{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T21:34:01Z","timestamp":1793136841000,"version":"4.5.0"},"reference-count":50,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2022,5,1]],"date-time":"2022-05-01T00:00:00Z","timestamp":1651363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,5,1]],"date-time":"2022-05-01T00:00:00Z","timestamp":1651363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","eu-focus.europeanurology.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["European Urology Focus"],"published-print":{"date-parts":[[2022,5]]},"DOI":"10.1016\/j.euf.2021.04.021","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T08:48:28Z","timestamp":1620636508000},"page":"840-850","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":11,"title":["The Effect of Low\u2010intensity Shockwave Therapy on Non-neurogenic Lower Urinary Tract Symptoms: A Systematic Review and Meta\u2010analysis of Preclinical and Clinical Studies"],"prefix":"10.1016","volume":"8","author":[{"given":"Ioannis","family":"Sokolakis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Pyrgidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Neisius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gierth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Knoll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Rassweiler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3170-7362","authenticated-orcid":false,"given":"Georgios","family":"Hatzichristodoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.euf.2021.04.021_bib0005","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S0090-4295(02)02243-4","article-title":"The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society","volume":"61","author":"Abrams","year":"2003","journal-title":"Urology"},{"key":"10.1016\/j.euf.2021.04.021_bib0010","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/j.eururo.2014.01.019","article-title":"What is the most bothersome lower urinary tract symptom? Individual- and population-level perspectives for both men and women","volume":"65","author":"Agarwal","year":"2014","journal-title":"Eur Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0015","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1016\/j.eururo.2006.09.019","article-title":"Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study","volume":"50","author":"Irwin","year":"2006","journal-title":"Eur Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0020","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.eururo.2008.03.109","article-title":"Lower urinary tract symptoms revisited: a broader clinical perspective","volume":"54","author":"Chapple","year":"2008","journal-title":"Eur Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0025","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.euf.2018.04.004","article-title":"Lower urinary tract symptoms including bladder outlet obstruction: what\u2019s new in diagnostics?","volume":"4","author":"Gravas","year":"2018","journal-title":"Eur Urol Focus"},{"key":"10.1016\/j.euf.2021.04.021_bib0030","doi-asserted-by":"crossref","unstructured":"Mykoniatis I, Pyrgidis N, Sokolakis I, et al. Low-intensity shockwave therapy for the management of chronic prostatitis\/chronic pelvic pain syndrome: a systematic review and meta-analysis. BJU Int. In press. https:\/\/doi.org\/10.1111\/bju.15335.","DOI":"10.1111\/bju.15335"},{"key":"10.1016\/j.euf.2021.04.021_bib0035","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.jsxm.2018.12.016","article-title":"The basic science behind low-intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic scoping review of pre-clinical studies","volume":"16","author":"Sokolakis","year":"2019","journal-title":"J Sex Med"},{"key":"10.1016\/j.euf.2021.04.021_bib0040","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1038\/nrurol.2017.119","article-title":"Low-intensity shockwave therapy for erectile dysfunction: is the evidence strong enough?","volume":"14","author":"Young Academic Urologists Men\u2019s Health Group","year":"2017","journal-title":"Nat Rev Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0045","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/iju.13403","article-title":"Potential applications of low-energy shock waves in functional urology","volume":"24","author":"Wang","year":"2017","journal-title":"Int J Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0050","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"10.1016\/j.euf.2021.04.021_bib0055","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"10.1016\/j.euf.2021.04.021_bib0060","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"10.1016\/j.euf.2021.04.021_bib0065","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/1471-2288-14-43","article-title":"SYRCLE\u2019s