Acupuncture may help reduce urinary incontinence episodes, symptoms in women

A meta-analysis of 10 clinical studies shows that various forms of acupuncture significantly reduced episodes of stress urinary incontinence (SUI), P<0.00001), episodes and symptoms of urge urinary incontinence (UUI), and resulted in higher rates of patient-reported SUI cure.

The benefits came from comparisons of acupuncture with sham procedures, pelvic floor muscle training (PFMT), and medication for incontinence.

Electroacupuncture for SUI had the strongest supporting evidence, whereas benefits in UUI came from single studies of different types of acupuncture and require confirmation in additional studies, reported Priya Kannan, PhD, of Hong Kong Polytechnic University, and Umar M. Bello, PhD, of Glasgow Caledonian University in Scotland, in Explore.

“We recommend that future trials evaluating the effectiveness of acupuncture be of high quality, be adequately powered, follow experimental protocol for the acupuncture and sham groups, and abide by the CONSORT statement in reporting,” the authors said.

Acupuncture has met with success in treating a variety of chronic conditions, particularly conditions that have proven difficult to treat with conventional therapies. In particular, the popularity and acceptance of acupuncture have grown in high-income countries, Kannan and Bello noted.

According to the researchers, acupuncture comprises a wide range of therapeutic techniques, some of which have been evaluated in randomised trials for SUI, UUI, and mixed incontinence in women, notably hand, laser, body, and electroacupuncture.

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Limited evidence of urinary incontinence exists for other types of acupuncture, including Saam, auricular, fire needle, scalp, and elongated needle.

Basic research has produced a plausible mechanistic basis for acupuncture to treat urinary incontinence. In animal models of overactive bladder, sacral acupuncture reduced symptoms, possibly by inhibiting nociceptive afferent C-fibers. Electroacupuncture reduced micturition-centre effects of chemically induced bladder irritation in rats.

According to traditional Chinese medicine theory, urinary incontinence results from a deficiency in the ‘Qi’ of the kidneys, Kannan and Bello continued.

Acupuncture applied to acupoints on the bladder, and kidney regulates Qi to promote recovery of bladder function and improve urinary incontinence.

Previous reviews of acupuncture for urinary incontinence yielded inconclusive results and required updating to incorporate newer studies.

Kannan and Bello performed a systematic review and meta-analysis to provide a more contemporary perspective on the use of acupuncture to treat urinary incontinence in women.

Literature searches identified 158 potential publications, which the authors reduced to 10 after multiple screenings and reviews. The meta-analysis included five studies of women with SUI: two moderate-quality studies comparing electroacupuncture to sham procedures, two low-quality studies comparing electroacupuncture plus PFMT to medication, and one low-quality study of hand acupuncture versus no treatment.

Three low-quality individual studies compared body acupuncture, electroacupuncture, and laser acupuncture versus sham for UUI. One study each (both low quality) evaluated body acupuncture versus sham and electroacupuncture versus PFMT for mixed incontinence.