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Effects of low-intensity extracorporeal shock wave therapy on lipopolysaccharide cystitis in a rat model of interstitial cystitis/bladder pain syndrome

  • Urology - Original Paper
  • Published:
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Abstract

Purpose

To investigate the effect of low-intensity extracorporeal shock wave therapy (LiESWT) on lipopolysaccharide (LPS)-induced cystitis in an animal model of interstitial cystitis/bladder pain syndrome (IC/BPS).

Methods

Sprague–Dawley rats were divided into three groups: control, cystitis (LPS group, intravesical injection of LPS (1 mg) twice), and cystitis with LiESWT (LiESWT group). On the third and fourth days, LiESWT was administered (0.12 mJ/mm2, 300 shots each time) on the lower abdomen toward the bladder. On the seventh day, the rats underwent pain assessment and a metabolic cage study. Subsequently, a continuous cystometrogram (CMG) was performed under urethane anaesthesia. Immunohistochemical studies were also performed, including S-100 staining, an immunohistochemical marker of Schwann cells in the bladder.

Results

In the LPS group, the pain threshold in the lower abdomen was significantly lower than that in the control group. In the metabolic cage study, the mean voided volume in the LPS group significantly increased. The CMG also revealed a significant decrease in bladder contraction amplitude, compatible with detrusor underactivity in the LPS group. Immunohistochemical studies showed inflammatory changes in the submucosa, increased fibrosis, and decreased S-100 stain-positive areas in the muscle layer of the LPS group. In the LiESWT group, tactile allodynia and bladder function were ameliorated, and S-100 stain-positive areas were increased.

Conclusion

By restoring nerve damage, LiESWT improved lower abdominal pain sensitivity and bladder function in an LPS-induced cystitis rat model. This study suggests that LiESWT may be a new therapeutic modality for IC/BPS.

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Availability of data and material

The data sets of the current study are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

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Acknowledgements

The authors express their gratitude to Hitoshi Uehara for assisting in preparing our experiments, Hiroyuki Arakawa for providing technical advice on pain assessment, and Ayako Nakaza for offering technical advice on immunohistochemistry. Additionally, we extend our appreciation to DOCTOR’s KITS Co., Ltd. for providing the ED-1000 and to Editage (www.editage.com) for their English language editing services.

Funding

This work was supported by AMED under Grant Number JP22gk0210025 and JSPS KAKENHI Grant Number 22K11420.

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Authors and Affiliations

  1. Department of System Physiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan

    Naohisa Kusakabe, Tadanobu Chuyo Kamijo & Minoru Miyazato

  2. Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan

    Naohisa Kusakabe, Hiroki Chiba & Nobuo Shinohara

  3. Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan

    Naoki Wada

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  1. Naohisa Kusakabe
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Contributions

The contributions of each author are as follows: (1) Substantial contributions to conception, experimental design, and investigation: NK, TCK, and MM. (2) Drafting and revising the article critically for important intellectual content: NK, TCK, NW, HC, NS, and MM. (3) Final approval of the version to be published: NK, TCK, NW, HC, NS, and MM. All contributors not meeting these criteria for authorship should instead be listed in the acknowledgements section.

Corresponding author

Correspondence to Minoru Miyazato.

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The authors declare no competing interests.

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The study protocol was approved by the University of Ryukyu Institutional Animal Care and Use Committee (protocol no. A2020077, A2020019) in compliance with the ARRIVE guidelines.

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Kusakabe, N., Kamijo, T.C., Wada, N. et al. Effects of low-intensity extracorporeal shock wave therapy on lipopolysaccharide cystitis in a rat model of interstitial cystitis/bladder pain syndrome. Int Urol Nephrol 56, 77–86 (2024). https://doi.org/10.1007/s11255-023-03770-3

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