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Meta-Analysis
. 2022 Sep 23;9(9):CD013519.
doi: 10.1002/14651858.CD013519.pub2.

Acupuncture for treating overactive bladder in adults

Emma Hargreaves  1 , Katherine Baker  2 , Gill Barry  2 , Christopher Harding  3 , Yingying Zhang  4 , Ngianga-Bakwin Kandala  5   6 , Xiaowen Zhang  4 , Ashleigh Kernohan  7 , Carl E Clarkson  2
Affiliations
Meta-Analysis

Acupuncture for treating overactive bladder in adults

Emma Hargreaves et al. Cochrane Database Syst Rev. .

Abstract

Background: Overactive bladder is a common, long-term symptom complex, which includes frequency of micturition, urgency with or without associated incontinence and nocturia. Around 11% of the population have symptoms, with this figure increasing with age. Symptoms can be linked to social anxiety and adaptive behavioural change. The cost of treating overactive bladder is considerable, with current treatments varying in effectiveness and being associated with side effects. Acupuncture has been suggested as an alternative treatment.

Objectives: To assess the effects of acupuncture for treating overactive bladder in adults, and to summarise the principal findings of relevant economic evaluations.

Search methods: We searched the Cochrane Incontinence Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (including In-Process, Epub Ahead of Print, Daily), ClinicalTrials.gov and WHO ICTRP (searched 14 May 2022). We also searched the Allied and Complementary Medicine database (AMED) and bibliographic databases where knowledge of the Chinese language was necessary: China National Knowledge Infrastructure (CNKI); Chinese Science and Technology Periodical Database (VIP) and WANFANG (China Online Journals), as well as the reference lists of relevant articles. SELECTION CRITERIA: We included randomised controlled trials (RCTs), quasi-RCTs and cross-over RCTs assessing the effects of acupuncture for treating overactive bladder in adults.

Data collection and analysis: Four review authors formed pairs to assess study eligibility and extract data. Both pairs used Covidence software to perform screening and data extraction. We assessed risk of bias using Cochrane's risk of bias tool and assessed heterogeneity using the Chi2 testand I2 statistic generated within the meta-analyses. We used a fixed-effect model within the meta-analyses unless there was a moderate or high level of heterogeneity, where we employed a random-effects model. We used the GRADE approach to assess the certainty of evidence.

Main results: We included 15 studies involving 1395 participants in this review (14 RCTs and one quasi-RCT). All included studies raised some concerns regarding risk of bias. Blinding of participants to treatment group was only achieved in 20% of studies, we considered blinding of outcome assessors and allocation concealment to be low risk in only 25% of the studies, and random sequence generation to be either unclear or high risk in more than 50% of the studies. Acupuncture versus no treatment One study compared acupuncture to no treatment. The evidence is very uncertain regarding the effect of acupuncture compared to no treatment in curing or improving overactive bladder symptoms and on the number of minor adverse events (both very low-certainty evidence). The study report explicitly stated that no major adverse events occurred. The study did not report on the presence or absence of urinary urgency, episodes of urinary incontinence, daytime urinary frequency or episodes of nocturia. Acupuncture versus sham acupuncture Five studies compared acupuncture with sham acupuncture. The evidence is very uncertain about the effect of acupuncture on curing or improving overactive bladder symptoms compared to sham acupuncture (standardised mean difference (SMD) -0.36, 95% confidence interval (CI) -1.03 to 0.31; 3 studies; 151 participants; I2 = 65%; very low-certainty evidence). All five studies explicitly stated that there were no major adverse events observed during the study. Moderate-certainty evidence suggests that acupuncture probably makes no difference to the incidence of minor adverse events compared to sham acupuncture (risk ratio (RR) 1.28, 95% CI 0.30 to 5.36; 4 studies; 222 participants; I² = 0%). Only one small study reported data for the presence or absence of urgency and for episodes of nocturia. The evidence is of very low certainty for both of these outcomes and in both cases the lower confidence interval is implausible. Moderate-certainty evidence suggests there is probably little or no difference in episodes of urinary incontinence between acupuncture and sham acupuncture (mean difference (MD) 0.55, 95% CI -1.51 to 2.60; 2 studies; 121 participants; I2 = 57%). Two studies recorded data regarding daytime urinary frequency but we could not combine them in a meta-analysis due to differences in methodologies (very low-certainty evidence). Acupuncture versus medication Eleven studies compared acupuncture with medication. Low-certainty evidence suggests that acupuncture may slightly increase how many people's overactive bladder symptoms are cured or improved compared to medication (RR 1.25, 95% CI 1.10 to 1.43; 5 studies; 258 participants; I2 = 19%). Low-certainty evidence suggests that acupuncture may reduce the incidence of minor adverse events when compared to medication (RR 0.34, 95% CI 0.26 to 0.45; 8 studies; 1004 participants; I² = 51%). The evidence is uncertain regarding the effect of acupuncture on the presence or absence of urinary urgency (MD -0.40, 95% CI -0.56 to -0.24; 2 studies; 80 participants; I2 = 0%; very low-certainty evidence) and episodes of urinary incontinence (MD -0.33, 95% CI -2.75 to 2.09; 1 study; 20 participants; very low-certainty evidence) compared to medication. Low-certainty evidence suggests there may be little to no effect of acupuncture compared to medication in terms of daytime urinary frequency (MD 0.73, 95% CI -0.39 to 1.85; 4 studies; 360 participants; I2 = 28%). Acupuncture may slightly reduce the number of nocturia episodes compared to medication (MD -0.50, 95% CI -0.65 to -0.36; 2 studies; 80 participants; I2 = 0%, low-certainty evidence). There were no incidences of major adverse events in any of the included studies. However, major adverse events are rare in acupuncture trials and the numbers included in this review may be insufficient to detect these events.

