Acupuncture in addition to standard conservative treatment for overactive bladder; a feasibility trial for a randomized controlled study

Abstract

Aims This study aims to assess the feasibility of an randomized controlled trial (RCT) to test treatment efficacy of acupuncture for symptoms of overactive bladder syndrome (OAB), a common long‐term condition with physical, psychological, social and sexual consequences. Methods A total of 30 participants were recruited and randomized to either standard conservative management for OAB or standard conservative management plus acupuncture. Standard care consisted of individually tailored advice regarding bladder health, pelvic floor exercises and lifestyle adjustments. The intervention group received 6 sessions of acupuncture over an 8‐week period. Outcomes measured included adherence to the study protocol, recruitment rate, participant attrition rate and adverse events. A 3‐day bladder diary and Incontinence Questionnaire—short form questionnaire were used to assess symptoms. The ICEpop CAPability measure for Adults measure was used to assess well‐being. Outcomes were collected at baseline, after 8 weeks of intervention and 6 weeks after completing intervention. An exit questionnaire captured participant experience data. Results Comparison of the two groups at baseline did not detect statistically significant differences in demographics and symptom profile. A total of 23 participants completed all study proceedures. Recruitment was completed in 11 months, quicker than anticipated. No serious adverse events occurred; minor adverse events were recorded in 11/114 (9.6%) treatments. A total of seven participants failed to complete one or more study proceedures with an overall attrition rate of 23.3%. Conclusions Most participants completed all aspects of the study and found the protocol acceptable. The interventions appear safe and well tolerated. The concept of a large‐scale RCT with a similar protocol was proven and appears feasible based on this pilot work.

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 ,…”

“…In total, 19 studies selected the “de qi” response ( 16 , 18 , 21 , 22 , 26 , 31 , 33 – 36 , 38 – 40 , 42 , 43 ). All studies reported needle stimulation methods.…”

“…A total of 14 studies had a low risk of bias regarding random sequence generation ( 16 – 21 , 26 , 29 , 30 , 34 , 37 , 39 , 40 , 43 ), whereas 16 studies did not provide detailed information about their random generation method ( 22 – 25 , 27 , 28 , 31 – 33 , 35 , 36 , 38 , 41 , 42 , 44 , 45 ). Notably, five studies reported the allocation concealment method ( 16 , 17 , 20 , 26 , 43 ), whereas the other 25 studies did not mention the allocation concealment method ( 18 , 19 , 21 – 25 , 27 – 42 , 44 , 45 ). A total of seven studies had a low risk of performance bias given that these studies selected AT as the intervention and sham AT as the control ( 16 – 22 ).…”

Mechanism of traditional Chinese medicine in treating overactive bladder

“…Acupuncture, moxibustion, herbal medicine, and massage, as classical TCM treatments, are regarded as an economical and safe alternative, and an increasing number of OAB patients may be willing to seek this treatment option with fewer side effects or less risks. There are several clinical trials by scholars in the United States, the United Kingdom and China, demonstrating the effectiveness and low side effects of acupuncture in the treatment of OAB [21][22][23][24][25]. Moxibustion is also a well-known non-invasive therapy that directly or indirectly stimulates acupoints through moxa to promote the recovery of many diseases, especially in chronic and refractory diseases [26].…”