Is manual acupuncture effective in reducing overactive bladder symptoms among female adults as compared to oral tolterodine tartrate?
Date of publication of randomized controlled trial: September 2015
Design
Randomized controlled trial (RCT).
Participants
240 female patients with overactive bladder (age range: 18 to 85 years).
Intervention
Weekly manual acupuncture treatment was performed. Needles insertion points were SP6, SP9, KI3, and CV4. Duration of treatment lasted for 4 weeks.
Comparator
Comparison: Manual acupuncture versus control group receiving pharmacological treatment of oral tolterodine tartrate (2mg twice daily).
Major Outcomes
Outcome 1: Change in number of urinary urgency episodes per 24 hours at week 4;
Outcome 2: Change in number of incontinence episodes per 24 hours at week 4;
Outcome 3: Change in number of nocturia episodes at week 4.
Settings
The trial was conducted in outpatient settings.
Comparison    Manual acupuncture versus oral tolterodine tartrate
Main Results
In the manual acupuncture group, the number of urinary urgency episodes reduced by -3.1 ±1.6, urgency incontinence episodes by -1.0 ±0.6 and nocturia episodes by -1.5 ±0.8. In the oral tolterodine tartrate group, number of urgency episodes reduced by -3.5 ±1.9, urgency incontinence episodes by -1.2 ±1.0 and nocturia episodes by -1.3 ±0.9. The mean differences in the number of urinary urgency episodes, incontinence episodes and nocturia episodes at week 4 between subjects in two groups were not statistically significant.
Comparison: Manual acupuncture versus oral tolterodine tartrate among female adults with overactive bladder
Outcomes (units) No. of studies (Total number of participants) Mean (SD)/ No. of participants Heterogeneity test (I2) MD (95% CI) p value Overall quality of evidence*
Intervention Comparator
1 (NA) 1(240) −3.1 (1.6)/ 118 −3.5 (1.9)/ 122 Not applicable as there is only 1 trial Not reported 0.08 Moderate
2 (NA) 1(240) −1.0 (0.6)/118 −1.2 (1.0)/ 122 Not applicable as there is only 1 trial Not reported 0.06 Moderate
3 (NA) 1(240) −1.5 (0.8)/ 118 −1.3 (0.9)/ 122 Not applicable as there is only 1 trial Not reported 0.07 Moderate
Keys: SD= standard deviation; MD: mean difference; CI: confidence interval.
Comparison    Manual acupuncture versus oral tolterodine tartrate
Main Results
In the manual acupuncture group, the number of urinary urgency episodes reduced by -3.1 ±1.6, urgency incontinence episodes by -1.0 ±0.6 and nocturia episodes by -1.5 ±0.8. In the oral tolterodine tartrate group, number of urgency episodes reduced by -3.5 ±1.9, urgency incontinence episodes by -1.2 ±1.0 and nocturia episodes by -1.3 ±0.9. The mean differences in the number of urinary urgency episodes, incontinence episodes and nocturia episodes at week 4 between subjects in two groups were not statistically significant.
Comparison: Manual acupuncture versus oral tolterodine tartrate among female adults with overactive bladder
Outcomes (units) 1 (NA) 2 (NA) 3 (NA)
No. of studies (Total number of participants) 1(240) 1(240) 1(240)
Mean (SD)/ No. of participants Intervention −3.1 (1.6)/ 118 −1.0 (0.6)/118 −1.5 (0.8)/ 118
Comparator −3.5 (1.9)/ 122 −1.2 (1.0)/ 122 −1.3 (0.9)/ 122
MD (95% CI) Not reported Not reported Not reported
p value 0.08 0.06 0.07
Overall quality of evidence* Moderate Moderate Moderate
Keys: SD= standard deviation; MD: mean difference; CI: confidence interval.
Conclusion
Benefits
This study showed that the numbers of urinary urgency, incontinence and nocturia episodes had decreased after four weeks of treatments in both acupuncture and oral tolterodine tartrate groups. There was no significant difference between the two groups. For all outcomes, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
No serious adverse events were reported in the study. Adverse events were generally mild, well tolerated and occurred at very low rates in both acupuncture and oral tolterodine tartrate groups. Dry mouth was most common with 11 cases among patients receiving oral tolterodine tartrate while needling pain was the most common adverse event with 9 cases among patients receiving acupuncture treatment.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/25399241
The synopsis is based on the following article:
Yuan Z, He C, Yan S, Huang D, Wang H, Tang W. Acupuncture for overactive bladder in female adult: a randomized controlled trial. World journal of urology. 2015 Sep 1;33(9):1303-8.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.