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Protocol 2: Intermediate approach (experienced researchers) Goal: Multi-target immune modulation with anti-inflammatory support Components: Thymosin alpha-1: 1.6 mg subcutaneously, three times weekly KPV: 200-500 mcg subcutaneously, once daily BPC-157: 250 mcg subcutaneously, twice daily Selank: 250-500 mcg intranasally, once daily Schedule: Monday, Wednesday, Friday: Thymosin alpha-1 Daily AM: KPV + BPC-157 Daily PM: BPC-157 Daily: Selank nasal spray (morning or midday) Duration: 12 weeks on, 4 weeks off Monitoring: Baseline labs, repeat every 4 weeks

Use of low-intensity extracorporeal shock wave therapy in the management of interstitial cystitis/bladder pain syndrome patients: a thirty case study in a tertiary medical center