Low-Energy Shock Wave Therapy for Overactive Bladder in Women With Metabolic Syndrome

Inclusion: * Female participants aged 20 to 75 years * Diagnosed with overactive bladder (OAB), defined as urinary frequency (≥8 times/day), nocturia (≥2 times/night), and urgency (≥2 episodes/week) for at least 3 months * Diagnosed with metabolic syndrome, defined by the presence of at least three of the following criteria: * Waist circumference ≥80 cm * Blood pressure ≥130/85 mmHg or receiving antihypertensive treatment * Fasting glucose ≥100 mg/dL or receiving treatment for diabetes * Triglycerides ≥150 mg/dL or receiving lipid-lowering treatment * High-density lipoprotein cholesterol \<50 mg/dL * No pharmacological or injection treatment for OAB within 3 months prior to enrollment * Able to understand and comply with study procedures and questionnaires * Willing to provide informed consent Exclusion: * History of kidney stones or bladder stones * Urinary tract infection within 3 months prior to enrollment or recurrent urinary tract infections (≥3 episodes) * Lower urinary tract surgery within 6 months prior to enrollment * Known or suspected malignancy of the urinary tract * Significant bladder outlet obstruction * Severe coagulopathy, liver failure, or renal failure * Prior pelvic malignancy or pelvic radiation therapy * Intravesical injection or electrical stimulation therapy within the past year * Substance abuse (drug or alcohol) within the past year * Chronic pelvic pain due to other causes * Inability to complete study questionnaires or procedures