{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T20:17:57Z","timestamp":1785356277174,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,4,20]],"date-time":"2018-04-20T00:00:00Z","timestamp":1524182400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R56DK105097"],"award-info":[{"award-number":["R56DK105097"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["1R01DK105097\u201001A1"],"award-info":[{"award-number":["1R01DK105097\u201001A1"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2018,9]]},"abstract":"\n Objectives<\/jats:title>\n \n To evaluate the therapeutic effect of once\u2010weekly low\u2010intensity extracorporeal shock wave therapy (Li\u2010\n ESWT<\/jats:styled-content>\n ) on underactive bladder (\n UAB<\/jats:styled-content>\n ) in the streptozotocin (\n STZ<\/jats:styled-content>\n )\u2010induced diabetic rat model.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n In all, 36 female Sprague\u2013Dawley rats were divided into three groups: normal control (\n NC<\/jats:styled-content>\n ), diabetes mellitus control (\n DMC<\/jats:styled-content>\n ), and\n DM<\/jats:styled-content>\n with Li\u2010\n ESWT<\/jats:styled-content>\n (\n DM<\/jats:styled-content>\n Li\u2010\n ESWT<\/jats:styled-content>\n ). The two\n DM<\/jats:styled-content>\n groups received an intraperitoneal 60 mg\/kg\n STZ<\/jats:styled-content>\n injection to induce\n DM<\/jats:styled-content>\n . The Li\u2010\n ESWT<\/jats:styled-content>\n was applied toward the pelvis of the rats starting 4 weeks after\n STZ<\/jats:styled-content>\n administration and lasting for 4 weeks. The Li\u2010\n ESWT<\/jats:styled-content>\n was given once weekly, with an energy flux density of 0.02 mJ\/mm\n 2<\/jats:sup>\n at 3 Hz for 400 pulses. All rats underwent conscious cystometry, leak\u2010point pressure (\n LPP<\/jats:styled-content>\n ) assessment,\n ex vivo<\/jats:italic>\n organ\u2010bath study, histology, immunofluorescence, and Western Blot analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Conscious cystometry revealed voiding dysfunction in the\n DMC<\/jats:styled-content>\n group, whereas the\n DM<\/jats:styled-content>\n Li\u2010\n ESWT<\/jats:styled-content>\n group showed significantly improved voiding function, reflected in a reduced post\u2010void residual urine volume and increased\n LPP<\/jats:styled-content>\n compared to the\n DMC<\/jats:styled-content>\n group.\n Ex vivo<\/jats:italic>\n organ\u2010bath studies showed that Li\u2010\n ESWT<\/jats:styled-content>\n enhanced muscle contractile activity of the bladder and urethra during electrical\u2010field stimulation and drug stimulation. Histologically, Li\u2010\n ESWT<\/jats:styled-content>\n significantly restored bladder morphology, reflected by a reduction in the intravesical lumen area and increased muscle proportion of the bladder wall. Western Blot analysis showed higher smooth muscle actin expression in the bladder wall in the\n DM<\/jats:styled-content>\n Li\u2010\n ESWT<\/jats:styled-content>\n group compared to the\n DMC<\/jats:styled-content>\n group. Immunofluorescence showed decreased nerve\u2010ending distribution, and destroyed and shortened nerve fibres in the\n DMC<\/jats:styled-content>\n group, and recovery of neuronal integrity and innervation in the\n DM<\/jats:styled-content>\n Li\u2010\n ESWT<\/jats:styled-content>\n group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In conclusion, Li\u2010\n ESWT<\/jats:styled-content>\n ameliorated\n UAB<\/jats:styled-content>\n and urinary incontinence in the diabetic\n UAB<\/jats:styled-content>\n rat model. The improvement appears to be the result of restoration of bladder and urethral structure and function by Li\u2010\n ESWT<\/jats:styled-content>\n . Li\u2010\n ESWT<\/jats:styled-content>\n is non\u2010invasive and may become a better alternative therapy for\n UAB<\/jats:styled-content>\n . Further investigations are warranted.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.14216","type":"journal-article","created":{"date-parts":[[2018,3,30]],"date-time":"2018-03-30T21:26:42Z","timestamp":1522445202000},"page":"490-500","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Low\u2010intensity extracorporeal shockwave therapy ameliorates diabetic underactive bladder in streptozotocin\u2010induced diabetic rats"],"prefix":"10.1111","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1063-9089","authenticated-orcid":false,"given":"Hsun Shuan","family":"Wang","sequence":"first","affiliation":[{"name":"Knuppe Molecular Urology Laboratory Department of Urology School of Medicine University of California San Francisco CA USA"},{"name":"Department of Urology Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Department of Urology Kaohsiung Municipal 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