Research: WANG and COLLEAGUES,

Listed in Issue 225

Abstract

WANG and COLLEAGUES, (1)Department of Acupuncture and Moxibustion, Guang An Men Hospital, China Academy of Chinese Medical Sciences, Beijing,China migofree@126.com assessed the effectiveness and side effects of acupuncture for stress urinary incontinence in adults.

Background

The use of acupuncture for stress urinary incontinence is increasing in frequency, especially in Asian area. However, its effectiveness and side effects have not been evaluated.

Methodology

The authors searched the Cochrane Incontinence Group Specialised Register (searched 28 January 2013), EMBASE, AMED, Chinese Biomedical Literature Database (CBM), Chinese Acupuncture Trials Register and China National Knowledge Infrastructure (CNKI) (all searched 20 February 2013). In addition, they searched the reference lists of relevant articles and contacted authors and trialists in the field. Selection Criteria: Randomized and quasi-randomized controlled trials of acupuncture interventions without other treatments for the management of stress urinary incontinence for adults. Data Collection And Analysis: Two review authors independently assessed eligibility, trial quality and extracted data. They meta-analysed data where appropriate.

Results

The authors identified 17 possibly eligible studies but only one small trial with 60 women met our inclusion criteria. The trial compared acupuncture versus midodrine, a drug for treating hypotension. The risk of bias was high as there was no concealment of randomised allocation, and there was no blinding of assessment of outcome. In addition, it was not possible to blind participants or health providers to the interventions. The statistical methods were not described. More women improved in the acupuncture group (73% with acupuncture versus 33% with midodrine; risk ratio (RR) 2.20, 95% confidence interval (CI) 1.27 to 3.81) but the cure rates were low and not statistically significantly different (13% versus 7%; RR 2.00, 95% CI 0.40 to 10.11). There were adverse events in the drug group only.

Conclusion

The effect of acupuncture for stress urinary incontinence for adults is uncertain. There is not enough evidence to determine whether acupuncture is more effective than drug treatment.

References

Wang Y(1), Zhishun L, Peng W, Zhao J, Liu B. Acupuncture for stress urinary incontinence in adults. Cochrane Database Syst Rev. 7:CD009408. doi: 10.1002/14651858.CD009408.pub2. Jul 1 2013.

Comment

The area of urinary incontinence - truly a Cinderella neglected discipline - requires further investigations to search for effective clinical approaches. The above research which demonstrated no adverse effects in the acupuncture group yet side effects in the drug group needs to followed up.

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