JAMA/Original Investigation Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence A Randomized Clinical Trial Stress uninary incontinence (SUI) is defined by the International Continence Society as an involuntary loss of urine on physical exertion, sneezing, or coughing. The prevalence of stress urinary incontinence is as high as 49% and varies according to population studied and the definition of stress urinary incontinence. SUI causes psychological burden, affects relationships, lowers physical productivity, and decreases quality of life in women. Yet, few effective therapies are available for treating SUI. Acupuncture may be an effective treatment option for SUI. Electroacupuncture has been found to decrease urine leakage. However, effects of acupuncture on SUI remain uncertain because of the small sample size, poor study design, and high risks of bias in previous clinical trials. The main objective of this study was to assess the effect of electroacupuncture involving the lumbosacral region, compared with sham electroacupuncture, in reducing urine leakage in women with SUI. A Randomzied Clinical Trial design, setting, and participants: multicenter, randomized clinical trial conducted at 12 hospitals in China and enrolling 504 women with SUI between October and May 2015, with data collection completed in December 2015. Results: Among the 504 randomized participants, 482 completed the study. Mean urine leakage at baseline was 18.4g for the electroacupuncture group and 19.1g for the sham elecroacupuncture group. Mean 72-hour incontinence episodes were 7.9 for the electroacupuncture group and 7.7 for the sham electroacupuncture group. At week 6, the electroacupuncture group had greater decrease in mean urine leakage (-9.9g)than the sham electroacupuncture group (-2.6g) with a mean difference of 7.4g. During some time peroids, the change in the mean 72 hours incontinence episodes from baseline was greater with electroacupuncture than sham electroacupuncture with between-group differences of 1.0 episode in weeks 1 to 6, 2.0 episode in weeks 15 to 18, and 2.1 episodes in weeks 27 to 30. The incidence of treatment-related adverse events was 1.6% in the elctroacupuncture group and 2.0% in the sham elctroacupuncture group, and all events were classified as mild. Conclusions: Among women with stress urinary incontinence, treatment with electroacupuncture involing the lumbosacral region compared with sham electroacupuncture resulted in less urine leakage after 6 weeks. Further research is needed to understand long term efficacy and the mechanism of action of this intervention. The research cited from JAMA. 2017; 317(24): 2493-2501.doi:10.1001/jama.2017.7220
