Stress urinary incontinence, a condition in which individuals experience incontinence during physical exertion, could affect up to half of older adults and may lead to a reduction in quality of life. In a randomized clinical trial, Liu and colleagues show that electroacupuncture may be an effective treatment for stress urinary incontinence.
Stress urinary incontinence, or SUI, is a condition in which individuals experience incontinence during physical exertion. This condition could affect as many of half of older adults, and causes significant distress and a reduction in quality of life, particularly for women. Despite this, there are few treatment options available.
In a study published in the Journal of the American Medical Association, Liu and colleagues tested the effectiveness of electroacupuncture in the lumbosacral region of the spine as a treatment for SUI. Electroacupuncture is a form of acupuncture in which electrical current passes through acupuncture needles. Liu and colleagues included 482 Chinese women in their study. These patients were randomly assigned to either treatment (18 sessions of electroacupuncture) or control groups (18 sessions of sham acupuncture with no skin penetration), over a period of six weeks. The researchers assessed urine leakage at baseline and at the end of six weeks by measuring leakage over a 1-hour period as well over 72-hour periods through a diary kept by the patients.
At baseline, both the treatment and control groups had similar levels of 1-hour urine leakage, with 18.4 grams and 19.1 grams respectively, and similar levels 72-hour urine leakage, with 7.9 and 7.7 episodes of incontinence on average respectively. After six weeks of treatment, the group receiving electroacupuncture experienced a decrease of 9.9 grams of urine leakage for the 1-hour test while the control group experienced a decrease of only 2.6 grams. Similarly, for the 72-hour periods, the treatment group experienced, on average, one to two fewer incontinence episodes than the control group, and this difference extended up to 24 weeks after treatment ended. However, these differences may not be clinically significant. Over 60% of the study participants receiving treatment experienced at least a 50% decrease in urine leakage. These results are similar to those of treatments that focus on the muscles of the pelvic floor.
Further research will clarify how electroacupuncture treatment leads to improvements in SUI. It may be that electroacupuncture indirectly causes muscle training in the muscles of the pelvic floor, it may increase the pressure on the urethra, or it may stimulate the nerves that supply the pelvic region. Further, future studies will require larger sample sizes and less onerous study procedures to determine the clinical significance and feasibility of electroacupuncture treatment.
Written By: C. I. Villamil
Reference: Liu et al. 2017. Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence: a randomized clinical trial. JAMA 317(24):2493-2501.