Electroacupuncture significantly improved urinary leakage in women with stress urinary incontinence

Electroacupuncture treatment has been shown to significantly improve urinary leakage in women with stress urinary incontinence (SUI), compared with sham acupuncture group, in a large size grouped clinical study which was recently published in the Journal of the American Medical Association.

SUI is the unintentional passing of urine when your bladder is under pressure e.g. when you cough, exercise or laugh. SUI occurs when the muscles that control your ability to hold urine get weak or don’t work. Weakened muscles such as bladder sphincter may be caused by childbirth, injury to the urethra area, some medicines or surgeries in the pelvic area or the prostate (in men). SUI is a common problem thought to affect millions of people and causes psychological burden, affects relationships, lowers physical productivity, and decreases quality of life in women. However, few effective therapies are available for treating SUI.

Acupuncture may be an effective treatment option for SUI as electroacupuncture has been found to decrease urine leakage. However, effects of acupuncture on SUI remain uncertain because of the small sample size, poor study design, and high risks of bias in previous clinical trials.

Very recently researchers in China conducted a multicenter, randomized clinical trial at 12 hospitals, enrolling 504 women with SUI to assess the effect of electroacupuncture on reducing urine leakage in women with SUI. Participants were randomly assigned (1:1) to receive 18 sessions (over 6 weeks) of electroacupuncture involving the lumbosacral region (acupoints BL33 and BL35, n = 252) or sham electroacupuncture (two sham acupoints, n = 252) with no skin penetration on sham acupoints. The primary outcome was change from baseline to week 6 in the amount of urine leakage, measured by the 1-hour pad test. Secondary outcomes included mean 72-hour urinary incontinence episodes measured by a 72-hour bladder diary (72-hour incontinence episodes).

Results showed that 482 out of 504 participants completed the study. At the end of 6-week treatment, the electroacupuncture group had significant decrease in mean urine leakage (−9.9 g) compared with baseline (18.4 g). In contrast, the sham electroacupuncture group had only minor decrease (-2.6 g) compared with baseline (19.1 g). The change in the mean 72-hour incontinence episodes from baseline was greater with electroacupuncture than sham electroacupuncture with between-group differences of 1.0 episode in weeks 1 to 6, 2.0 episodes in weeks 15 to 18, and 2.1 episodes in weeks 27 to 30. The incidence of treatment-related adverse events was 1.6% in the electroacupuncture group and 2.0% in the sham electroacupuncture group, and all events were classified as mild.

The study showed that among women with SUI, electroacupuncture treatment, compared with sham electroacupuncture, resulted in less urine leakage after 6 weeks. Authors suggested that further research is needed to understand long-term efficacy and the mechanism of action of this intervention.

Reference

Liu Z et al., Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence A Randomized Clinical Trial. JAMA. 2017;317(24):2493-2501.    http://jamanetwork.com/journals/jama/article-abstract/2633916