Authors' conclusions: The evidence is very uncertain about the effect acupuncture has on cure or improvement of overactive bladder symptoms compared to no treatment. It is uncertain if there is any difference between acupuncture and sham acupuncture in cure or improvement of overactive bladder symptoms. This review provides low-certainty evidence that acupuncture may result in a slight increase in cure or improvement of overactive bladder symptoms when compared with medication and may reduce the incidence of minor adverse events. These conclusions must remain tentative until the completion of larger, higher-quality studies that use relevant, comparable outcomes. Timing and frequency of treatment, point selection, application and long-term follow-up are other areas relevant for research.

Trial registration: ClinicalTrials.gov NCT02047032 NCT02452879 NCT05158361 NCT03087578.

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Conflict of interest statement

In accordance with Cochrane's Commercial Sponsorship Policy, the following declarations are applicable for the three years prior to the publication date of this review.

EH: is a practising NHS physiotherapist (Newcastle upon Tyne Hospital NHS Foundation Trust) and uses acupuncture as one of a number of relevant interventions within their practice. KB: none to declare. GB: none to declare. CH: is a subject matter specialist engaged with several parties including Medronic, Allergan, Astellas and Teleflex Medical, and is the guidelines panel chair for the European Association of Urology. YYZ: none to declare. NBK: none to declare. XZ: none to declare. CEC: provides acupuncture education courses, including a course on acupuncture for women's health that discusses overactive bladder treatment strategies.

