{"title":"体外冲击波治疗女性压力性尿失禁的疗效：系统回顾和荟萃分析。","authors":"Tianlong Xi, Mingchen Jin, Xiaoli Gao","doi":"10.21037/tau-2025-123","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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<sup>2</sup>=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<sup>2</sup>=0%). Significant improvements were also observed in OABSS (SMD =-1.88, 95% CI: -3.51 to -0.38, I<sup>2</sup>=91.2%). However, changes in IIQ-7 and UDI scores showed no statistical significance.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 8","pages":"2185-2194"},"PeriodicalIF":1.7000,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433078/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy of extracorporeal shock wave therapy for female stress urinary incontinence: a systematic review and meta-analysis.\",\"authors\":\"Tianlong Xi, Mingchen Jin, Xiaoli Gao\",\"doi\":\"10.21037/tau-2025-123\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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<sup>2</sup>=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<sup>2</sup>=0%). Significant improvements were also observed in OABSS (SMD =-1.88, 95% CI: -3.51 to -0.38, I<sup>2</sup>=91.2%). However, changes in IIQ-7 and UDI scores showed no statistical significance.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":23270,\"journal\":{\"name\":\"Translational andrology and urology\",\"volume\":\"14 8\",\"pages\":\"2185-2194\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-08-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433078/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Translational andrology and urology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/tau-2025-123\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"ANDROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational andrology and urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/tau-2025-123","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/26 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ANDROLOGY","Score":null,"Total":0}
Efficacy of extracorporeal shock wave therapy for female stress urinary incontinence: a systematic review and meta-analysis.
Background: 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.
Methods: 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.
Results: 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, I2=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, I2=0%). Significant improvements were also observed in OABSS (SMD =-1.88, 95% CI: -3.51 to -0.38, I2=91.2%). However, changes in IIQ-7 and UDI scores showed no statistical significance.
Conclusions: 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.
期刊介绍：
ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.
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