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Randomized Controlled Trial
. 2017 Jun 27;317(24):2493-2501.
doi: 10.1001/jama.2017.7220.

Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence: A Randomized Clinical Trial

Zhishun Liu  1 , Yan Liu  2 , Huanfang Xu  3 , Liyun He  2 , Yuelai Chen  4 , Lixin Fu  5 , Ning Li  6 , Yonghui Lu  7 , Tongsheng Su  8 , Jianhua Sun  9 , Jie Wang  10 , Zenghui Yue  11 , Wei Zhang  12 , Jiping Zhao  13 , Zhongyu Zhou  14 , Jiani Wu  1 , Kehua Zhou  15 , Yanke Ai  2 , Jing Zhou  1 , Ran Pang  1 , Yang Wang  1 , Zongshi Qin  1 , Shiyan Yan  2 , Hongjiao Li  2 , Lin Luo  2 , Baoyan Liu  1
Affiliations
Randomized Controlled Trial

Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence: A Randomized Clinical Trial

Zhishun Liu et al. JAMA. .

Abstract

Importance: Electroacupuncture involving the lumbosacral region may be effective for women with stress urinary incontinence (SUI), but evidence is limited.

Objective: To assess the effect of electroacupuncture vs sham electroacupuncture for women with SUI.

Design, setting, and participants: Multicenter, randomized clinical trial conducted at 12 hospitals in China and enrolling 504 women with SUI between October 2013 and May 2015, with data collection completed in December 2015.

Interventions: Participants were randomly assigned (1:1) to receive 18 sessions (over 6 weeks) of electroacupuncture involving the lumbosacral region (n = 252) or sham electroacupuncture (n = 252) with no skin penetration on sham acupoints.

Main outcomes and measures: 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: Among the 504 randomized participants (mean [SD] age, 55.3 [8.4] years), 482 completed the study. Mean urine leakage at baseline was 18.4 g for the electroacupuncture group and 19.1 g for the sham electroacupuncture group. Mean 72-hour incontinence episodes were 7.9 for the electroacupuncture group and 7.7 for the sham electroacupuncture group. At week 6, the electroacupuncture group had greater decrease in mean urine leakage (-9.9 g) than the sham electroacupuncture group (-2.6 g) with a mean difference of 7.4 g (95% CI, 4.8 to 10.0; P < .001). During some time periods, 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 (95% CI, 0.2-1.7; P = .01), 2.0 episodes in weeks 15 to 18 (95% CI, 1.3-2.7; P < .001), and 2.1 episodes in weeks 27 to 30 (95% CI, 1.3-2.8; P < .001). 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.

Conclusions and relevance: Among women with stress urinary incontinence, treatment with electroacupuncture involving the lumbosacral region, compared with sham electroacupuncture, resulted in less urine leakage after 6 weeks. Further research is needed to understand long-term efficacy and the mechanism of action of this intervention.

Trial registration: clinicaltrials.gov Identifier: NCT01784172.

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Conflict of interest statement

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Figures

Figure 1.
Figure 1.. Location of Acupoints for the Electroacupuncture and Sham Electroacupuncture Groups
Figure 2.
Figure 2.. Flow of Participants Randomized to Receive Electroacupuncture or Sham Electroacupuncture
aStages of pelvic organ prolapse range from 0 (no prolapse, apex can descend within 2 cm of hymen) to 4 (complete eversion, leading edge >2 cm of total vaginal length).
See this image and copyright information in PMC

Comment in

References

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