Research Methodology in Acupuncture for Managing Interstitial Cystitis/Bladder Pain Syndrome: A Scoping Review

Abstract

Background: Acupuncture and moxibustion are being explored as complementary therapies with promising potential in managing interstitial cystitis/bladder pain syndrome (IC/BPS). While some studies indicate possible benefits, their scientific basis and clinical efficacy remain subjects of debate, partly due to methodological flaws in study designs involving acupuncture and related modalities, which warrant further attention and discussion. The main objective is to analyze and evaluate the research methodologies used in existing literature on acupuncture for managing IC/BPS, providing insight into the methodological challenges and opportunities in this field.

Materials and methods: National Library of Medicine (PubMed), Allied and Complementary Medicine Database (AMED), Cochrane Library, Excerpta Medica database (EMBASE), Web of Sciences (WOS), Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulated Index in Nursing and Allied Health Literature (CINAHL), Scopus, SPORTDiscus, Epistemonikos, and Physiotherapy Evidence Database (PEDro) were searched from their inception to August 2024. Data were extracted based on the study designs, primary outcome measures, adverse events (AEs), and participants' subjective views.

Results: All the experimental studies (27.3%, 6 of 22) were randomized controlled trials (RCTs), but only 2 full texts were accessible. Of the 4 RCTs, 3 involved rats. Observational research (50%) included case reports (27.3%), cohort studies (9.1%), and theoretical studies (4.5%). Additionally, reviews (22.7%) were included. The main languages were English (77.3%), Chinese (13.6%), Japanese (4.5%), and Russian (4.5%). The most frequently reported outcome was pain, followed by quality-of-life impact (symptom burden), urinary frequency and urgency, nocturia, and bladder capacity. AEs were reported in only 5 articles, all of which concluded that these effects were not significant and that acupuncture could be considered a safe and relatively noninvasive technique. One review found a risk of 1 AE/76 000 patients, with the most common side effects being minor, such as bleeding or bruising.

Conclusion: Current evidence on acupuncture for interstitial cystitis is limited in quality, with studies often compromised by biases, small sample sizes, and lack of standardized protocols. Acupuncture is frequently part of multimodal treatments, aligning with Traditional Chinese Medicine's holistic approach to balance physical, mental, and emotional health. More high-quality experimental research is needed, focusing on standardized protocols and participant experiences to better evaluate its efficacy and safety.

Keywords: IC/BPS; acupuncture; acupuncture therapy; acupuncture treatment; bladder pain syndrome; interstitial cystitis; painful bladder syndrome.

Figure 1

Flowchart of the review process. National Library of Medicine (PubMed), Allied and Complementary Medicine Database (AMED), Excerpta Medica database (EMBASE), Web of Sciences (WOS), Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulated Index in Nursing and Allied Health Literature (CINAHL), and Physiotherapy Evidence Database (PEDro).

Figure 2

Overview of included studies. (a) Languages of included studies. (b) Year of publications: 1993–2024. (c) Types of study designs: observational (case study, cohorts, theoretical, survey), experimental, and reviews. (d) Intervention of included studies: electroacupuncture, classical acupuncture, classical acupuncture with moxibustion, electroacupuncture with moxibustion, acupuncture as a multimodal treatment or within the CAM, transdermal laser therapy in acupoints. CAM, complementary and alternative medicine.