A randomized controlled trial to assess the effectiveness and safety of acupuncture for overactive bladder: a study in Hong Kong population

Abstract

Background Around 15% of the Hong Kong population was found to suffer from overactive bladder (OAB), but the current available treatments, such as medication, behavioral therapy and physical therapy are unsatisfactory. Previous studies have suggested that acupuncture may have promising effect for OAB, but some limitations on the study design render the evidence questionable. This study aimed to evaluate the effectiveness and safety of acupuncture treatment for patients with OAB in Hong Kong. Methods One hundred patients with OAB were enrolled. The patients were randomized to receive either active acupuncture or sham needle intervention twice a week for 8 consecutive weeks, and had a follow-up consultation 12 weeks after the completion of acupuncture intervention. The primary outcome assessment was the 3-Day Voiding Diary, which records daytime and night-time urinary frequency and symptoms, at the baseline, the end of the 8-week intervention and 12 weeks after acupuncture intervention. Secondary outcomes included Urine NGF level, Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6), as well as Overactive Bladder Symptom Score (OABSS). Results After 16 sessions of treatment, when compared with the baseline, both active and sham acupuncture significantly reduced the frequency of urgency urinary incontinence (UUI), daytime and night-time urinary frequency as well as the scores of IIQ-7, UDI-6 and OABSS. Moreover, the treatment effects could last for at least 3 months. However, no significant difference in frequency of UUI and daytime urinary frequency was found between the active and sham acupuncture groups. On the other hand, the night-time urinary frequency decreased more significantly during the treatment and follow-up in the active acupuncture group than in the sham control group after controlling baseline night-time urinary frequency. Urine NGF level could not be detected by ELISA method in our experiments. Conclusion This study suggests a beneficial effect of acupuncture on improving OAB symptoms. Both active and sham acupuncture treatment were able to improve the symptoms of frequency of urgency urinary incontinence, and the daytime and night-time urinary frequency, while only mild adverse effects were found. This project was unable to establish the specific effect of acupuncture for OAB. Trial registration Chinese Clinical Trial Registry, ChiCTR-INR-16010048. Registered on 29 Nov 2016.

Effect of Electroacupuncture on Bladder Dysfunction via Regulation of MLC and MLCK Phosphorylation in a Rat Model of Type 2 Diabetes Mellitus

“…According to our previous animal experimental protocol [ 27 ] and related clinical studies [ 28 ], acupuncture needles were affixed to the surface of BL33 and SP6 in the sham EA group, without penetrating into the acupoints in order to avoid nonspecific acupuncture effect. The stimulator is connected to the acupuncture needles, but the power switch is turned off.…”

Acupuncture for the treatment of overactive bladder: A systematic review and meta-analysis

“…A total of 25 studies were conducted in China ( 19 – 28 , 30 – 42 , 44 , 45 ), two in the United Kingdom ( 29 , 43 ), one in the United States ( 16 ), one in Turkey ( 18 ), and one in Hong Kong ( 17 ). The main characteristics of the 30 included studies are presented in Table 1 .…”

“…All studies reported acupoints, and the more frequently used acupoints included SP6 (17 studies) ( 16 – 19 , 24 – 29 , 31 , 34 , 35 , 39 , 41 , 43 , 44 ), BL23 (17 studies) ( 17 , 19 , 23 – 25 , 27 – 29 , 31 , 35 , 38 – 42 , 44 , 45 ), BL28 (15 studies) ( 16 , 17 , 23 – 25 , 27 – 29 , 31 , 35 , 38 , 39 , 42 , 44 , 45 ), CV4 (15 studies) ( 16 – 18 , 23 , 25 – 27 , 29 , 31 , 34 , 35 , 39 , 40 , 43 , 44 ), BL32 (15 studies) ( 17 , 19 , 21 , 23 – 25 , 27 , 31 – 33 , 35 , 39 , 41 , 44 , 45 ), and CV3 (11 studies) ( 19 , 23 , 25 , 27 , 29 , 31 , 34 ,…”

“…All studies reported needle stimulation methods. The most frequently used retention time was 30 min (17 studies) ( 17 , 21 – 24 , 31 , 33 , 35 , 37 , 38 , 40 – 44 ). The treatment period varied from 1 to 12 weeks, and the largest number of studies was conducted over 4 weeks ( 16 , 18 , 22 – 24 , 26 , 27 , 30 , 38 , 42 ).…”

Urinary brain-derived neurotrophic factor and nerve growth factor as noninvasive biomarkers of overactive bladder in children

“…On the one hand, some studies found no significant difference in the NGF/creatinine ratio between patients with OAB and the control group (17,18). On the other hand, other studies showed unmeasurable NGF concentrations using various commercially available ELI-SA kits (19)(20)(21). These studies have drawn attention to the importance of using multiple methods to establish optimal procedures for biomarker detection in urine.…”