Electroacupuncture reduces early urinary incontinence burden after RP

Electroacupuncture helps reverse urinary incontinence following radical prostatectomy (RP) for prostate cancer, according to a study from China. 

The study included 110 men (median age 69 years, mean BMI 24.35 kg/m²) with localized prostate cancer who underwent robot-assisted RP. These men experienced urinary incontinence (use of ≥2 pads per day) 4–6 weeks after RP. None of them had any prior neoadjuvant hormonal therapy, any prior prostatic surgery, any history of pelvic surgery, and history of urinary incontinence before RP.

Participants were randomly assigned to undergo electroacupuncture (n=55) or sham stimulation (n=55). Electroacupuncture was administered at bilateral Ciliao, Zhongliao, and Xialiao acupoints, with sparse-dense wave electrostimulation (alternating between 2 and 15 Hz) for 30 min per session. The sham stimulation was performed using identical procedures with nonpuncturing flat-tip needles at offset points. Treatment session was conducted three times per week for 6 weeks.

After 6 weeks, the primary outcome of urinary continence (ie, the use of 0 to 1 pad per day) occurred with significantly greater frequency in the electroacupuncture group than in the sham stimulation group (43.6 percent vs 21.8 percent; relative risk [RR], 2.00, 95 percent confidence interval [CI], 1.12–3.59; p=0.02). This difference persisted in the post hoc sensitivity analysis adjusted for nerve-sparing techniques and diabetes status (adjusted RR, 1.96, 95 percent CI, 1.09–3.52; p=0.03).

Results for the secondary outcomes also favoured electroacupuncture vs sham stimulation. Significantly greater reductions were seen in 24-h urine leakage (difference, −140 g, 95 percent CI, −200 to −50; p<0.001) and in the mean number pads used daily (difference, −0.5, 95 percent CI, −1.0 to 0; p=0.02). 

Adverse events (AEs) were infrequent, reported in 4 percent of participants in the electropuncture group and in 1.8 percent in the sham stimulation group. None experienced severe AEs. Local muscle spasms occurred in a participant in the sham stimulation group, while pain induced by needle insertion and subcutaneous haemorrhage were each reported in one participant in the electroacupuncture group.