Effect of Electroacupuncture Added to Pelvic Floor Muscle Training in Women with Stress Urinary Incontinence: A Randomized Clinical Trial

• Published in: European urology focus 2023-03, Vol.9 (2), p.352-360
• Main Authors: Tang, Kangmin, Su, Tongsheng, Fu, Lixin, Chen, Zhaoming, Liu, Guiming, Hou, Wenguang, Ming, Shuren, Song, Qinqin, Feng, Shanshan, Liu, Xiaoman, Wang, Ruiping, Liu, Baoyan, Chen, Yuelai
• Format: Article
• Language: English
• Subjects: Acupuncture; Electroacupuncture; Exercise Therapy - methods; Female; Humans; Middle Aged; Pelvic Floor; Pelvic floor muscle training; Prospective Studies; Stress urinary incontinence; Urinary Incontinence, Stress - therapy
• ISSN: 2405-4569; 2405-4569
• DOI: 10.1016/j.euf.2022.10.005

We evaluated the effectiveness and safety of pelvic floor muscle training plus electroacupuncture for stress urinary incontinence. The results demonstrate that this is a promising therapeutic approach for the treatment of stress urinary incontinence. Pelvic floor muscle training (PFMT) is a first-line conservative therapy for stress urinary incontinence (SUI). Electroacupuncture (EA) has been used to treat SUI recently. To compare the effectiveness of PFMT + EA versus PFMT + sham EA for SUI in women. A prospective, multicenter, randomized, controlled clinical trial was conducted at four hospitals in China involving 304 women with SUI from May 20, 2014 to November 21, 2017. Data were analyzed from April 20 to December 21, 2018. Participants were randomized to receive 8 wk of PFMT+ EA (n = 154) or PFMT + sham EA (n = 150). The primary outcome was the change in the amount of urine leakage measured on a 1-hr pad test. Student’s t test, the χ2 test, and the Wilcoxon rank-sum test were used for data analysis. Among the 304 participants randomized, 286 completed the study. The mean age was 57.6 yr (standard deviation [SD] 8.9) for the PFMT + sham EA group and 57.2 yr (SD 9.1) for the PFMT + EA group. The mean urine leakage at baseline was 13.6 g for the PFMT + sham EA group and 13.9 g for the PFMT + EA group. After the 8-wk intervention, the PFMT + EA group had a greater decrease in mean urine leakage (−9.8 g) than the PFMT + sham EA group (−5.8 g) with a mean difference of 4.0 g (95% confidence interval [CI] 0.8–7.2). Significantly more patients experienced a ≥50% reduction in urine leakage and the mean number of incontinence episodes in 24 h in the PFMT + EA group than in the PFMT + sham EA group (26.3%, 95%CI 15.8–36.8%). The PFMT + EA group experienced better improvement in participant-reported SUI severity at 6 wk (p