ICS 2018: Acupuncture: A Viable Treatment for UI and LUTS?

Philadelphia, PA (UroToday.com) Sandra Engberg, Ph.D., RN, provided an overview of current studies related to acupuncture for the treatment of urinary incontinence (UI) and presented results of a randomized clinical trial to examine short-term efficacy of acupuncture for the treatment of urge, stress and mixed urinary incontinence in women.

While Chinese medicine recognizes acupuncture as a treatment that restores energy balance within the human body, western providers still question its’ mechanism.

First, Dr. Engberg examined existing evidence of acupuncture use for the overactive bladder. According to Dr. Engberg, data are limited but promising. Randomized control trial conducted in 2017 by Liu et al. showed that the number of stress urinary incontinence (SUI) episodes significantly decreased in a group that received electroacupuncture (EA) compared to sham electroacupuncture. A research study by Xu et al (2016) showed a reduction in SUI episodes as well. Two studies performed by Olivera (2016) showed non-statistically significant reduction in urge urinary incontinence (UUI) episodes. However, one of the trials reported a significantly greater reduction in urgency and frequency in the true acupuncture group.

Dr. Engberg reviewed a number of recent studies on acupuncture for urinary incontinence and LUTS. While some research protocols demonstrated no significant difference in the number of voids and urgency episodes, some studies indicated that EA significantly decreased nocturia episodes compared to sham EA.

Second, Dr. Engberg presented the results of a double-blinded clinical trial to evaluate the efficacy of acupuncture in decreasing urge, stress and mixed UI. A convenience sample of women ages 25 and older were randomly assigned to either true penetrating or sham acupuncture groups. Both groups received 12 sessions over 6 weeks. Figure 1 reflects sample characteristics:

UroToday ICS2018 A Viable Treatment for UI and LUTS Sociodemographics
Figure 1

Results showed that true acupuncture didn’t produce any significant difference in decreasing urge incontinence episodes compared to the sham arm. However, stress urinary incontinence incidence reduced after one week in the true acupuncture group compared to the sham group (Figure 2).

UroToday ICS2018 A Viable Treatment for UI and LUTS
Figure 2

In conclusion, Dr. Engberg stated that currently there is not enough evidence to suggest that acupuncture can be a viable treatment for urinary incontinence and LUTS. It could be beneficial to add antimuscarinic medication to the acupuncture, but more research is needed.

Presented by: Sandra Engberg, Ph.D., RN, CRNP, FAAN University of Pittsburgh School of Nursing

Written by: Hanna Stambakio, BS, Clinical Research Coordinator, Division of Urology, University of Pennsylvania, @PennUrology at the 2018 ICS International Continence Society Meeting - August 28 - 31, 2018 – Philadelphia, PA USA