Low-energy extracorporeal shock wave therapy for interstitial cystitis/bladder pain syndrome: mechanisms, evidence, and translational perspectives-a narrative review.

Authors

Xueting Sun, Huiying Chen, Lu Wang, Yanting Shen, Fei Wang

Published in

Translational andrology and urology. Volume 15. Issue 9. Pages 349. Sep 30, 2026. Epub Aug 28, 2026.

Abstract

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic heterogeneous disorder characterized by persistent bladder-related pain, urinary symptoms, and substantial impairment in quality of life. Despite currently available multimodal treatment strategies, therapeutic outcomes vary among patients, highlighting the need to further investigate non-invasive approaches targeting inflammation, tissue repair, and sensory dysfunction. Low-energy extracorporeal shock wave therapy (ESWT) has been investigated as a non-invasive intervention with potential regenerative and neuromodulatory effects in IC/BPS. Its clinical relevance and translational applicability require further clinical validation. This narrative review summarizes the biological rationale, current clinical evidence, and translational considerations of low-energy ESWT in IC/BPS.
PubMed/MEDLINE and Web of Science Core Collection were searched for English-language studies published from January 1, 2010 to May 31, 2026. Relevant clinical, preclinical, and mechanistic studies were narratively synthesized.
Among 53 relevant publications, 13 original studies formed the main evidence base. Preclinical studies suggest that low-energy ESWT may affect inflammation, oxidative stress, urothelial barrier function, angiogenesis, and neural sensitization. Clinical studies, including randomized controlled trials and prospective investigations, have reported improvements mainly in pain-related outcomes among selected patient populations, whereas effects on symptom scores, voiding outcomes, bladder capacity, and long-term outcomes remain uncertain. Heterogeneity in protocols, patient characteristics, and outcome measures limits interpretation.
Low-energy ESWT remains an investigational adjunctive treatment for IC/BPS, and current evidence is insufficient to support routine clinical use. Future studies should prioritize adequately powered, sham-controlled trials with standardized treatment protocols, prespecified phenotype stratification, harmonized outcome assessment, and longer follow-up to determine whether clinically meaningful and durable benefit exists and which patients, if any, are most likely to benefit.

PMID:
42866837
Bibliographic data and abstract were imported from PubMed on 14 Oct 2026.

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