risk of bias tool for animal studies","volume":"14","author":"Hooijmans","year":"2014","journal-title":"BMC Med Res Methodol"},{"key":"10.1016\/j.euf.2021.04.021_bib0070","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.eururo.2017.08.016","article-title":"Key steps in conducting systematic reviews for underpinning clinical practice guidelines: methodology of the European Association of Urology","volume":"73","author":"Knoll","year":"2018","journal-title":"Eur Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0075","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"Br Med J"},{"key":"10.1016\/j.euf.2021.04.021_bib0080","doi-asserted-by":"crossref","DOI":"10.1177\/1557988319831899","article-title":"Radial extracorporeal shock wave therapy as a novel agent for benign prostatic hyperplasia refractory to current medical therapy","volume":"13","author":"Zhang","year":"2019","journal-title":"Am J Mens Health"},{"key":"10.1016\/j.euf.2021.04.021_bib0085","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.amsu.2016.12.051","article-title":"Long term efficacy of extracorporeal shock wave therapy [ESWT] for treatment of refractory chronic abacterial prostatitis","volume":"14","author":"Al Edwan","year":"2017","journal-title":"Ann Med Surg"},{"key":"10.1016\/j.euf.2021.04.021_bib0090","first-page":"1","article-title":"The 12-month follow-up of the low-intensity extracorporeal shockwave therapy in the treatment of patients with chronic pelvic pain syndrome refractory to 3-As medications","author":"Guu","year":"2019","journal-title":"Aging Male"},{"key":"10.1016\/j.euf.2021.04.021_bib0095","doi-asserted-by":"crossref","unstructured":"Mykoniatis I, Kalyvianakis D, Zilotis F, et al. Evaluation of a low-intensity shockwave therapy for chronic prostatitis type IIIb\/chronic pelvic pain syndrome: a double-blind randomized sham-controlled clinical trial. Prostate Cancer Prostatic Dis. https:\/\/doi.org\/10.1038\/s41391-020-00284-2.","DOI":"10.1038\/s41391-020-00284-2"},{"key":"10.1016\/j.euf.2021.04.021_bib0100","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1080\/13685538.2016.1197899","article-title":"Comparison of the efficiency of combined extracorporeal shock-wave therapy and triple therapy versus triple therapy itself in category III B chronic pelvic pain syndrome (CPPS)","volume":"19","author":"Pajovic","year":"2016","journal-title":"Aging Male"},{"key":"10.1016\/j.euf.2021.04.021_bib0105","first-page":"185","article-title":"Extracorporeal shockwave therapy combined with drug therapy in chronic pelvic pain syndrome: a randomized clinical trial","volume":"17","author":"Rayegani","year":"2020","journal-title":"Urol J"},{"key":"10.1016\/j.euf.2021.04.021_bib0110","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1111\/j.1464-410X.2008.07742.x","article-title":"Extracorporeal shock-wave therapy for treating chronic pelvic pain syndrome: a feasibility study and the first clinical results","volume":"102","author":"Zimmermann","year":"2008","journal-title":"BJU Int"},{"key":"10.1016\/j.euf.2021.04.021_bib0115","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/j.eururo.2009.03.043","article-title":"Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome in males: a randomised, double-blind, placebo-controlled study","volume":"56","author":"Zimmermann","year":"2009","journal-title":"Eur Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0120","first-page":"631","article-title":"Extracorporeal shock wave therapy ameliorates cyclophosphamide-induced rat acute interstitial cystitis though inhibiting inflammation and oxidative stress-in vitro and in vivo experiment studies","volume":"6","author":"Chen","year":"2014","journal-title":"Am J Transl Res"},{"key":"10.1016\/j.euf.2021.04.021_bib0125","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s10020-018-0062-1","article-title":"Extracorporeal shockwave against inflammation mediated by GPR120 receptor in cyclophosphamide-induced rat cystitis model","volume":"24","author":"Chen","year":"2018","journal-title":"Mol Med Camb Mass"},{"key":"10.1016\/j.euf.2021.04.021_bib0130","doi-asserted-by":"crossref","first-page":"359","DOI":"10.4111\/icu.2019.60.5.359","article-title":"Treatment with low-energy shock wave alleviates pain in an animal model of uroplakin 3A-induced autoimmune interstitial cystitis\/painful bladder syndrome","volume":"60","author":"Li","year":"2019","journal-title":"Investig