Figures

1
1
PRISMA flow diagram ‐ clinical effectiveness studies
2
2
PRISMA flow diagram ‐ brief economic commentary (BEC)
3
3
4
4
2.1
2.1. Analysis
Comparison 2: Acupuncture versus sham acupuncture, Outcome 1: Cure or improvement in urinary symptoms
2.2
2.2. Analysis
Comparison 2: Acupuncture versus sham acupuncture, Outcome 2: Number of minor adverse events
2.3
2.3. Analysis
Comparison 2: Acupuncture versus sham acupuncture, Outcome 3: Presence or absence of urinary urgency
2.4
2.4. Analysis
Comparison 2: Acupuncture versus sham acupuncture, Outcome 4: Episodes of urinary incontinence in a 24‐hour period
2.5
2.5. Analysis
Comparison 2: Acupuncture versus sham acupuncture, Outcome 5: Episodes of nocturia
2.6
2.6. Analysis
Comparison 2: Acupuncture versus sham acupuncture, Outcome 6: Improvement in objective measures of urinary incontinence (first sensation of filling in mL)
2.7
2.7. Analysis
Comparison 2: Acupuncture versus sham acupuncture, Outcome 7: Improvement in objective measures of urinary incontinence (first urge in mL)
2.8
2.8. Analysis
Comparison 2: Acupuncture versus sham acupuncture, Outcome 8: Improvement in objective measures of urinary incontinence (maximum cystometric capacity in mL)
2.9
2.9. Analysis
Comparison 2: Acupuncture versus sham acupuncture, Outcome 9: Improvement in objective measures of urinary incontinence (QMax mL/sec)
2.10
2.10. Analysis
Comparison 2: Acupuncture versus sham acupuncture, Outcome 10: Improvement in objective measures of urinary incontinence (post void residual in mL)
2.11
2.11. Analysis
Comparison 2: Acupuncture versus sham acupuncture, Outcome 11: Improvement in general quality of life
3.1
3.1. Analysis
Comparison 3: Acupuncture versus conservative treatment, Outcome 1: Minor adverse events
4.1
4.1. Analysis
Comparison 4: Acupuncture versus medication, Outcome 1: Cure or improvement in urinary symptoms
4.2
4.2. Analysis
Comparison 4: Acupuncture versus medication, Outcome 2: Number of minor adverse events
4.3
4.3. Analysis
Comparison 4: Acupuncture versus medication, Outcome 3: Presence or absence of urinary urgency
4.4
4.4. Analysis
Comparison 4: Acupuncture versus medication, Outcome 4: Daytime urinary frequency
4.5
4.5. Analysis
Comparison 4: Acupuncture versus medication, Outcome 5: Episodes of urinary incontinence in a 24‐hour period
4.6
4.6. Analysis
Comparison 4: Acupuncture versus medication, Outcome 6: Episodes of nocturia
4.7
4.7. Analysis
Comparison 4: Acupuncture versus medication, Outcome 7: Improvement in objective measures of urinary incontinence (volume of urine voided)
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Kwon 2014 {published data only}
    1. Kwon JN, NCT02271607. The effect and safety of moxibustion therapy for overactive bladder patients [A pilot study about the effects of indirect-moxibustion on bladder- functional improvement and symptoms management in patients with overactive bladder: a randomized controlled trial]. clinicaltrials.gov/show/NCT02271607 (first received 22 October 2014).
Lee 2016 {published data only}
    1. Lee LL, Chan SS, ChiCTRINR16007766. Acupuncture for urinary incontinence in Chinese women: a randomized controlled trial [針灸用於處理華人婦女小便失禁問題之隨機研究]. chictr.org.cn/showproj.aspx?proj=13144 (first received 11 January 2016).
Liao 2007 {published data only}
    1. Liao X, Tang H, Xiao P. 35 cases of overactive bladder treated by electroacupuncture at Zhongliao point [for information only English title translated via Google Translate™] [电针中髎穴为主治疗膀胱过度活动症35例]. Journal of Clinical Acupuncture and Moxibustion 2007;23(1):35-6.
Liao X 2007 {published data only}
    1. 廖小七, 唐华, 肖鹏. 35 cases of overactive bladder treated by electroacupuncture at Zhongliao point [for information only English title translated via Google Translate™] [电针中髎穴为主治疗膀胱过度活动症35例]. Journal of Clinical Acupuncture and Moxibustion 2007;23(1):35-6.
Lillie 2014 {published data only}
    1. Lillie R. News from the front: Professor Si-you Wang: pudendal nerve stimulation for incontinence. Journal of the Acupuncture Association of Chartered Physiotherapists 2014;Autumn(1):129-30. [ISSN: 1748-8656]
