Low-intensity extracorporeal shock wave therapy (LiESWT), as a non-invasive physical therapeutic modality, is increasingly recognized for its potential in treating lower urinary tract dysfunction (LUTD). This article systematically explores the potential molecular mechanisms through which LiESWT acts on various types of LUTD, including the downregulation of pro-inflammatory cytokine expression, induction of neovascularization, mobilization and activation of tissue stem cells, regulation of neural regeneration and repair processes, and restoration of lower urinary tract muscle function. It also elaborates the latest therapeutic advances in the application of LiESWT for overactive bladder, underactive bladder, stress urinary incontinence, chronic prostatitis/chronic pelvic pain syndrome, and interstitial cystitis/bladder pain syndrome. This review also provides an in-depth analysis of the therapeutic efficacy differences associated with various treatment parameters (energy density, number of shocks, treatment frequency, and total sessions), summarizing the challenges currently faced in clinical translation and proposes future research directions and perspectives, so as to offer new feasible ideas for the treatment of LUTD and provide a theoretical basis for clinical practice.

Compared with simple stress urinary incontinence (SUI), complicated female SUI is more diverse in etiology and more difficult to treat.Based on domestic and foreign literature and our diagnosis and treatment experience, this paper makes a detailed introduction to the definition, diagnosis, evaluation and clinical treatment of complicated female SUI, so as to provide guidance and reference for the treatment of this disease.

Objective To compare the outcomes between interstitial cystitis/bladder pain syndrome (IC/BPS)patients treated with three-drug combination (M blockers + alpha blockers + Amitriptyline) and Sodium hyaluronate intravesical instillation.Methods The patients who came to Second Affiliated Hospital of Nanjing Medical University during October 2014 to September 2015 were investigated if they had IC/BPS.According to the treatment plan,27 patients (group A) received three-drug combination (M blocker + alpha blockers + Amitriptyline)therapy.Thirty-eight patients recelved instillation of sodium hyaluronate (40 mg/50 ml) therapy (group B).Intravesical instillations were performed weekly in the first 6 weeks,and monthly until sixth month.Interstitial cystitis symptom index,interstitial cystitis problem index,overactive bladder symptom score,visual analogue scale/score,the maximum urination and self-rating depression scale were assessed at baseline and the sixth month.Measurement data were expressed as ((x) ±s),t test was used for comparison between groups,and paired t-test was used for comparison of paired data.Results There were 65 patients.Age range was 25-73 years,course of disease (2-99 months),average age (51.4 ± 13.5),average duration (39.8 ± 31.0) months,of which 9 male (13.8％) and 56 female (86.2％) patients.The group A variation of ICSI、ICPI、OABSS、VAS、SDS and maximum urination were 3.7 ± 2.4、1.3 ± 1.5、1.2 ± 1.3、2.1 ± 1.5、3.1 ± 4.5、74.6 ± 52.4,The variation of group B ware 6.8 ± 3.6、5.0 ± 3.8、2.5 ± 1.8、2.8 ± 1.7、8.9 ± 6.4、109.0 ± 81.1.The improvement in ICSI,ICPI,OABSS,SDS of group B were higher than group A (P ＜ 0.05).Conclusion IC/BPS seriously affect the quality of life and the patients are prone to depression.The sodium hyaluronate intravesical instillation therapy could achieve more effect than the three-drug combination therapy.