Näytönastekatsaukset

Acupuncture in treatment of urinary incontinence

Näytönastekatsaukset
31.3.2026
Minna Törnävä

Level of evidence: D

The evidence on acupuncture for urinary incontinence symptoms is uncertain.

A Cochrane review compared acupuncture to sham acupuncture for overactive bladder and suggested an uncertain impact on urinary incontinence episodes (MD 0.55, 95 % CI -1.51 to 2.60). The same review compared acupuncture to medications and suggested an increase in cure or improvement rates (RR 1.25, 95% CI 1.10 to 1.43). Adverse events were rare «Hargreaves E, Baker K, Barry G, et al. Acupuncture for treating overactive bladder in adults. Cochrane Database Syst Rev 2022;9(9):CD013519 »1.

A systematic review and meta-analysis compared acupuncture to rehabilitation training or medication and suggested reduced urinary incontinence measured by the pad test (SMD = -2.67, 95% CI -4.05 to -1.29), and ICIQ-SF scores (MD = -3.46, 95% CI -3.69 to-3.22) «Yang N, Ge X, Ye J, et al. Efficacy of acupuncture for urinary incontinence in middle-aged and elderly women: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gyneco»2.

The level of evidence was downgraded due to imprecision and inconsistency.

Table 1. Description of the included studies.
Reference Study type Population Intervention and comparison Outcomes Risk of bias
RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis; ICIQ-SF= International Consultation on Incontinence Questionnaire Short Form;
«Hargreaves E, Baker K, Barry G, et al. Acupuncture for treating overactive bladder in adults. Cochrane Database Syst Rev 2022;9(9):CD013519 »1SR/MA Adults with overactive bladder symptomsAcupuncture vs Sham Acupuncture or Medication Incontinence episodes;
Cure or improvement in urinary symptoms		Low
«Yang N, Ge X, Ye J, et al. Efficacy of acupuncture for urinary incontinence in middle-aged and elderly women: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gyneco»2SR/MA Women >40 ageAcupuncture vs
Rehabilitation or Medication 		Pad test;
ICIQ-SF		High
Table 2. Additional comments for included studies.
Reference Comments
«Hargreaves E, Baker K, Barry G, et al. Acupuncture for treating overactive bladder in adults. Cochrane Database Syst Rev 2022;9(9):CD013519 »1, «Yang N, Ge X, Ye J, et al. Efficacy of acupuncture for urinary incontinence in middle-aged and elderly women: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gyneco»2Sources of bias include the heterogeneity in acupuncture methods utilized across the studies and the lack of clear reporting on group blinding in some studies.

Results

Table 3. Outcome 1: Number of incontinence episodes per day.
Reference Number of studies and number of patients (n; I/C) Follow-up time Mean (sd) IMean (sd) CMean difference
(Fixed, 95 % CI)
Level of evidence: moderate
The quality of evidence is downgraded due to imprecision and inconsistency.
«Hargreaves E, Baker K, Barry G, et al. Acupuncture for treating overactive bladder in adults. Cochrane Database Syst Rev 2022;9(9):CD013519 »12 (n=121; 60/61)2-3 months--0.55 (-1.51, 2.60)
Table 4. Outcome 2: Cure or improvement in urinary symptoms.
Reference Number of studies and number of patients (n; I/C) Follow-up time Mean (sd) IMean (sd) CRisk Ratio (Fixed, 95% CI)
Level of evidence: low
The quality of evidence is downgraded due to imprecision and inconsistency.
«Hargreaves E, Baker K, Barry G, et al. Acupuncture for treating overactive bladder in adults. Cochrane Database Syst Rev 2022;9(9):CD013519 »15 (n=258; 130/128)1-2 months--1.25 (1.10, 1.43), favors acupuncture
Table 5. Outcome 3: Pad test.
Reference Number of studies and number of patients (n;I/C) Follow-up time Mean (sd) IMean (sd) CStd. Mean Difference (Random 95% CI)
Level of evidence: low
The quality of evidence is downgraded due to imprecision and inconsistency.
I=intervention; C=comparison; CI=confidence interval
«Yang N, Ge X, Ye J, et al. Efficacy of acupuncture for urinary incontinence in middle-aged and elderly women: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gyneco»2 5 (n= 417; 210/207) --- -2.67 (-4.05, -1.29)
Table 6. Outcome 4: ICIQ-SF score (scale 0-21).
Reference Number of studies and number of patients (n; I/C) Follow-up time Absolute number of events (%) I Absolute number of events (%) C Mean difference (Fixed 95% CI)
Level of evidence: low
The quality of evidence is downgraded due to imprecision and inconsistency.
I=intervention; C=comparison; CI=confidence interval
«Yang N, Ge X, Ye J, et al. Efficacy of acupuncture for urinary incontinence in middle-aged and elderly women: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gyneco»2 4 (n=366; 183/183) - -- -3.46 (-3.69, -3.22)

References

  1. Hargreaves E, Baker K, Barry G, et al. Acupuncture for treating overactive bladder in adults. Cochrane Database Syst Rev 2022;9(9):CD013519 «PMID: 36148895»PubMed
  2. Yang N, Ge X, Ye J, et al. Efficacy of acupuncture for urinary incontinence in middle-aged and elderly women: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol 2021;257():138-143 «PMID: 33419589»PubMed