Liu 1998 {published data only}
    1. Liu ZS, Shao SJ, Ye YM, Li YS, Huang M, Zhang H, et al. Analysis of the curative effect of electro-acupuncture at Ciliao & Huiyang points to treat senile urinary incontinence [电针次 、会阳治疗老年尿失禁疗效分析]. Shanghai Journal of Acupuncture and Moxibustion 1998;17(3):14-5.
Liu 2010 {published data only}
    1. 刘超. 中西医结合治疗膀胱过度活动症的临床观察 [Masters thesis] [Clinical Observation on Treatment of Overactive Bladder with Integrated Traditional Chinese and Western Medicine. For information only English title translated via Google Translate™]. Hubei (China): 湖北中医药大学, 2010.
Liu 2013 {published data only}
    1. Liu B, NCT01784172. Efficacy and safety study of electroacupuncture for simple female stress urinary incontinence-a multicenter trial [The efficacy and safety study of electro-acupuncture for simple female stress urinary incontinence - a multicenter, randomized controlled trial]. clinicaltrials.gov/show/NCT01784172 (first received 5 February 2013).
Liu  2015a {published data only}
    1. Liu ZS, Xu HF, NCT02445573. Efficacy of electroacupuncture (EA) for women with pure stress urinary incontinence (SUI) [A pilot randomized placebo controlled trial of electroacupuncture for women with pure stress urinary incontinence]. clinicaltrials.gov/show/NCT02445573 (first received 15 May 2015).
Liu 2015b {published data only}
    1. Liu Z, Chen H, Wu W, Luo Q, Huang X, Shen T, et al. The clinical observation in treating overactive bladder by the combination of tolterodine and electroacupuncture [托特罗定联合电针治疗膀胱过度活动症临床观察]. China Medical Innovation 2015;12(1):52-4. [DOI: 10.3969/j.issn.1674-4985.2015.01.018] - DOI
Liu 2016 {published data only}
    1. Liu YM, Jin HY, Li ZQ. Effect of pelvic floor biofeedback combined with Huiyang acupuncture and moxibustion on muscle potential and quality of life in patients with postpartum urinary incontinence [盆底生物反馈结合针灸会阳穴对产后尿失禁患者肌电位及生活质量的影响]. Maternal and Child Health Care of China 2016;31(14):2799-801.
Liu 2017 {published data only}
    1. Liu Z, Liu Y, Xu H, He L, Chen Y, Fu L, et al. Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence: a randomized clinical trial. JAMA 2017;317(24):2493-501. [DOI: 10.1001/jama.2017.7220] - DOI - PMC - PubMed
Lu 2002 {published data only}
    1. Lu ZQ. Clinical analysis on scalp-plus body-acupuncture for treatment of senile urinary incontinence. World Journal of Acupuncture-Moxibustion 2002;12(2):50-2. [ISSN: 1003-5257]
Mao 2012 {published data only}
    1. Hou C, Gao W, Hu S. Clinical observation of M receptor antagonist combined with acupuncture in the treatment of overactive bladder [for information only English title translated via Google Translate™] [M受体拮抗剂与针刺疗法联合治疗膀胱过度活动症的临床观察]. Hubei Journal of Traditional Chinese Medicine 2014;36(3):40-1.
    1. Mao HH. 针刺联合M受体拮抗剂优化治疗膀胱过度活动症的临床研究 [Masters thesis] [Acupuncture Combined M Receptor Antagonist Optimization Overactive BIadder CIinicaI Research]. Wuhan, ‎Hubei‎ (China): Hubei University of Traditional Chinese Medicine, 2012.
Miao 2015 {published data only}
    1. Miao G, Jia M, Zhang X. Efficacy observation of electroacupuncture combined with pelvic floor muscle training in the treatment of female overactive bladder [for information only English title translated via Google Translate™] [电针联合盆底肌训练治疗女性膀胱过度活动症的疗效观察]. Journal of Emergency in Traditional Chinese Medicine 2015;24(11):2054-6.
Nam 2017 {published data only}
    1. Nam EY, Kim DI, NCT03260907. Efficacy and safety of electroacupuncture and acupuncture in postmenopausal women with overactive bladder [Efficacy and safety of electroacupuncture and acupuncture in postmenopausal women with overactive bladder; a multicenter, randomized, controlled, parallel clinical trial]. clinicaltrials.gov/show/NCT03260907 (first received 24 August 2017).
Pang  2018 {published data only}
