1. JAMA. 2017 Jun 27;317(24):2493-2501. doi: 10.1001/jama.2017.7220.

Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary
Incontinence: A Randomized Clinical Trial.

Liu Z(1), Liu Y(2), Xu H(3), He L(2), Chen Y(4), Fu L(5), Li N(6), Lu Y(7), Su
T(8), Sun J(9), Wang J(10), Yue Z(11), Zhang W(12), Zhao J(13), Zhou Z(14), Wu
J(1), Zhou K(15), Ai Y(2), Zhou J(1), Pang R(1), Wang Y(1), Qin Z(1), Yan S(2),
Li H(2), Luo L(2), Liu B(1).

Author information: 
(1)Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing,
China.
(2)Institute of Basic Research in Clinical Medicine, China Academy of Chinese
Medical Sciences, Beijing, China.
(3)Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing,
China3Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical 
Sciences, Beijing, China.
(4)Yueyang Hospital of Integrated Traditional Chinese and Western Medicine
Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai,
China.
(5)First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,
Tianjin, China.
(6)West China Hospital of Sichuan University, Chengdu, China.
(7)Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
(8)Shaanxi Province Hospital of Traditional Chinese Medicine, Xi'an, China.
(9)Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China.
(10)Shanxi Hospital of Integrated Traditional and Western Medicine, Taiyuan,
China.
(11)Hengyang Hospital Affiliated to Hunan University of Chinese Medicine,
Hengyang, China.
(12)The First Hospital of Hunan University of Chinese Medicine, Changsha, China.
(13)Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine,
Beijing, China.
(14)Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China.
(15)Daemen College Physical Therapy Wound Care Clinic, Daemen College, Amherst,
New York.

Comment in
    JAMA. 2017 Oct 17;318(15):1500.
    JAMA. 2017 Jun 27;317(24):2489-2490.
    Explore (NY). 2018 Jan - Feb;14 (1):96-98.

Importance: Electroacupuncture involving the lumbosacral region may be effective 
for women with stress urinary incontinence (SUI), but evidence is limited.
Objective: To assess the effect of electroacupuncture vs sham electroacupuncture 
for women with SUI.
Design, Setting, and Participants: Multicenter, randomized clinical trial
conducted at 12 hospitals in China and enrolling 504 women with SUI between
October 2013 and May 2015, with data collection completed in December 2015.
Interventions: Participants were randomly assigned (1:1) to receive 18 sessions
(over 6 weeks) of electroacupuncture involving the lumbosacral region (n = 252)
or sham electroacupuncture (n = 252) with no skin penetration on sham acupoints.
Main Outcomes and Measures: The primary outcome was change from baseline to week 
6 in the amount of urine leakage, measured by the 1-hour pad test. Secondary
outcomes included mean 72-hour urinary incontinence episodes measured by a
72-hour bladder diary (72-hour incontinence episodes).
Results: Among the 504 randomized participants (mean [SD] age, 55.3 [8.4] years),
482 completed the study. Mean urine leakage at baseline was 18.4 g for the
electroacupuncture group and 19.1 g for the sham electroacupuncture group. Mean
72-hour incontinence episodes were 7.9 for the electroacupuncture group and 7.7
for the sham electroacupuncture group. At week 6, the electroacupuncture group
had greater decrease in mean urine leakage (-9.9 g) than the sham
electroacupuncture group (-2.6 g) with a mean difference of 7.4 g (95% CI, 4.8 to
10.0; P < .001). During some time periods, the change in the mean 72-hour
incontinence episodes from baseline was greater with electroacupuncture than sham
electroacupuncture with between-group differences of 1.0 episode in weeks 1 to 6 
(95% CI, 0.2-1.7; P = .01), 2.0 episodes in weeks 15 to 18 (95% CI, 1.3-2.7;
P < .001), and 2.1 episodes in weeks 27 to 30 (95% CI, 1.3-2.8; P < .001). The
incidence of treatment-related adverse events was 1.6% in the electroacupuncture 
group and 2.0% in the sham electroacupuncture group, and all events were
classified as mild.
Conclusions and Relevance: Among women with stress urinary incontinence,
treatment with electroacupuncture involving the lumbosacral region, compared with
sham electroacupuncture, resulted in less urine leakage after 6 weeks. Further
research is needed to understand long-term efficacy and the mechanism of action
of this intervention.
Trial Registration: clinicaltrials.gov Identifier: NCT01784172.

DOI: 10.1001/jama.2017.7220 
PMCID: PMC5815072
PMID: 28655016  [Indexed for MEDLINE]