Clin Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0135","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1002\/nau.23141","article-title":"Effects of low energy shock wave therapy on inflammatory moleculars, bladder pain, and bladder function in a rat cystitis model","volume":"36","author":"Wang","year":"2017","journal-title":"Neurourol Urodyn"},{"key":"10.1016\/j.euf.2021.04.021_bib0140","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1002\/nau.24382","article-title":"Pain reduction realized with extracorporeal shock wave therapy for the treatment of symptoms associated with interstitial cystitis\/bladder pain syndrome\u2014a prospective, multicenter, randomized, double-blind, placebo-controlled study","volume":"39","author":"Chuang","year":"2020","journal-title":"Neurourol Urodyn"},{"key":"10.1016\/j.euf.2021.04.021_bib0145","doi-asserted-by":"crossref","first-page":"2130","DOI":"10.1002\/nau.24160","article-title":"The effects of microenergy acoustic pulses on an animal model of obesity-associated stress urinary incontinence. Part 1: functional and histologic studies","volume":"38","author":"Wang","year":"2019","journal-title":"Neurourol Urodyn"},{"key":"10.1016\/j.euf.2021.04.021_bib0150","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.21037\/tau.2017.12.36","article-title":"Treatment of stress urinary incontinence with low-intensity extracorporeal shock wave therapy in a vaginal balloon dilation induced rat model","volume":"7","author":"Wu","year":"2018","journal-title":"Transl Androl Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0155","doi-asserted-by":"crossref","first-page":"187.e1","DOI":"10.1016\/j.urology.2020.03.035","article-title":"Delayed treatment with low-intensity extracorporeal shock wave therapy in an irreversible rat model of stress urinary incontinence","volume":"141","author":"Zhang","year":"2020","journal-title":"Urology"},{"key":"10.1016\/j.euf.2021.04.021_bib0160","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-62471-4","article-title":"Therapeutic effects of low intensity extracorporeal low energy shock wave therapy (LiESWT) on stress urinary incontinence","volume":"10","author":"Long","year":"2020","journal-title":"Sci Rep"},{"key":"10.1016\/j.euf.2021.04.021_bib0165","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.juro.2015.12.078","article-title":"Urodynamic and immunohistochemical evaluation of intravesical botulinum toxin A delivery using low energy shock waves","volume":"196","author":"Chuang","year":"2016","journal-title":"J Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0170","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.1002\/nau.24511","article-title":"Low energy shock wave-delivered intravesical botulinum neurotoxin-A potentiates antioxidant genes and inhibits proinflammatory cytokines in rat model of overactive bladder","volume":"39","author":"Nageib","year":"2020","journal-title":"Neurourol Urodyn"},{"key":"10.1016\/j.euf.2021.04.021_bib0175","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1080\/2090598X.2019.1605676","article-title":"Delivery of intravesical botulinum toxin A using low-energy shockwaves in the treatment of overactive bladder: a preliminary clinical study","volume":"17","author":"Nageib","year":"2019","journal-title":"Arab J Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0180","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/9175676","article-title":"Low-intensity extracorporeal shock wave therapy ameliorates the overactive bladder: a prospective pilot study","volume":"2020","author":"Lee","year":"2020","journal-title":"BioMed Res Int"},{"key":"10.1016\/j.euf.2021.04.021_bib0185","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1002\/nau.23381","article-title":"Urodynamic and molecular characteristics of detrusor underactivity in a rat cryoinjury model and effects of low energy shock wave therapy","volume":"37","author":"Chuang","year":"2018","journal-title":"Neurourol Urodyn"},{"key":"10.1016\/j.euf.2021.04.021_bib0190","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1007\/s11255-019-02095-4","article-title":"Long-term functional change of cryoinjury-induced detrusor underactivity and effects of extracorporeal shock wave therapy in a rat model","volume":"51","author":"Chuang","year":"2019","journal-title":"Int Urol Nephrol"},{"key":"10.1016\/j.euf.2021.04.021_bib0195","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s00508-020-01692-z","article-title":"A glimpse into the efficacy of alternative therapies in the management of benign prostatic hyperplasia","volume":"133","author":"Ullah","year":"2021","journal-title":"Wien