    1. Pang R, NCT03450902. Chinese herbal therapy combined with acupuncture for female mixed urinary incontinence [Combination therapy with Chinese herbal formula, Yiqi Suoquan granule, and acupuncture for female mixed urinary incontinence]. clinicaltrials.gov/show/NCT03450902 (first received 1 March 2018).
Penson 2018 {published data only}
    1. Penson DF. Re: effect of electroacupuncture on urinary leakage among women with stress urinary incontinence: a randomized clinical trial. Journal of Urology 2018;199(1):35-6. [DOI: 10.1016/j.juro.2017.09.112] - DOI - PubMed
Philp 1988 {published data only}
    1. Philp T, Shah PJ, Worth PH. Acupuncture in the treatment of bladder instability. British Journal of Urology 1988;61(6):490-3. [DOI: 10.1111/j.1464-410x.1988.tb05086.x] - DOI - PubMed
Qu 2013 {published data only}
    1. Qu Y, Chen X, Qu M, Zhao R, Yu J, Wang S. 32 cases of overactive bladder treated by electroacupuncture [for information only English title translated via Google Translate™] [电针治疗膀胱过度活动症 32 例]. 中国保健营养: 下半月 2013;3:641.
Ren 2020 {published data only}
    1. Ren TT. Comparison of effects of acupuncture and solifenacin succinate tablets in treatment of female overactive bladder patients [for information only English title translated via Google Translate™] [针灸和琥珀酸索利那新片治疗女性膀胱过度活动症患者的效果比较]. Medical Journal of Chinese People’s Health 2020;32(6):115-7.
Rong 2015 {published data only}
    1. Rong Q. The quality of life effects acupuncture treatment for the female pelvic floor dysfunction [针灸治疗压力性尿失禁60例临床观察]. Chinese Journal of Ethnomedicine and Ethnopharmacy 2015;24(21):92-3; 95.
Ruan 2018 {published data only}
    1. Ruan L, ChiCTR1800014351. Clinical study of pelvic floor electrical stimulation combined with traditional Chinese medicine and acupoint sticking in the treatment of postpartum urinary incontinence [Clinical study of pelvic floor electrical stimulation combined with traditional Chinese medicine and acupoint sticking in the treatment of postpartum urinary incontinence (Qi Deficiency syndrome)]. trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR1800014351 (first received 7 January 2018).
Shen 2012a {published data only}
    1. Shen YZ, Lin X, Lin Q. Overactive bladder after transurethral resection of prostate treated with electroacupuncture therapy and tolterodine [电针联合托特罗定治疗经尿道前列腺电切术后膀胱过度活动症]. Chinese Acupuncture and Moxibustion 2012;32(5):404-8. - PubMed
Shen 2012b {published data only}
    1. Shen YZ, Shen L. Electroacupuncture for overactive bladder after transurethral resection of prostate [电针治疗经尿道前列腺电切术后膀胱过度活动症效果]. Medical Journal of Qilu 2012;27(4):341-2, 5.
Su 2013 {published data only}
    1. Su TS, NCT01940432. The efficacy of electroacupuncture for treatment of simple female stress urinary incontinence: comparison with pelvic floor muscle training-a multicenter randomized controlled trial. clinicaltrials.gov/ct2/show/NCT01940432 (first received 12 September 2013).
Su 2020a {published data only}
    1. Su YY, Zhao D, Lin MQ. Clinical observation of urine three-needling combined with tolterodine in treating overactive bladder [尿三针联合托特罗定治疗膀胱过度活动症的临床疗效观察]. Journal of Guangzhou University of Traditional Chinese Medicine 2020;37(8):1495-500.
Su 2020b {published data only}
    1. Su Y, Zhao D, Lin MQ. Clinical observation of urine three-needling combined with tolterodine in the treatment of overactive bladder [尿三针联合托特罗定治疗膀胱过度活动症的临床疗效观察]. Journal of Guangzhou University of Traditional Chinese Medicine 2020;37(8):1495-500.
Suen 2015 {published data only}
    1. Suen LK, NCT02330107. Auriculotherapy on lower urinary tract symptoms in elderly men [Effectiveness of auriculotherapy on lower urinary tract symptoms in elderly men: a randomized controlled feasibility study]. clinicaltrials.gov/show/NCT02330107 (first received 1 January 2015).
Tang 2016 {published data only}
    1. Tang KM, Shen R, Jiang F, Wang Q, Xie XB, Chen YL. Therapeutic evaluation of acupuncture for female stress urinary incontinence [针刺治疗女性单纯性压力性尿失禁临床疗效评价]. Shanghai Journal of Acupuncture and Moxibustion 2016;35(12):1439-41.
Wan 2019 {published data only}
