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Acupuncture for Overactive Bladder

A Randomized Controlled Trial

From the Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon; and Providence Continence Center, Providence St. Vincent Medical Center, Portland, Oregon.

Address reprint requests to: Address correspondence to: Sandra L. Emmons, MD, Department of Obstetrics and Gynecology, L466, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239; e-mail: emmonss{at}ohsu.edu.

Objective: To compare acupuncture treatment for overactive bladder with urge incontinence with a placebo acupuncture treatment.

Methods: Eighty-five women enrolled in this randomized, placebo-controlled trial. Women were randomly assigned to either receive an acupuncture treatment expected to improve their bladder symptoms, or a placebo acupuncture treatment designed to promote relaxation. They underwent cystometric testing, completed a 3-day voiding diary, and completed the urinary distress inventory and incontinence impact questionnaire, validated quality-of-life inventories, before and after 4 weekly acupuncture treatments. The primary endpoint was number of incontinent episodes over 3 days. Secondary endpoints included voiding frequency and urgency, cystometric bladder capacity, maximum voided volume, and the urinary distress inventory and incontinence impact questionnaire symptom scores.

Results: Seventy-four women completed all aspects of the study. Women in both treatment and placebo groups had significant decreases in number of incontinent episodes (59% for treatment, 40% for placebo) without a significant difference in the change between the groups. Women in the treatment group had a 14% reduction in urinary frequency (P = .013), a 30% reduction in the proportion of voids associated with urgency (P = .016), and a 13% increase in both maximum voided volume and maximum cystometric capacity (P = .01). Both groups also had an improvement in the urinary distress inventory and incontinence impact questionnaire scores (54% decrease for treatment, 30% decrease for placebo, P < .001 for the difference in change between the groups).

Conclusion: Women who received 4 weekly bladder-specific acupuncture treatments had significant improvements in bladder capacity, urgency, frequency, and quality-of-life scores as compared with women who received placebo acupuncture treatments.

Level of Evidence: I

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