What is Shock Wave Therapy?
Shock wave therapy (ESWT); It is a treatment method where intense and pressurized sound waves created from the generator are directed to the targeted area of the body by means of a
probe. This method was designed for the first time
for the purpose of breaking kidney and urinary tract stones (ESWL) and is still being used successfully. The device, which is designed in the same way and whose density is reduced or adjustable, has been used for other purposes. /> does it by increasing it. For example, low-intensity extracorporeal shock
wave therapy (Li-ESWT) can promote local inflammation, promote
new vessel formation, recruit stem cells and blood vessel formation cells, enhance cellular
proliferation and it can stimulate cell regeneration, and block oxidative stress, thus improving blood
circulation and promoting tissue repair.
Shock Wave Therapy for Stress Incontinence
Stress urinary incontinence (stress incontinence); It is called involuntary leakage of urine during physical exertion, exertion, coughing or sneezing
. A condition that occurs in
approximately 50% of adult women, the woman leaks urine when exerting, sneezing or coughing, laughing, and
lifting something heavy. This adversely affects social interaction and physical activity, and it is a condition that can cause important problems such as avoidance of sexual intercourse, deterioration and deterioration of the quality of life (QoL). It also negatively affects emotional and
mental health. Stress urinary incontinence is caused primarily by disruption of the pelvic floor, and weakening of the inner valve (internal sphincter) that controls urine, and secondarily due to excessive mobility and
laxity of the urethra and/or bladder neck ( hypermobility) is thought to be related. In the treatment of stress urinary incontinence
; In addition to lifestyle changes, pelvic floor muscle exercises and drug treatments;
surgical interventions are applied. is rising. No method offers a 100% solution. Therefore, there is an urgent need for new treatments that can
restore normal pelvic floor strength and function of the internal urinary valve (internal sphincter).
In women with stress urinary incontinence, once a week for 8 weeks, low-intensity shock wave
therapy(Li-eswt, 0.25 mJ/mm2, 3000 beats, 3/sec beat frequency) when applied along the urinary tract
not only significantly reduces urine leakage, but also overactive
it also alleviates the symptom of the urgent need to void the bladder and significantly
improves the quality of life. It has been found that shock wave therapy shows its effect by restoring the stress type urinary incontinence problem, pelvic floor
function, and then by activating the responsible part in the urinary reflex, by providing conscious control of the bladder. The
procedure has no significant side effects, it can be done in any situation except pregnancy. In conclusion, low-intensity shock wave therapy (Li-ESWT) is a new, non-invasive, and effective treatment method for stress urinary incontinence, especially in women, and a glimmer of hope in
women with urinary incontinence. can be seen as Although this method is lacking in evidence
, it can be used in combination with conventional treatments or as an alternative
to conventional treatment in the treatment of stress urinary incontinence. The implementation of this treatment should be seen as an option and an option that the physician and the patient can decide
together. When low-intensity shock wave
therapy is combined with stem cell therapy, its effect may be greater. .
Shock Wave Therapy in Overactive Bladder, Impingement Type Incontinence
Overactive bladder, urge incontinence: again, general quality of life (QoL) It is a common condition that can severely
reduce. Urge urinary incontinence is the condition of not being able to reach the toilet or delaying urination with the sudden-urgent need to urinate
and the urine escapes during this
. It is a condition that affects approximately 16-17% of adult people. e
this situation is increasing. The physiological basis of overactive bladder is due to the overactivity of the bladder muscle (detrusor). It is known that involuntary overactivity of the bladder
(hypoxia), oxidative stress and decreased blood flow play a role.
Botulinum toxin injection into the bladder and posterior tibial nerve
stimulation (PTNS) or sacral neuromodulation (SNM) with interventional-invasive treatments
. These treatments also do not yield 100% results. Therefore, finding an alternative
treatment, especially a less invasive-
interventional treatment that is non-medical and without bothersome side effects, is extremely important for patients with overactive bladder.
Urinary due to overactive bladder Interestingly, low
intensity shock wave therapy can yield good results in incontinence (urge incontinence. However, the molecular mechanism underlying this curative
effect is still unclear. However, the oxidative stress of shock wave
application may be associated with planned It is known to relatively inhibit cell death (apoptosis) and promote
tissue repair.Li-ESWT achieves these effects by dramatically increasing
vascular endothelial growth factor (VEGF), for example low
intensity extracorporeal shock wave therapy (LiESWT) promotes new vessel formation
, collects stem cells and blood vessel formation cells, stimulates cellular
proliferation and cell regeneration, and blocks oxidative stress. Thus,
can improve blood circulation and provide tissue repair. As a result,
increases bladder blood circulation and bladder nerves (innervation). Accordingly, it activates cell renewal (regeneration) in the bladder muscle, improves the muscle contraction function of the bladder and
urinary tract, and ultimately supports the ability to retain urine
.
Overactive bladder with low-intensity shock wave application in patients with (0.10-
0.25 mJ/mm2, 3000 beats, once a week, 4-8 weeks) the frequency of voiding decreases, the volume of urine per voiding
increases, and the amount of urine remaining after voiding may decrease.
Overactive in women with bladder and urinary incontinence c Decreased sexual desire and loss of sexual arousal are seen. . Therefore, shock wave application
may play an important role in the treatment of female sexual dysfunction
together with the use of estrogen, especially in postmenopausal women. In conclusion, low-intensity shock
wave therapy in women with stress urinary incontinence and
urge incontinence with overactive bladder is a new, easy to apply, repeatable, painless, with no known side effects
and It can be considered as a noninvasive-non-invasive treatment method.
Low-intensity shock wave application (Li-eswt), although lack of conclusive evidence,
classic in urinary incontinence due to stress type and overactive bladder in women. It can be used together with treatments
or as an alternative to conventional treatment. The implementation of this treatment should be seen as an option and an option that the physician and the patient can decide together with
. When low
intensity shock wave therapy is combined with stem cell therapy, its effect may be greater
. Application of shock wave therapy and stem cell therapy together
can be expected to have a positive effect on the result to be achieved.
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