    1. Wan OY, Cheung YK, Law MP, Lee LL, Chan SS. A randomized controlled trial on the effect of acupuncture on urinary incontinence and quality of life in women (Abstract 96). Female Pelvic Medicine and Reconstructive Surgery 2019;25(5 Suppl):S74-5. [DOI: 10.1097/SPV.0000000000000763] - DOI
Wang 2008 {published data only}
    1. Wang HX, Cui H. Observation on the effect of electroacupuncture on senile urge urinary incontinence [for information only English title translated via Google Translate™] [电针治疗老年急迫性尿失禁疗效观察]. Chinese Journal of Information on Traditional Chinese Medicine 2008;15(2):70.
Wang 2013b {published data only}
    1. Wang YF, Pan ZL, Chen JJ, Zhang W, Meng L. Clinical study of electroacupuncture in the treatment of overactive bladder [for information only English title translated via Google Translate™] [电针疗法治疗膀胱过度活动症的临床研究]. Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine 2013;13(3):1-3.
Wang 2015 {published data only}
    1. Wang S, NCT02599831. Efficacy of electrical pudendal nerve stimulation for patients with post prostatectomy urinary incontinence. clinicaltrials.gov/show/NCT02599831 (first received 9 November 2015).
Wang 2016 {published data only}
    1. Wang S, Lv J, Feng X, Wang G, Lv T. Efficacy of electrical pudendal nerve stimulation in treating female stress incontinence. Urology 2016;91:64-9. [DOI: 10.1016/j.urology.2016.02.027] - DOI - PubMed
Wang 2017a {published data only}
    1. Wang M. Acupuncture for stress urinary incontinence. JAMA 2017;318(15):1500. [DOI: 10.1001/jama.2017.13424] - DOI - PubMed
Wang 2017b {published data only}
    1. Wang S, NCT02311634. A comparison of electrical pudendal nerve stimulation and transvaginal electrical stimulation for urge incontinence [A comparison of efficacies of electrical pudendal nerve stimulation versus transvaginal electrical stimulation in treating urge incontinence]. clinicaltrials.gov/show/NCT02311634 (first received 8 December 2014).
    1. Wang SY, Lv JW, Feng XM, Lv TT. Efficacy of electrical pudendal nerve stimulation versus transvaginal electrical stimulation in treating female idiopathic urgency urinary incontinence. Journal of Urology 2017;197(6):1496-501. [DOI: 10.1016/j.juro.2017.01.065] - DOI - PubMed
Wang 2019 {published data only}
    1. Wang W, Liu Y, Sun S, Liu B, Su T, Zhou J, et al. Electroacupuncture for postmenopausal women with stress urinary incontinence: secondary analysis of a randomized controlled trial. World Journal of Urology 2019;37(7):1421-7. [DOI: 10.1007/s00345-018-2521-2] - DOI - PubMed
Xie 2020 {published data only}
    1. Xie N, Yang Y, Jiang HY. Clinical observation of applying acupuncture and nursing intervention in the treatment of overactive bladder [针灸及护理干预治疗膀胱过度活动症临床观察]. Journal of Sichuan of Traditional Chinese Medicine 2020;38(7):202-5.
Xiong 2020 {published data only}
    1. Xiong C, Tang Y, Shi R, Zhou YH, Sun S, Xiang Y, et al. Therapeutic effect of myofascial trigger point electroacupuncture technology on the treatment of overactive bladder syndrome in female [电针刺激肌筋膜触发点治疗女性膀胱过度活动症的临床疗效]. Journal of Central South University (Medical Science) 2020;45(2):155-9. - PubMed
Xu 2010 {published data only}
    1. 徐海蓉. 针刺治疗膀胱过度活动症的系统评价及中风后急迫性尿失禁电针疗效的 RCT 研究 [PhD thesis] [A Systematic Review of Acupuncture for Overactive Bladder and an RCT Study on the Efficacy of Electroacupuncture for Post-Stroke Urge Urinary Incontinence. For information only English title translated via Google Translate™]. 北京: 中国中医科学院, 2010.
Xu 2016 {published data only}
    1. Xu H, Liu B, Wu J, Du R, Liu X, Yu J, et al. A pilot randomized placebo controlled trial of electroacupuncture for women with pure stress urinary incontinence. PLOS One 2016;11(3):e0150821. [DOI: 10.1371/journal.pone.0150821] - DOI - PMC - PubMed
Yang 2020 {published data only}
    1. Xie N, Yue J, Jiang HY. Clinical observation of applying acupuncture and nursing intervention in the treatment of overactive bladder [针灸及护理干预治疗膀胱过度活动症临床观察]. Journal of Sichuan of Traditional Chinese Medicine 2020;38(7):202-5.
