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Randomized Controlled Trial
. 2022 Dec 1:17:1751-1760.
doi: 10.2147/CIA.S382912. eCollection 2022.

Effect of Transcutaneous Acupoint Electrical Stimulation on Urinary Retention and Urinary ATP in Elderly Patients After Laparoscopic Cholecystectomy: A Prospective, Randomized, Controlled Clinical Trial

Yanfang Zhang  1 , Lirong Gong  1 , Yuan Zhang  1 , Shuan Dong  1 , Jia Shi  1 , Xiangyun Li  1 , Yan Guo  1 , Simeng He  1 , Xiaoyang Wu  1 , Shasha Liu  1 , Huayang Liu  1 , Lantian Zhang  1 , Jianbo Yu  1
Affiliations
Randomized Controlled Trial

Effect of Transcutaneous Acupoint Electrical Stimulation on Urinary Retention and Urinary ATP in Elderly Patients After Laparoscopic Cholecystectomy: A Prospective, Randomized, Controlled Clinical Trial

Yanfang Zhang et al. Clin Interv Aging. .

Abstract

Purpose: To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on urinary retention after laparoscopic cholecystectomy in elderly patients, and to explore the relationship between TEAS and urinary ATP.

Patients and methods: The TEAS group was administered active TEAS at specific acupuncture points prior to induction of anesthesia and continued for 45 mins after surgery. In the control group, participants received sham stimulus at the same acupoints and no output current was delivered by disconnecting the device's output line. Urine samples were collected and evaluated in the first spontaneous voiding after surgery. In this study, postoperative urinary retention (POUR) was the primary outcome, which was diagnosed based on clinical symptoms, ultrasound assessments, and the need for bladder catheterization. Secondary outcomes include urinary ATP, postoperative spontaneous urination, urination symptoms, catheter-related bladder discomfort (CRBD), delirium, duration and hospitalization costs.

Results: The study involved 598 patients recruited and randomized between August 2018 and June 2020. Among these patients, 547 (91.5%) completed the study and were analyzed. There were 64 cases of POUR, including 23 (8.4%, 95% confidence interval [CI]: 6.4-9.9%) in the TEAS group and 41 (15.0%, 95% CI: 9.3-13.4%) in the control group (p = 0.017). A significant difference was observed between the TEAS and control groups for urinary ATP concentration in the first spontaneous urine postoperatively (344 nmol/L versus 233 nmol/L, p=0.001). There was a shorter spontaneous voiding recovery time, smaller voiding threshold, less postoperative catheterization, less CRBD, and lower hospitalization costs in TEAS group compared with control group.

Conclusion: TEAS reduces the incidence of POUR in elderly patients undergoing laparoscopic cholecystectomy, which may be related to an increase in bladder ATP release.

Keywords: ATP; catheter-related bladder discomfort; catheterization; laparoscopic surgery; transcutaneous electrical acupoint stimulation; urinary retention.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Location of acupoints in the trial.
Figure 2
Figure 2
Patient flow chart.
Figure 3
Figure 3
Postoperative spontaneous voiding recovery and urinary ATP. (A) spontaneous voiding recovery, (B) Voiding threshold, (C) ATP concentrations (n=30 in the TEAS group; n=30 in the control group).
See this image and copyright information in PMC

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