Figure 1.

Pilot study, urodynamic study of bladder contraction, urine amount and ratio of urine protein to urine creatinine at day 60 after radiotherapy. (A-F) Escalation of dosage of radiation energy (i.e., stepwise increase of the radiotherapy dosage) in the pilot study with consistent ECSW application (i.e., 0.1 mJ/mm²/120 impulses/once every 3 days after radiation). We utilized 300 cGy (A, B), 450 cGy (C, D) and 600 cGy (E, F)/twice with 4-h interval for each animal in CC (A, C, E) and CC + ECSW (B, D, F) groups (n = 2/each group). By day 60 after CC induction, the results showed that no detrusor contractility wave was observed in either CC only or in CC + ECSW animals in 600 cGy, only CC + ECSW animals had notable detrusor contractility wave in 450 cGy and 300 cGy. Thus, radiotherapy for induction of CC by 450 cGy twice with 4-h interval was utilized for this study. (G-I) Illustrating the anatomical structure of urinary bladder in three groups. As compared with NC (G), the wall of urinary bladder was notably thinner and the lumen of urinary bladder was more increased in CC animals (H), suggesting that the elastic property of urinary bladder was diminished in CC animals. However, these phenomena were reversed in CC animals after receiving ECSW treatment (I). (J-L) Illustrating the graphics of urinary bladder contractility. (M) Analytical result of detrusor contraction, * vs. other groups with different symbols (†, ‡), P < 0.0001. (N) Interval of bladder contraction, * vs. other groups with different symbols (†, ‡), P < 0.0001. (O) Urine amount (ml) at day 60, * vs. other groups with different symbols (†, ‡), P < 0.001. (P) Ratio of urine protein to creatinine, * vs. †, P < 0.001. All statistical analyses were performed by one-way ANOVA, followed by Bonferroni multiple comparison post hoc test (n = 6 for each group). Symbols (*, †, ‡) indicate significance at the 0.05 level. NC = normal control; CC = chronic cystitis; ECSW = extracorporeal shock wave.