Xi Tianlong, Jin Mingchen, Gao Xiaoli
Department of Lithotripsy, The First Hospital of Zhangjiakou, Zhangjiakou, China.
Department of Pharmaceutical, The First Hospital of Zhangjiakou, Zhangjiakou, China.
Transl Androl Urol. 2025 Aug 30;14(8):2185-2194. doi: 10.21037/tau-2025-123. Epub 2025 Aug 26.
Stress urinary incontinence (SUI) significantly impacts women's quality of life. Extracorporeal shock wave therapy (ESWT) has emerged as a promising non-invasive treatment option. This systematic review and meta-analysis evaluates the efficacy of ESWT in treating female SUI.
A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure and Wanfang databases from their inception to January 2024 using 'extracorporeal shock wave', 'Low Intensity Extracorporeal Shock Wave Therapy' and 'stress urinary incontinence'. Randomised controlled trials (RCTs) and clinical studies comparing ESWT with control groups for SUI treatment were included. The primary outcomes included International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) scores and treatment efficacy. Secondary outcomes included Incontinence Impact Questionnaire-7 (IIQ-7), Overactive Bladder Symptom Score (OABSS) and Urogenital Distress Inventory (UDI) scores.
Four studies involving 287 patients met the inclusion criteria. The ESWT method significantly improved ICIQ-SF scores [standardised mean difference (SMD) =-4.22, 95% confidence interval (CI): -6.71 to -1.73, I=96.6%] equating to approximately 3.8 raw score points, exceeding the established minimal clinically important difference of 2.5 points and thus representing a clinically meaningful improvement. The method also demonstrated better treatment efficacy (risk ratio =0.30, 95% CI: 0.11-0.77, I=0%). Significant improvements were also observed in OABSS (SMD =-1.88, 95% CI: -3.51 to -0.38, I=91.2%). However, changes in IIQ-7 and UDI scores showed no statistical significance.
This meta-analysis suggests that ESWT is an effective treatment for SUI, significantly improving symptoms and quality-of-life measures. The evidence suggests that ESWT is a promising non-invasive option for SUI, particularly for patients seeking non-invasive alternatives to surgery. However, high heterogeneity among studies indicates the need for larger, well-designed RCTs to further validate these findings.
压力性尿失禁（SUI）对女性生活质量有显著影响。体外冲击波疗法（ESWT）已成为一种有前景的非侵入性治疗选择。本系统评价和荟萃分析评估了ESWT治疗女性SUI的疗效。
从创刊至2024年1月，在PubMed、Embase、Cochrane图书馆、科学网、中国知网和万方数据库中进行全面的文献检索，检索词为“体外冲击波”、“低强度体外冲击波疗法”和“压力性尿失禁”。纳入比较ESWT与对照组治疗SUI的随机对照试验（RCT）和临床研究。主要结局包括国际尿失禁咨询委员会简表（ICIQ-SF）评分和治疗效果。次要结局包括尿失禁影响问卷-7（IIQ-7）、膀胱过度活动症症状评分（OABSS）和泌尿生殖系统困扰量表（UDI）评分。
四项涉及287例患者的研究符合纳入标准。ESWT方法显著改善了ICIQ-SF评分[标准化均数差（SMD）=-4.22，95%置信区间（CI）：-6.71至-1.73，I=96.6%]，相当于约3.8个原始评分点，超过了既定的最小临床重要差异2.5分，因此代表了具有临床意义的改善。该方法还显示出更好的治疗效果（风险比=0.30，95%CI：0.11-0.77，I=0%）。OABSS也有显著改善（SMD=-1.88，95%CI：-3.51至-0.38，I=91.2%）。然而，IIQ-7和UDI评分的变化无统计学意义。
本荟萃分析表明，ESWT是治疗SUI的有效方法，可显著改善症状和生活质量指标。证据表明，ESWT是SUI一种有前景的非侵入性选择，尤其适用于寻求手术非侵入性替代方案的患者。然而，研究之间的高度异质性表明需要更大规模、设计良好的RCT来进一步验证这些发现。
