Is electroacupuncture efficacious in managing urinary leakage among women with stress urinary incontinence?
Date of publication of the randomized controlled trial: June 2017
Design
Randomized controlled trial (RCT).
Participants
504 women adults (mean age: 55.3 years) who reported involuntary urine leakage when sneezing, coughing or exerting effort under stress (where urine leakage stopped when stress ended), with weight gain of incontinence pad measured greater than 1 gram by the 1-hour pad test that the subject was wearing.
Intervention
18 sessions of electroacupuncture over 6 weeks with 30 minutes per session, at a frequency of 3 sessions per week.
Comparator
Comparison: Electroacupuncture versus sham electroacupuncture.
Major Outcomes
Outcome 1: Change of baseline in the amount of urine leakage in gram measured by the 1-hour pad test at week 6.
Settings
This trial was performed in an outpatient setting.
Comparison    Electroacupuncture versus sham electroacupuncture
Main Results
Compared to sham electroacupuncture, electroacupuncture had shown significant impact on reducing the amount of urine leakage measured by the 1-hour pad test at week 6 (mean difference (MD): 7.4, 95% CI: 4.8 to 10.0).
Comparison: Electroacupuncture versus sham electroacupuncture among women adults with reported involuntary urine leakage
Outcomes No. of studies (Total number of participants) Mean score (SD)/ No. of participants Heterogeneity test (I2) MD (95% CI) p value Overall quality of evidence*
Intervention Comparator
1 (gram) 1 (504) 8.2 (NR)/252 16.8 (NR)/252 Not applicable as there is only 1 study. 7.4 (4.8 to 10.0) <0.001 High
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval; NR = not reported.
Comparison    Electroacupuncture versus sham electroacupuncture
Main Results
Compared to sham electroacupuncture, electroacupuncture had shown significant impact on reducing the amount of urine leakage measured by the 1-hour pad test at week 6 (mean difference (MD): 7.4, 95% CI: 4.8 to 10.0).
Comparison: Electroacupuncture versus sham electroacupuncture among women adults with reported involuntary urine leakage
Outcomes 1 (gram)
No. of studies (Total number of participants) 1 (504)
Mean score (SD)/ No. of participants Intervention 8.2 (NR)/252
Comparator 16.8 (NR)/252
MD (95% CI) 7.4 (4.8 to 10.0)
p value <0.001
Overall quality of evidence* High
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval; NR = not reported.
Conclusion
Benefits
Compared to sham electroacupuncture, electroacupuncture significantly reduces the amount of urine leakage among women with stress urinary incontinence. For outcome 1, the overall quality of evidence is high. Further research is unlikely to have an important impact on our confidence in this estimate of effect.
Harms
Hematoma and fatigue were reported among 4 patients in electroacupuncture group and 5 patients in sham electroacupuncture group.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/28655016
The synopsis is based on the following article:
Liu Z, Liu Y, Xu H, He L, Chen Y, Fu L, Li N, Lu Y, Su T, Sun J, Wang J. Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence: A Randomized Clinical Trial. JAMA. 2017 Jun 27;317(24):2493-501.


* 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.