All of the 504 women in the study had stress incontinence, which
happens when the pelvic muscles are too weak to prevent urinary
leakage when women do things like cough, sneeze or exercise.
Childbirth is a common reason for weak pelvic muscles and obesity
makes the problem worse.
Researchers tested what’s known as electroacupuncture, where an
electrical current is passed between a pair of acupuncture needles
compared to a dummy treatment with similar needles, for six weeks.
Women who received electroacupuncture had a greater decrease in
urine leakage after treatment and after six months than the
participants who got the sham intervention, researchers report in
JAMA.
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“The safety and effect of electroacupuncture for stress urinary
incontinence were comparable to those of pelvic floor muscle
training,” an approach currently used in some instances to help
women reduce leakage, said senior study author Dr. Baoyan Liu of
Guang’an Men Hospital, which is affiliated with the China Academy of
Chinese Medical Sciences in Beijing.
“Electroacupuncture was effective with rapid response, short
treatment period and good compliance,” Liu said by email. “Pelvic
floor muscle training takes at least three months with less
compliance.”
At the start of the study, women in the electroacupuncture group
leaked an average of 18.4 grams of urine during a one-hour pad test
and had an average of 7.9 episodes of leakage in a typical 72-hour
period.
By comparison, women in the sham treatment group had average leakage
of 19.4 grams and experienced 7.7 episodes in a typical 72-hour
period.
Women assigned to electroacupuncture had 18 sessions over six weeks.
The treatment consisted of inserting needles at traditional
acupoints in the lumbrosacral region near the small of the back and
the back of the pelvis near the hips. Women in the control group got
sham electroacupuncture at nonacupoints in the same region of the
back.
After six weeks, women who got electroacupuncture had an average
decrease in urine leakage of 9.9 grams, compared with a 2.6 gram
decrease among women in the group that got the sham treatment. With
electroacupuncture, women averaged one less episode of leakage in 72
hours than those in the comparison group.
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Over six months, there were also some time periods when
electroacupuncture was associated with a bigger reduction in the
number of episodes of incontinence, but this didn’t happen
consistently.
Side effects associated with treatment such as fatigue and hematoma,
or swelling of clotted blood inside tissue, occurred with 1.6
percent of women in the electroacupuncture group and 2 percent of
the other participants.
One limitation of the study is the lack of a clinically meaningful
reduction in the average amount of urine that leaked before and
after treatment, the authors note. They also didn’t assess the
amount of urine leaked after treatment stopped.
Researchers also could not be sure that participants were unaware of
whether they received real or fake electroacupuncture, which might
influence the results people reported experiencing after getting
this treatment, the researchers note.
Even so, the results suggest that electroacupuncture, like pelvic
muscle exercises, may be a reasonable option for some women with
stress urinary incontinence to try before considering surgery for
the problem, Dr. Josephine Briggs of the National Center for
Complimentary and Integrative Health at the National Institutes of
Health in Bethesda, Maryland, writes in an accompanying editorial.
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The approach has a long history of success, noted Zhang Jianbin, a
researcher at Nanjing University of Chinese Medicine who wasn’t
involved in the study.
“Incontinence was already treated by acupuncture in ancient China,”
Jianbin said by email. “Many experiences have been accumulated
before, and are guiding clinical practice at present.”
SOURCE: http://bit.ly/2udTA3N and http://bit.ly/2tiZmVq JAMA, online
June 27, 2017.
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