Zhang 1999 {published data only}
    1. Zhang H. Scalp acupuncture plus body acupuncture for senile urinary incontinence. International Journal of Clinical Acupuncture 1999;10:101-4.
Zhang 2012 {published data only}
    1. Zhang GT, Bao ZH, Zhang LD. Efficacy of solifenacin combined with electrical stimulation in the treatment of women with overactive bladder [for information only English title translated via Google Translate™] [索利那新联合电刺激治疗女性膀胱过度活动症的疗效]. Journal of Practical Medicine 2012;28(23):3990-2. [ISSN: 1006-5725]
Zhao 2012 {published data only}
    1. Zhao L. Acusector Overactive Bladder in 68 Cases of Disease Clinical Observation [电针参与治疗膀胱过度活动症68例临床观察] [Masters thesis]. Zhengzhou (China): Henan College of Traditional Chinese Medicine, 2012.
Zhao 2013 {published data only}
    1. Zhao L, Wang SY. Treatment frequency and long-term efficacy observation on electric pudendal nerve stimulation for stress urinary incontinence. Journal of Acupuncture and Tuina Science 2013;11(3):177-80. [DOI: 10.1007/s11726-013-0684-3] - DOI
Zhao 2013a {published data only}
    1. Zhao L, Wang SY. Efficacy impacts of the different treatment frequencies on female stress urinary incontinence. Chinese Acupuncture and Moxibustion 2013;33(12):1088-90. - PubMed
Zhao 2016 {published data only}
    1. Zhao J, Cui X, Lu Y, He X, Wen C. Clinical study of acupuncture combined with aconite cake-separated moxibustion in treating senile female stress urinary incontinence [针刺联合隔附子饼灸治疗老年女性压力性尿失禁临床研究]. World Chinese Medicine 2016;11(5):891-3.
Zheng 1990 {published data only}
    1. Zheng H, Sun Y, Xu Z, Hao M, Cao X. Urodynamic study of acupuncture and moxibustion on female stress urinary incontinence [for information only English title translated via Google Translate™] [针灸对女性压力性尿失禁的尿流动力学研究]. Shanghai Journal of Acupuncture and Moxibustion 1990;9(3):1-3.
Zheng 1992 {published data only}
    1. Zheng H, Sun Y, Xu Z, Hou M. Flow dynamics of urine in female patients with stress urinary incontinence treated by acupuncture and moxibustion. International Journal of Clinical Acupuncture 1992;3(3):243-7.
Zheng 2015 {published data only}
    1. Zheng HM, Xu SF, Yin P, Tang KM, Chen YL. Observation on short-term and long-term therapeutic effects of electro-acupuncture on mild and moderate stress urinary incontinence [电针治疗轻中度女性压力性尿失禁的近远期疗效观察]. World Journal of Integrated Traditional and Western Medicine 2015;10(2):191-3, 209.
Zhishun 2002 {published data only}
    1. Zhishun L, Baoyan L, Tao Y, Yongming Y, Hong Z, Wei Z, et al. Clinical study of electroacupuncture treatment of senile urge urinary incontinence. International Journal of Clinical Acupuncture 2002;13(4):255-62.
Zhong  2016 {published data only}
    1. Zhong P, Yu H, Zhou Q, Lu Z, Yang C. Clinical study of electroacupuncture combined with M receptor antagonist in optimal treatment of overactive bladder [for information only English title translated via Google Translate™] [电针联合M 受体拮抗剂优化治疗膀胱过度活动症的临床研究]. In: 中国中西医结合学会泌尿外科专业委员会第十四次全国学术会议暨 2016 年广东省中西医结合学会泌尿外科专业委员会学术年会论文集 2016 [The 14th National Academic Conference of the Urology Professional Committee of the Chinese Society of Chinese and Western Medicine and the 2016 Academic Conference of the Professional Committee of Urology of the Chinese and Western Medical Association of Guangdong Province. For information only English title translated via Google Translate™]. Vol. 1. 2016:1604-7.
Zhu 2018 {published data only}
    1. 朱彬彬, 童钟, 周世超, 成慧慧, 赵嫦莹, 萧韵雅. Observation of curative effect of acupuncture at Bliao point combined with injection of botulinum toxin type A in the treatment of overactive bladder after spinal cord injury [for information only English title translated via Google Translate™] [针刺八髎穴联合A型肉毒毒素注射治疗脊髓损伤后膀胱过度活动症疗效观察]. 河北中医 2018;40(5):759-62.
Zhu 2021 {published data only}
    1. Zhu Z, Bi Q. Analysis of the value of acupuncture in the treatment of frequent urination [for information only English title translated via Google Translate™] [针刺治疗尿频的价值分析]. Clinical Research 2021;29(2):113-4.

