Does electroacupuncture reduce urinary leakage and incontinence episodes in women with stress urinary incontinence?

Active electroacupuncture (compared with sham electroacupuncture) significantly reduced the volume of urine leakage and the mean number of 72-hour incontinence episodes in women with stress urinary incontinence (UI). (LOE = 1b)

Liu Z, Liu Y, Xu H, et al. Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence. A randomized clinical trial. JAMA 2017;317(24):2493-2501.  [PMID:28655016]

Randomized controlled trial (double-blinded)

Foundation

Concealed

Outpatient (any)

These investigators identified women, aged 40 years to 75 years, with involuntary loss of urine on physical exertion, sneezing, or coughing (stress UI) and with an incontinence pad weight gain greater than 1 g in the 1-hour pad test. Exclusion criteria included urge UI or mixed UI. The women, from multiple centers in China, randomly received (concealed allocation assignment) either active or sham electroacupuncture consisting of 18 sessions over 6 weeks. Both groups received acupuncture at bilateral locations in the third sacral foramen and lateral to the coccyx. Sham electroacupuncture consisted of the use of a placebo needle with no actual skin penetration and an electroacupuncture device with a broken inner wire and no actual current output. Individuals masked to treatment group assignment assessed outcomes. Complete follow-up occurred for 95.6% of participants at 30 weeks. The mean baseline urine leakage for both groups was 18 g. Using intention-to-treat analysis, reduction in the amount of urine leakage measured by the 1-hour pad test was significantly greater in the active electroacupuncture group than in the sham electroacupuncture group (mean difference 7.4 g; 95% CI 4.8 - 10.0). Similarly, a 50% or more reduction in the mean number of 72-hour incontinence episodes occurred significantly more often in the active group versus sham group (between-group difference at 30 weeks 25.6%; number needed to treat = 3.9; 3.0 - 6.0). The percentage of patients who correctly guessed their treatment group assignment was similar in both groups.