Effect of additional acupuncture to pelvic floor exercise on urinary incontinence: A randomized controlled trial

Abstract

Aims: To investigate the additional benefit of acupuncture to pelvic floor exercise (PFE) on the improvement of urinary incontinence (UI) and quality of life (QoL) in women.Methods: This was a single-blinded randomized controlled trial in a tertiary university hospital. Women with UI in various severity and types were randomized to receive either a weekly course of acupuncture with PFE or PFE alone for 6 weeks and then followed up for 24 weeks in every 6 weeks.Investigators were blinded to group allocation in pre-and postintervention assessments. Primary outcome was subjective changes of UI symptoms at 24 weeks. Secondary outcomes were episodes and severity of UI from bladder diary, severity by Visual Analogue Scale, and QoL scores by validated Chinese short-form of Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7). Results: One hundred seventy-nine women were screened while 137 were randomized. Significant subjective improvement in UI symptoms was demonstrated at all follow-up, latest at 24 weeks (odds ratio [OR]: 2.29, 95% confidence Interval [CI]: 1.02-5.12, respectively), with reduced episodes and severity of UI after (p < 0.05), and a trend of improvement in IIQ-7 score (p = 0.05). No major adverse events occurred. History of 2 years or longer duration of UI symptoms was associated with lower effectiveness of acupuncture (OR: 0.08, 95% CI: 0.01-0.68).

Response to the letter to the editor regarding ‘effect of additional acupuncture to pelvic floor exercise on urinary incontinence’ Wan OYK et al. (2022): Neurourol Urodyn. Wan OYK et al.

“…We understand the advantage of more objective primary outcomes measurement. However, we regarded invasive investigation, such as urodynamic studies, is not an optimal assessment for research purpose, as it still carries possible risks of infection and pain to patient as mentioned in our paper 1 . The infection and pain caused by the invasive investigation may result in undesired effects on the outcome measured.…”

“…Thank you so much for the interest in our recent paper on “Effect of additional acupuncture to pelvic floor exercise on urinary incontinence” 1 …”

Regarding ‘effect of additional acupuncture to pelvic floor exercise on urinary incontinence’ Wan OYK et al. (2022): Neurourol Urodyn

“…Regarding 'effect of additional acupuncture to pelvic floor exercise on urinary incontinence ' Wan OYK et al (2022): Neurourol Urodyn Dear Editor, We enjoyed reading the interesting study of Wan et al 1 in which the additional effects of conventional acupuncture to pelvic floor exercises (PFE) were evaluated in the treatment of urinary incontinence (UI).…”

“…In this RCT, Wan et al 1 included UI patients with kidney deficiency diagnosed with low backache, weak knees, tinnitus, fatigue, and a weak pulse palpated at the kidney "qi" position according to traditional Chinese medicine. They stated that the reason for this, reinforcing qi and promoting recovery of the bladder, can be used as treatment management for patients with qi deficiency.…”

“…In sum, Wan et al 1 concluded that additional acupuncture treatment for PFE helped to improve UI symptoms and can be considered a potential and feasible alternative treatment for women with UI.…”