References to studies awaiting assessment

Bulut 2014 {published data only}
    1. Bulut BB, Kilic MA, Resim S, Efe E, Bahar MR, Koluş E. S231: Comparison between acupuncture treatment and tolteradine in overactive bladder. European Urology Supplements 2014;13(7):e1556. [DOI: 10.1016/S1569-9056(14)61758-9] [sr-incont99190] - DOI
Han 2011 {published data only}
    1. Han C. Clinical observation of electroacupuncture on 48 cases of overactive bladder [for information only English title translated via Google Translate™] [电针治疗膀胱过度活动症48例临床疗效观察]. In: 首届全国脑外伤治疗与康复学术大会论文汇编 (下) [First National Academic Conference on Treatment and Rehabilitation of Brain Trauma (Part 2) For information only English title translated via Google Translate™]. 2011. [sr-incont99545]

References to ongoing studies

Huang 2020 {published data only}
    1. Huang Y, Mo Q, ChiCTR1900027846. Randomized controlled trial for the efficacy of electroacupuncture in the treatment of acute urinary incontinence. chictr.org.cn/showprojen.aspx?proj=45632 (first received 30 November 2019). [ChiCTR1900027846] [sr-incont85138] [PARTNER REGISTRY: ChiMCTR1900025384]
    1. Huang Y, Qi S, Wu X, Zhi N, He T, Shen M, et al. Randomized controlled trial for the efficacy of electroacupuncture in the treatment of urge urinary incontinence: a clinical study protocol. Medicine 2020;99(9):e19315. [DOI: 10.1097/MD.0000000000019315] [ChiCTR1900027846] [sr-incont85335] - DOI - PMC - PubMed
Jia 2015 {published data only}
    1. Jia BH, NCT02452879. Treatment, parallel assignment, double blind (subject, outcomes assessor), efficacy study [The effectiveness, superiority and safety of EA on OAB: multi-center randomized controlled trial]. clinicaltrials.gov/show/NCT02452879 (first received 25 May 2015). [NCT02452879] [sr-incont68790]
Pang 2021 {published data only}
    1. Pang R, NCT05158361. Acupuncture for overactive bladder in adults [Effectiveness and safety of acupuncture for overactive bladder in adults: a random control clinical trial]. clinicaltrials.gov/show/NCT05158361 (first received 15 December 2021). [NCT05158361] [sr-incont98453]
Shen 2019 {published data only}
    1. Shen J, ChiCTR1900021372. A randomized controlled trial for the efficacy and safety of electro-acupuncture in the treatment of female overactive bladder [电针治疗女性膀胱过度活动症的有效性和安全性的随机对照试验]. chictr.org.cn/showproj.aspx?proj=36078 (first received 14 January 2019). [ChiCTR1900021372] [sr-incont78551]
Sheyn 2017 {published data only}
    1. Sheyn D, NCT03087578. Comparison of electroacupuncture to mirabegron for treatment of overactive bladder [Comparison of electroacupuncture to mirabegron on symptoms of overactive bladder in women who have failed anti-cholinergic therapy]. clinicaltrials.gov/show/NCT03087578 (first received 22 March 2017). [NCT03087578] [sr-incont76095]
Wen 2020 {published data only}
    1. Ning L, Qian W, ChiCTR1800019928. Clinical study for relieving symptoms of moderate and severe overactive bladder by electroacupuncture [Efficacy evaluation for electroacupuncture in the treatment of neurogenic urinary retention and overactive bladder]. chictr.org.cn/showproj.aspx?proj=33670 (first received 9 December 2018). [ChiCTR1800019928] [sr-incont78573]
    1. Wen Q, Li N, Wang X, Li H, Tian F, Chen W, et al. Effect of electroacupuncture versus solifenacin for moderate and severe overactive bladder: a multi-centre, randomized controlled trial study protocol. BMC Complementary Medicine and Therapies 2020;20(1):224. [ChiCTR1800019928] - PMC - PubMed

Additional references

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Avery 2004
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Clarkson 2015
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