{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T23:12:51Z","timestamp":1789600371819,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T00:00:00Z","timestamp":1600732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To study the effect of intravesical instillation of botulinum neurotoxin\u2010A (BoNT\u2010A) combined with low energy shock wave (LESW) for treatment of overactive bladder (OAB) in a rat model and to investigate its effect on the associated inflammatory and oxidative stress process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>Forty rats were subdivided into four equal groups: normal control group, OAB group, LESW group, and BoNT\u2010A plus LESW group. Cystometrogram (CMG) changes and histopathological changes in the bladder mucosa were assessed in the different groups. Oxidative stress markers (malondialdehyde [MDA] and superoxide dismutase [SOD]) and proinflammatory cytokines (tumor necrotic factor\u2010\u03b1 [TNF\u2010\u03b1] and interleukin\u20106 [IL\u20106]) were compared among groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>BoNT\u2010A plus LESW group showed statistically significant lower amplitude (<jats:italic>p<\/jats:italic>\u2009=\u2009.001) and lower frequency of detrusor contractions (<jats:italic>p<\/jats:italic>\u2009=\u2009.01) compared to LESW, which showed no statistically significant difference in comparison to the OAB group. Also, the combined group significantly reduced submucosal edema and inflammatory cell infiltrate scores compared to all groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). LESW was associated with 42% reduction of MDA expression while, LESW plus BoNT\u2010A decreased it by 68% (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Also, LESW and LESW plus BoNT\u2010A increased SOD expression by 43% and 75%, respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). LESW plus BoNT\u2010A was associated with statistically significant lower expression of TNF\u2010\u03b1 and IL\u20106 expression by 37% and 66% in comparison to LESW group (<jats:italic>p<\/jats:italic>\u2009=\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intravesical instillation of BoNT\u2010A plus LESW is an effective method for increasing the urothelial permeability to BoNT\u2010A and enhancing its therapeutic effect against OAB in rat model through the expression of a substantial anti\u2010inflammatory and antioxidative stress effect.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.24511","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:44:08Z","timestamp":1600821848000},"page":"2447-2454","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Low energy shock wave\u2010delivered intravesical botulinum neurotoxin\u2010A potentiates antioxidant genes and inhibits proinflammatory cytokines in rat model of overactive bladder"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1511-4874","authenticated-orcid":false,"given":"Mohammed","family":"Nageib","sequence":"first","affiliation":[{"name":"Urology Department, Urology and Nephrology Center Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed H.","family":"Zahran","sequence":"additional","affiliation":[{"name":"Urology Department, Urology and Nephrology Center Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3619-1916","authenticated-orcid":false,"given":"Ahmed S.","family":"El\u2010Hefnawy","sequence":"additional","affiliation":[{"name":"Urology Department, Urology and Nephrology Center Mansoura University  Mansoura 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Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Shokeir","sequence":"additional","affiliation":[{"name":"Urology Department, Urology and Nephrology Center Mansoura University  Mansoura Egypt"},{"name":"Center of Excellence for Genome and Cancer Research, Urology and Nephrology Center Mansoura University  Mansoura 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