Klin Wochenschr"},{"key":"10.1016\/j.euf.2021.04.021_bib0200","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.sxmr.2019.09.004","article-title":"The basic physics of waves, soundwaves, and shockwaves for erectile dysfunction","volume":"8","author":"Katz","year":"2020","journal-title":"Sex Med Rev"},{"key":"10.1016\/j.euf.2021.04.021_bib0205","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1111\/bju.14988","article-title":"Pharmacological interventions for treating chronic prostatitis\/chronic pelvic pain syndrome: a Cochrane systematic review","volume":"125","author":"Franco","year":"2020","journal-title":"BJU Int"},{"key":"10.1016\/j.euf.2021.04.021_bib0210","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1111\/bju.14492","article-title":"Non-pharmacological interventions for treating chronic prostatitis\/chronic pelvic pain syndrome: a Cochrane systematic review","volume":"124","author":"Franco","year":"2019","journal-title":"BJU Int"},{"key":"10.1016\/j.euf.2021.04.021_bib0215","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1038\/pcan.2008.42","article-title":"Clinical phenotyping in chronic prostatitis\/chronic pelvic pain syndrome and interstitial cystitis: a management strategy for urologic chronic pelvic pain syndromes","volume":"12","author":"Shoskes","year":"2009","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"10.1016\/j.euf.2021.04.021_bib0220","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1111\/j.1464-410X.2010.09701.x","article-title":"Phenotypic approach to the management of the chronic prostatitis\/chronic pelvic pain syndrome","volume":"106","author":"Nickel","year":"2010","journal-title":"BJU Int"},{"key":"10.1016\/j.euf.2021.04.021_bib0225","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1038\/s41585-018-0135-5","article-title":"Urologic chronic pelvic pain syndrome: insights from the MAPP Research Network","volume":"16","author":"Clemens","year":"2019","journal-title":"Nat Rev Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0230","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1016\/j.juro.2007.05.157","article-title":"Overlap of voiding symptoms, storage symptoms and pain in men and women","volume":"178","author":"Clemens","year":"2007","journal-title":"J Urol"},{"issue":"Suppl 4","key":"10.1016\/j.euf.2021.04.021_bib0235","first-page":"S76","article-title":"Applicability of regenerative medicine and tissue engineering for the treatment of stress urinary incontinence in female patients","volume":"38","author":"Zambon","year":"2019","journal-title":"Neurourol Urodyn"},{"key":"10.1016\/j.euf.2021.04.021_bib0240","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1038\/nrurol.2016.10","article-title":"Shock waves enable BoNT-A uptake by urothelium","volume":"13","author":"Sidaway","year":"2016","journal-title":"Nat Rev Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0245","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/j.eururo.2018.07.037","article-title":"Detrusor underactivity and the underactive bladder: a systematic review of preclinical and clinical studies","volume":"74","author":"Osman","year":"2018","journal-title":"Eur Urol"},{"key":"10.1016\/j.euf.2021.04.021_bib0250","series-title":"EAU Guidelines on management of non-neurogenic male lower urinary tract symptoms (LUTS), incl. benign prostatic obstruction (BPO) 2020. European Association of Urology guidelines. ed. 2020, Presented at the EAU Annual Congress Amsterdam 2020","author":"Gravas","year":"2020"}],"container-title":["European Urology Focus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405456921001279?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405456921001279?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T06:51:30Z","timestamp":1762498290000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2405456921001279"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":50,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["S2405456921001279"],"URL":"https:\/\/doi.org\/10.1016\/j.euf.2021.04.021","relation":{},"ISSN":["2405-4569"],"issn-type":[{"value":"2405-4569","type":"print"}],"subject":[],"published":{"date-parts":[[2022,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The Effect of Low\u2010intensity Shockwave Therapy on Non-neurogenic Lower Urinary Tract Symptoms: A Systematic Review and Meta\u2010analysis of Preclinical and Clinical Studies","name":"articletitle","label":"Article Title"},{"value":"European Urology Focus","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.euf.2021.04.021","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}]}}