From pharmacological management to regenerative medicine: a bibliometric analysis of global trends and evolutionary...

Diabetic bladder dysfunction (DBD) is a prevalent complication of diabetes that severely impacts quality of life. Conventional treatments have long been confined to managing downstream symptoms with minimal efficacy in advanced stages. This study employs systematic bibliometric analysis to comprehensively map the knowledge foundations, evolving research hotspots, and future translational trajectories in global DBD research spanning 2000 to 2024.

A comprehensive search was conducted on the Web of Science Core Collection (WoSCC) for literature published between January 1, 2000, and August 8, 2024. To maximize the elimination of "noise" data typical of automated retrievals, a rigorous two-stage manual full-text screening process was employed, ultimately yielding 264 high-quality core original articles. Bibliometric tools, including CiteSpace and VOSviewer, were utilized to perform visual analyses of country/institution collaboration networks, citation bursts, and keyword timelines.

Over the past 25 years, the publication volume in the DBD field has exhibited a fluctuating upward trajectory. The global research landscape has evolved from the absolute dominance of U.S. in the early stages to a multipolar collaborative network that now includes China, Greece, and Germany. Keyword timeline clustering revealed a clear three-phase paradigm shift: the early phase (2000-2010) focused on physiological characterizations and symptomatic management (e.g., 'muscarinic receptors', 'smooth muscle'); the intermediate phase (2010-2018) delved into upstream core pathological mechanisms (e.g., 'oxidative stress', 'hypoxia', 'autonomic neuropathy'); and the recent phase (2019-2024) witnessed the sudden emergence of novel hot clusters such as 'defocused low-energy shock wave' and 'regeneration'.

DBD research is undergoing a transition from pharmacological symptom control to regenerative repair targeting the underlying pathologies. Emerging physical-biomodulatory therapies, represented by low-energy shock waves, offer new hope for reversing the decompensation stage of bladder dysfunction. Future research urgently requires large-scale randomized controlled trials to advance the clinical translation of these regenerative medicine strategies.