’ functional bladder capacity was assessed using a 3-day urinary diary and uroflowmetry.
- Before treatment, participants drank 1000 mL of water to fill the bladder to 50% of its functional capacity.
- The fSWT probe was placed on the lower abdomen, tilted at 45 degrees above the pubic symphysis to target the bladder.
Figure 1. Improvement of OAB symptoms and life bothersome questionnaire scores after LiESWT treatment. (a,c) The therapeutic effect of LiESWT was analyzed by the OAB symptoms and life bothersome questionnaires, including OABSS, ICIQ-SF, UDI-6, and IIQ-7. LiESWT treatment significantly reduced the scores of OABSS, ICIQ-SF, UDI-6, and IIQ-7 as compared with the sham group. (b,d) Improvement of questionnaires scores for OAB symptom after LiESWT treatment, including daytime frequency, nocturia, urgency, and urgency incontinence. LiESWT improved OAB symptoms and the QoL. OABSS, overactive bladder symptom scores. ICIQ-SF: international consultation on incontinence questionnaire-short form, UDI-6: urogenital distress inventory–6, IIQ-7: incontinence impact questionnaire-7, W0: the baseline, W4: 4-week LiESWT treatment, W8: 8-week LiESWT treatment, F1: 1-month follow-up, F3: 3-month follow-up. The blue or orange font denotes the p-value before and after 4 weeks treatment in the sham group or in the LiESWT group, respectively. The purple font indicates the p-value between the sham group and the LiESWT group at the W0 and W4. # p < 0.05; ## p < 0.01 compared to W0.
Key Results of the Study
- Significant Reduction in OAB Symptoms
The fSWT group experienced significant improvements in key OAB symptoms, including:
- Daytime Urinary Frequency: Participants showed a meaningful reduction in how often they needed to urinate during the day, with significant improvements seen as early as four weeks into treatment and continuing to improve up to the eighth week. This effect was maintained throughout the 6-month follow-up period.
- Nocturia (Nighttime Urination): The number of times participants woke up at night to urinate decreased notably, enhancing their sleep quality—a critical factor often overlooked in OAB treatment.
- Urgency and Urgency Incontinence: fSWT led to a marked reduction in the sudden, intense urge to urinate and the associated episodes of incontinence. This improvement directly impacted the participants’ daily lives, allowing them to regain confidence and reduce the anxiety associated with sudden urges.
- Improved Bladder Function
Focused shockwave therapy not only reduced symptoms but also improved overall bladder function, as evidenced by objective measures:
- Increased Functional Bladder Capacity
- Average Voided Volume
- Maximal Flow Rate (Qmax):
- Reduction in Post-Void Residual (PVR) Volume:
- Long-Lasting Benefits Up to Six Months
The therapeutic effects of fSWT were not just short-lived; improvements in OAB symptoms, bladder function, and quality of life measures persisted for at least six months after the completion of treatment. This suggests that fSWT provides durable symptom relief, making it a viable long-term management option for OAB.
- Safety and Tolerance
The therapy was well-tolerated by participants, with no reported adverse effects such as pain, skin bruising, or other complications commonly associated with more invasive treatments. This makes it a particularly appealing option for those looking to avoid the risks of surgery or the side effects of medications.
The study concluded that fSWT significantly improves OAB symptoms, enhances bladder function, and positively impacts the quality of life, with effects lasting up to six months post-treatment. These results underscore the potential of fSWT as a non-invasive, safe, and effective alternative to traditional OAB treatments, providing patients with a new option to manage their condition without the burden of side effects or invasive procedures.
Treating OAB with focus shockwave therapy offers a groundbreaking alternative to traditional treatments, primarily because it is non-invasive and free from the common side effects associated with medications and surgical interventions. Unlike conventional options that often come with a host of downsides—like dry mouth, constipation, blurred vision, and even cognitive change, fSWT uses gentle sound waves to stimulate tissue repair, improve bladder function, and reduce inflammation without any incisions or chemicals.
This means patients can enjoy significant symptom relief without the discomfort, recovery time, or risks of invasive procedures. With no known adverse effects reported in studies, this therapy provides a safe, pain-free experience, allowing those with OAB to regain control of their lives without compromising their overall health or well-being. It’s time to rethink how we treat OAB and embrace innovative therapies that put patient comfort and wellness first. With focus shockwave therapy, reclaiming control is no longer a distant dream—it’s a real, attainable possibility.
Benoy Mathew, MSc, MCSP,
Advanced Practice Physio/MSK Sonographer,
Head of MSK Education, Venn Healthcare
Twitter: @function2fitnes Instagram: @function2fitness
Reference:
Lu, J.H., Chueh, K.S., Chuang, S.M., Wu, Y.H., Lin, K.L., Long, C.Y., Lee, Y.C., Shen, M.C., Sun, T.W. and Juan, Y.S., 2021. Low intensity extracorporeal shock wave therapy as a potential treatment for overactive bladder syndrome. Biology, 10(6), p.540.
