Electroacupuncture linked to improvements for stress urinary incontinence

1. Electroacupuncture was found to result in less urinary leakage for women with stress urinary incontinence compared to sham electroacupuncture after 6 weeks.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Stress urinary incontinence (SUI) refers to the involuntary loss of urine during physical exertion, sneezing, coughing or laughing. Many therapies exist, including behavioral therapies, pessary devices, urethral bulking agents, and slings, but these have variable success rates. Because minimal research has been performed on electroacupuncture and SUI, the purpose of this paper was to investigate its role in treating SUI. The authors randomized over 500 women with SUI at 12 hospitals in China to electroacupuncture of the lumbosacral region or sham electroacupuncture, over 6 weeks. At 6 weeks, the electroacupuncture group had a greater decrease in mean urinary leakage than the sham group. The electroacupuncture group also had better changes in mean 72-hour incontinence episodes compared to baseline, with 1 less episode at 6 weeks and 2 less episodes at 18 and 30 weeks. Treatment-related adverse effects were mild and were similar rates in both groups.

Overall, this study suggests that electroacupuncture may be effective for women with SUI. However, it was compared to a sham procedure and not to other recognized therapies currently seen as standard of care. Thus, we cannot make conclusions about whether electroacupuncture is as effective as urethral bulking agents or slings.

Click to read the study, published in JAMA

Relevant Reading: Acupuncture for stress urinary incontinence in adults

In-Depth [randomized controlled trial]: This study assessed the role of electroacupuncture in treating SUI. 504 women at 12 hospitals in China were randomized, between 2013 and 2015, to 18 sessions of lumbosacral acupuncture over 6 weeks or sham electroacupuncture that did not involve any skin penetration. At baseline, urinary leakage as determined by a 1-hour pad test was 18.4g for the electroacupuncture group and 19.1g for the sham group. At 6 weeks, there were a 9.9g decrease in the 1-hour pad test in the electroacupuncture group as compared to a 2.6g decrease in the sham group (CI_95% 4.8 to 10.0, p < 0.001). At baseline, mean 72-hour incontinence episodes were 7.9 in the electroacupuncture group and 7.7 for the sham group. At 6 weeks, the between-group difference in incontinence episodes was 1 episode (CI_95% 0.2-1.7, p = 0.01), 2 episodes at 18 weeks (CI_95% 1.3-2.7, p < 0.001), and 2.1 episodes at 30 weeks (CI_95% 1.3-2.8, p < 0.001). Treatment-related adverse effects were mild and 1.6% in the electroacupuncture group compared to 2.0% in the sham group.

Image: PD

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