Immediate effects of Zhongji point acupuncture on pelvic floor structure in female patients with stress urinary incontinence: a randomized, single-blind, and sham-controlled clinical trial protocol

Abstract

Background: Stress urinary incontinence (SUI) is defined as involuntary leakage of urine from the external urethra due to increased abdominal pressure, for example, upon sneezing, coughing, or exercise.Acupuncture is an effective therapy for patients with SUI, although objective evidence of its benefits or mechanism of action is limited. Patients with SUI often harbor structural changes of pelvic floor, the parameters of which are measurable from various perspectives and in multiple dimensions, dynamically and comprehensively, through transperineal ultrasound (TPUS). The status of such changes may then be assessed following acupuncture procedures. In the present investigation, TPUS serves to gauge the immediate effects of acupuncture on pelvic floor structures in female patients with SUI.Methods: This protocol calls for a prospective, randomized, controlled, and single-blinded study of 72 female patients with SUI, each randomly assigned as test or control group members. The test group is subjected to one-time acupuncture at the Zhongji (RN3) acupoint for a period of 10 min, whereas the control group undergoes sham acupuncture in the same manner. In both groups, TPUS imaging of pelvic floor is performed before, during, and immediately after acupuncture procedures. Bladder neck mobility (BND), urethral rotation angle (URA), retrovesical angle (RVA), lowest point of bladder (BN-S), and presence/absence of urethral funneling or bladder bulging are then recorded as outcome measures.Discussion: Above efforts are intended to assess real-time pelvic floor structural changes in women undergoing acupuncture for SUI. The subsequent findings may help objectively document the efficacy of acupuncture in this setting and clarify its mechanism of action. Trial registration: Registration with the Chinese Clinical Trial Registry (ChiCTR200041559) (http:// www.chictr.org.cn/edit.aspx?pid=64591&htm=4), was effective December 29, 2020.

A Critical Overview of Systematic Reviews and Meta-Analyses of Acupuncture for Female Stress Urinary Incontinence

“…The main treatment modalities for SUI include lifestyle interventions, electrical stimulation, pelvic floor muscle training (PFMT), medication, and surgery [ 6 ]. The American Urological Association (AUA) currently recommends conservative treatment, such as PFMT, for patients with mild and moderate SUI [ 7 ].…”

A Comparison of Effectiveness of Thai Traditional Massage and Tamsulosin in Lower Urinary Tract Symptoms: A Randomized Controlled Trial

“… 10 Recently, Li-Xin Guan and colleagues discovered that after 10 min of acupuncture at the Zhongji (RN3) acupoint, there was a difference in bladder neck mobility (BND) between the distance between the bladder neck and the lower margin of the pubic symphysis in the resting state and the Valsalva state. 11 In Thailand, Thai traditional medicine such as Thai massage has long been a part of Thailand's healing culture and has a potential treatment for several ailments.The Wat Pho (Temple of the Reclining Buddha) has an ancient marble inscription that is thought to describe a medical massage for LUTS.…”