Low-intensity extracorporeal shockwave therapy (Li-ESWT) is a non-invasive treatment that uses shockwave as the application medium to produce mechanical, cavitation and thermal effects, and then produce special physiological effects on organisms. Li-ESWT has anti-inflammatory, analgesic, induces cell proliferation, promotes angiogenesis and nerve regeneration, and increases tissue and biofilm permeability. A large number of studies have reported that Li-ESWT is used in the treatment of coronary heart disease, tendonitis, delayed union of fractures, and nonunion. In recent years, low-intensity extracorporeal shockwave therapy has been more and more widely used in urological diseases, and the application progress of low-intensity extracorporeal shockwave therapy in urological diseases is summarized as follows.
01【Stress urinary incontinence】
Stress urinary incontinence (SUI) is the most common type of urinary incontinence in women, in which urine leaks involuntarily from the urethral opening when the patient sneezes, coughs, laughs, or exercises and the abdominal pressure increases. According to an epidemiological survey in China, the incidence of SUI in mainland women was 18.9%, and the incidence of SUI gradually increased with age, and the prevalence in rural areas (21.4%) was higher than that in urban areas (16.4%). Vaginal birth and obesity are important risk factors for SUI. SUI seriously affects the quality of life of patients and causes a huge social and psychological burden on patients.
One randomized controlled trial included 60 female patients with SUI who were randomly divided into treatment (45) and control (15) groups, with the treatment group receiving the same Li-ESWT stimulation as described above, and the control group receiving the same shockwave treatment without energy transmission. At the fourth week of treatment, 64.4% of patients in the treatment group achieved moderate or greater improvement in urinary leakage symptoms compared with the control group. At the end of treatment at week 8 and at follow-up at 1, 3 and 6 months after the end of treatment, the proportion of improvement increased to 68.8%, 77.8%, 82.3% and 84.5%, respectively. In addition to the Overactive Bladder Score (OABSS), the Urinary Incontinence Questionnaire Short Form (ICIQ-SF), the Genitourinary Tract Disease-Related Questionnaire (UDI-6), and the Urinary Incontinence Associated Questionnaire (IQ-7) scores were significantly different from those of the control group at the fourth week of treatment (P<0.05), indicating that Li-ESWT could be used as a potential treatment for patients with SUI.
02. [ Erectile dysfunction ]
Erectile dysfunction (ED) is a common sexual dysfunction disorder in adult men in which patients are unable to achieve or maintain a penile erection sufficient for sexual activity for more than 3 months. According to the etiology, ED can be divided into psychological, organic (i.e., vascular-derived, neurorgenic, anatomically derived, endocrine-metabolic) and mixed. Vascular-derived ED caused by penile vascular dysfunction is the most common type of organic ED, accounting for about 50%~60%@. Phosphodiesterase-5 inhibitors are the most commonly used first-line therapy, but PDE5i is not effective in all patients with ED and has adverse effects. Li-ESWT is the only possible cure for vasogenic ED, and the European Urological Association recommends that it be used in patients with mild vasogenic ED.
In an RCT evaluating the efficacy of Li-ESWT in patients with PDE5i-unresponsive ED, 37 patients in the treatment group were treated with Li-ESWT at 0.09 mJ/mm² and 16 patients in the control group were treated with Li-ESWT without energy transmission. At follow-up one month after the end of treatment, it was found that 20 patients in the treatment group achieved an erection sufficient for sexual intercourse, i.e., EHS grade 3, while none of the patients in the control group achieved grade 3 EHS. Subsequently, the control group was treated with Li-ESWT of the same energy as the treatment group, and nine patients achieved EHS grade 3 at the following 1-month follow-up. This suggests that Li-ESWT treatment is effective even in patients with severe ED who do not respond to PDE5i.
03. [ Chronic prostatitis/chronic pelvic pain syndrome ]
Type III. prostatitis, also known as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), is a common and frequent disease in urology andrology, accounting for about 90%~95% of all prostatitis. The main manifestations are long-term recurrent pain and discomfort in the lower abdomen and perineum, abnormal urination, and some patients are also accompanied by sexual dysfunction and psychiatric and psychological symptoms. The recurrence and prolongation of CP/CPPS disease bring great economic and mental burden to patients and seriously affect their physical and mental health. Studies have shown that CP/CPPS affects quality of life in the same severity as chronic conditions such as myocardial infarction, unstable angina, and active Crohn's disease.
Wu et al. recruited 215 patients with CP/CPPS to undergo perineal 0.25 mJ/mm² Li-ESWT treatment, and found that Li-ESWT treatment significantly improved the severity of other symptoms in addition to reducing pain. At the follow-up one year after the end of Li-ESWT treatment, it was found that the patients had a 53.6% reduction in chronic prostatitis symptom score (NH-CPSI), a 50.9% decrease in the International Prostate Symptom Score (IPSS), a 17.9% increase in IEF-5 score, a 6.8% increase in EHS, and a corresponding improvement in quality of life (QoL) score (2.6±1.56VS4.29±1.54, P<0.05) compared with baseline, which confirmed that Li-ESWT was effective in relieving pain symptoms and improving erectile function and quality of life in patients with refractory CP/CPPS.
