The goal of this clinical trial is to evaluate the effectiveness and safety of low-intensity shockwave therapy (Li-SWT) for the treatment of overactive bladder (OAB) in adult women.

The main questions this study aims to answer are whether Li-SWT improves overactive bladder symptoms and quality of life, and whether these improvements are sustained over a 12-month follow-up period, compared with standard medical therapy.

Researchers will compare Li-SWT with oral solifenacin succinate, a commonly used antimuscarinic medication for OAB.

Participants will be randomly assigned to receive either Li-SWT once weekly for 8 weeks or solifenacin 5 mg taken orally once daily for 12 months. All participants will complete symptom questionnaires and three-day voiding diaries and will undergo uroflowmetry, post-void residual measurement, and filling cystometry at specified time points during follow-up.

Inclusion Criteria:

• OAB symptoms persisting for ≥3 months.
• OAB Symptom Score (OABSS) ≥7.
• Ability and willingness to provide informed consent

Exclusion Criteria:

• Active urinary tract infection.
• Stress urinary incontinence as primary diagnosis.
• Pelvic organ prolapse stage ≥II.
• History of pelvic radiation or surgery within 6 months.
• Use of anticholinergics or β3-agonists for the past 4 weeks who are unwilling to undergo washout.
• Pregnancy or breast feeding.
• Neuropathic diseases or psychological disorders.
• History of urogenital malignancy.
• Uncontrolled DM (HbA1c > 6.8)
• Uncorrected coagulopathy or severe cardiovascular disease.
• Contraindication to solifenacin e.g.: closed angle glaucoma)