In a nutshell
This article investigated the safety and effectiveness of electroacupuncture (EA) compared with pelvic floor muscle training (PFMT) and solifenacin (Vesicare) in women with mixed urinary incontinence (MUI). The authors concluded that EA is safer and may be more efficacious with the effect lasting up to 36 weeks.
Some background
Overactive active bladder (OAB) is a condition where there is a frequent feeling of needing to urinate. Stress urinary incontinence (SUI) is needing to urinate when pressure is placed on the bladder (running, jumping, sneezing). Urgency predominant-mixed urinary incontinence (UP-MUI) is a mix of both of these conditions with worse urgency. UP-MUI is recommended to be first managed with solifenacin. SUI is recommended to be managed with PFMT. However, patients on solifenacin experience dry mouth blurred vision and constipation. Also, PFMT may not be as successful for patients with severe symptoms. An alternative is to manage patients with EA. This works by enhancing the function of the nerves in the pelvis which helps to improve bladder control.
It is not known whether EA is better than PFMT combined with solifenacin to manage UP-MUI in these patients.
Methods & findings
The study involved 173 female patients. Group 1 received 12 week EA treatment and were followed up at 24 weeks. Group 2 received 36 weeks of PFMT-solifenacin treatment. The main outcome measured was a 50% reduction in 24h urgency incontinence episode frequency (UIEF; how often they had to urinate in 24h). Voiding diaries were used to evaluate patients' symptoms.
Group 1 had a response of 45.78% and group 2 had a 50% response. Nocturia (waking at night to urinate), urgency, and urinary pad usage were all decreased after 12 weeks of treatment in group 1. This effect lasted for up to 36 weeks.
Treatment satisfaction was higher in group 1 (71.1%) compared to group 2 (62.8%). Bowel side effects occurred more commonly in group 2 (28.42%) compared to group 1 (1.2%).
The bottom line
The authors concluded that EA is safe and may be more efficacious with the effect lasting up to 36 weeks.
The fine print
This study involved a small sample size so a larger study would be required to confirm the results.
Published By :
World Journal of Urology
Date :
Jun 03, 2019