04. [ Overactive bladder ]
Overactive bladder (OAB) is a syndrome characterized by urinary urgency, usually with urinary frequency and nocturia, with or without urge incontinence, in the absence of urinary tract infection or other well-established pathology. The overall prevalence of OAB in the adult population in mainland China was 5.2%, and the prevalence of OAB in women (5.6%) was slightly higher than that in men (4.8%).
Lee et al. reported for the first time a clinical study that Li-ESWT could improve OAB symptoms, and all enrolled patients (with a history of more than 3 months) were treated with 0.25 mJ/mm² of Li-ESWT for 8 weeks. OAB symptom score (OABSS), OAB questionnaire (OAB-q), voiding diary, urinary flow rate and PVR measurements were completed at the 4th and 8th weeks of treatment and the 1st and 3rd months of follow-up, respectively. The results showed that after 8 weeks of Li-ESWT treatment, the patient's urodynamic parameters such as functional bladder capacity, urine output and Qmax were significantly increased, the residual urine volume after urination was significantly reduced, and the symptoms of daytime urinary frequency, urgency and nocturia were significantly reduced. Li-ESWT treatment was shown to improve urodynamic parameters, reduce OAB symptoms, and improve the quality of life of patients with OAB.
Lepu Electromagnetic Shock Wave Therapy Device FS10 Series
It covers the high, medium and low energy range, and is suitable for a wider range of diseases
As a new tool for pain rehabilitation, the FS10 series integrates advanced technology and innovative concepts to shine in the field of rehabilitation with excellent efficacy. It is mainly through the release of pulsed high-voltage electricity and the generation of pulsed magnetic field through the coil, resulting in electromagnetic induction effect, so that the concave metal diaphragm vibrates up and down in the water to produce a focused shock wave, which is transmitted to the lesion point through the water bladder head. It has a fast propagation rate, low energy loss, can treat deep lesions, and has no skin redness and swelling after treatment, and is a non-invasive, non-invasive, and immediately effective pain treatment device.
Superior efficacy, restoring health
The FS10 series adopts a self-focusing wave source, which does not require an acoustic lens, reduces energy transmission loss, and the energy is more stable, without bruising and redness after treatment, non-invasive and accurate, and the effect is significant and reliable. At the same time, its energy coverage is 0.01-0.45mJ/mm², covering three energy ranges of low, medium and high, suitable for a variety of energy needs, suitable for rehabilitation department, pain department, traditional Chinese medicine department, andrology, pelvic floor center, obstetrics and gynecology, urology, institutional community and other different departments and disease treatment.
In addition, the effective treatment depth of the FS10 series can reach 110mm and has the function of adjusting the treatment depth, so that medical staff can carry out personalized treatment plans according to the actual situation of patients, not limited to the depth of skin and muscle, and can treat deep lesions, so as to ensure that each patient can get the best treatment effect and improve the pertinence and accuracy of treatment.
Patented design, innovation and upgrading
The FS10 series has two unique patents and has been carefully optimized for more stable overall probe energy delivery and longer head life. At the same time, the 125° ergonomic grip angle design of the treatment head can support multi-angle grip and key operation to alleviate the fatigue of long-term grip treatment;
The FS10 series is also equipped with a VAS pain assessment system, which allows medical staff to record the pain level before and after treatment, score from 0 to 10, understand the patient's treatment response and pain relief in real time, adjust the treatment plan according to the assessment results, and provide patients with a more personalized rehabilitation plan, so that the effect can be seen.
Intelligent operation, comfortable experience
The FS10 series is designed with user experience in mind, and intelligent operation makes the treatment process simple and efficient. Through the user-friendly 12.1-inch large touchscreen interface, medical staff can easily set treatment parameters and personalize the treatment plan according to the actual situation of the patient, ensuring that each patient can get the best treatment results. Moreover, the equipment can be portable and mobile, which can be more flexible in treatment arrangement, which improves the work efficiency of the rehabilitation department and expands the venue.
The FS10 series shockwave therapy device also has an advanced intelligent safety reminder system, which supports a variety of intelligent identification and reminder functions such as overvoltage, overtemperature, water shortage, and insufficient probe life, and comes with a human anatomy chart and prescription index, which can be quickly loaded and treated quickly to ensure safety and reliability. The treatment does not require the use of anesthesia or medications, which not only reduces the patient's discomfort, but also reduces the risks and side effects during the treatment.
Bibliography:
ZHONG Rongfang, LIANG Chaochao, ZHANG Xiansheng, et al.Application progress of low-intensity extracorporeal shock wave therapy in urologic andrology[J].Chinese Journal of Andrology, 2022, 36(4):5.
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