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Clinical question
Is specific acupuncture treatment for overactive bladder with urge
incontinence more effective than placebo acupuncture treatment?
Bottom line
In this short-term study, targeted acupuncture treatment reduced urge
sensation more than the placebo intervention, but did not demonstrate a
clear reduction in incontinence episodes.
Reference
Emmons SL, Otto L. Acupuncture for overactive bladder: A randomized
controlled trial. Obstet Gynecol 2005; 106:138-43.
Study design: Randomized controlled
trial (single-blinded)
Allocation: Concealed
Setting: Outpatient (specialty)
Synopsis
In this study 85 women with urge incontinence were randomized to 4 weekly
sessions of specific acupuncture treatment or an acupuncture treatment to
promote general relaxation as a control procedure. Women completed a 3-day
voiding diary before and after the study period. Despite randomization,
women in the acupuncture group had fewer episodes of incontinence per day,
though the difference was not statistically different (6 episodes per day vs
d 9 episodes per day, P = .09). Outcome assessment was blinded. A small
attrition occurred during the study: 3 women in both groups did not complete
the acupuncture treatments because of scheduling difficulties. The follow-up
3-day diary was not completed by 7 of 44 women in the specific treatment
group and 5 of 41 women in the control group. The analysis included only the
women who completed the study (rather than being by intention to treat). The
main outcome -- the decrease in the number of incontinence episodes -- was a
mean of 59% with active treatment compared with 40% for placebo, and did not
reach statistical significance. The study included enough subjects to detect
a 35% difference in the number of incontinence episodes. There was a
statistically significant 14% decrease in urinary frequency in the active
treatment group versus 4% in the placebo group (P = .013). Validated
questionnaires were used to assess the impact of urinary distress and
incontinence, and the improvements for active treatment over placebo reached
statistical significance for these measures (P < .001).
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