Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence: A Randomized Clinical Trial | Complementary and Alternative Medicine | JAMA | JAMA Network
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Original Investigation
June 27, 2017

Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence: A Randomized Clinical Trial

Author Affiliations
  • 1Guang’an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
  • 2Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
  • 3Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
  • 4Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
  • 5First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
  • 6West China Hospital of Sichuan University, Chengdu, China
  • 7Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
  • 8Shaanxi Province Hospital of Traditional Chinese Medicine, Xi’an, China
  • 9Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China
  • 10Shanxi Hospital of Integrated Traditional and Western Medicine, Taiyuan, China
  • 11Hengyang Hospital Affiliated to Hunan University of Chinese Medicine, Hengyang, China
  • 12The First Hospital of Hunan University of Chinese Medicine, Changsha, China
  • 13Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
  • 14Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
  • 15Daemen College Physical Therapy Wound Care Clinic, Daemen College, Amherst, New York
JAMA. 2017;317(24):2493-2501. doi:10.1001/jama.2017.7220
Key Points

Question  Is electroacupuncture involving the lumbosacral region effective in reducing urine leakage for women with stress urinary incontinence?

Findings  In this randomized clinical trial that included 504 women, the mean decrease in urine leakage, measured by the 1-hour pad test from baseline to week 6, was 9.9 g with electroacupuncture vs 2.6 g with sham electroacupuncture, a significant difference.

Meaning  Among women with stress urinary incontinence, treatment with electroacupuncture involving the lumbosacral region, compared with sham electroacupuncture, resulted in less urine leakage after 6 weeks.

Abstract

Importance  Electroacupuncture involving the lumbosacral region may be effective for women with stress urinary incontinence (SUI), but evidence is limited.

Objective  To assess the effect of electroacupuncture vs sham electroacupuncture for women with SUI.

Design, Setting, and Participants  Multicenter, randomized clinical trial conducted at 12 hospitals in China and enrolling 504 women with SUI between October 2013 and May 2015, with data collection completed in December 2015.

Interventions  Participants were randomly assigned (1:1) to receive 18 sessions (over 6 weeks) of electroacupuncture involving the lumbosacral region (n = 252) or sham electroacupuncture (n = 252) with no skin penetration on sham acupoints.

Main Outcomes and Measures  The primary outcome was change from baseline to week 6 in the amount of urine leakage, measured by the 1-hour pad test. Secondary outcomes included mean 72-hour urinary incontinence episodes measured by a 72-hour bladder diary (72-hour incontinence episodes).

Results  Among the 504 randomized participants (mean [SD] age, 55.3 [8.4] years), 482 completed the study. Mean urine leakage at baseline was 18.4 g for the electroacupuncture group and 19.1 g for the sham electroacupuncture group. Mean 72-hour incontinence episodes were 7.9 for the electroacupuncture group and 7.7 for the sham electroacupuncture group. At week 6, the electroacupuncture group had greater decrease in mean urine leakage (−9.9 g) than the sham electroacupuncture group (−2.6 g) with a mean difference of 7.4 g (95% CI, 4.8 to 10.0; P < .001). During some time periods, the change in the mean 72-hour incontinence episodes from baseline was greater with electroacupuncture than sham electroacupuncture with between-group differences of 1.0 episode in weeks 1 to 6 (95% CI, 0.2-1.7; P = .01), 2.0 episodes in weeks 15 to 18 (95% CI, 1.3-2.7; P < .001), and 2.1 episodes in weeks 27 to 30 (95% CI, 1.3-2.8; P < .001). The incidence of treatment-related adverse events was 1.6% in the electroacupuncture group and 2.0% in the sham electroacupuncture group, and all events were classified as mild.

Conclusions and Relevance  Among women with stress urinary incontinence, treatment with electroacupuncture involving the lumbosacral region, compared with sham electroacupuncture, resulted in less urine leakage after 6 weeks. Further research is needed to understand long-term efficacy and the mechanism of action of this intervention.

Trial Registration  clinicaltrials.gov Identifier: NCT01784172.

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