Efficacy and safety of acupuncture combined with pelvic floor muscle training in the treatment of stress urinary incontinence in women: A systematic review meta-analysis

Abstract

Background: To conduct a meta-analysis of the effectiveness and safety of acupuncture combined with pelvic floor muscle training (PFMT) vs PFMT for the treatment of female stress urinary incontinence (SUI).

Methods: Four English databases (PubMed, EMBASE, Web of Science, and Cochrane Library) and 4 Chinese databases (the China National Knowledge Infrastructure, Wanfang DATA, the Chongqing VIP Database, China Biomedical Database) were manually searched for literature published from dates of the inception of the databases to December 23rd, 2023. Randomized controlled trials (RCTs) of acupuncture combined with PFMT vs PFMT for female SUI were included. Relevant literature was screened, and the data of the included studies were extracted according to the risk of bias tool for quality assessment.

Results: A total of 1974 patients were included in 22 RCTs. There were 990 cases in the experimental group (acupuncture combined with PFMT) and 984 cases in the control group (PFMT). The result showed that combination treatment was superior to PFMT alone, and there were statistically significant differences in several outcomes including relative risk in change for total effective rate (relative risk = 1.29, 95% CI 1.21-1.37, P < .001), weighted mean differences (WMD) in change for urine leakage on a 1-hour pad test (WMD = -2.58, 95% CI -3.33 to -1.84, P < .001), Incontinence Questionnaire-Short Form score (WMD = -2.69, 95% CI -3.45 to -1.92, P < .001), Quality of Life Questionnaire score (WMD = 11.09, 95% CI 8.41-13.77, P < .001), and IIQ-7 score (WMD = -3.35, 95% CI -4.14 to -2.56, P < .001).

Conclusion: Acupuncture combined with PFMT can significantly reduce the urine leakage on a 1-hour pad test, and improve the total effective rate and quality of life in female SUI patients. However, the number of included articles are limited, and more high-quality RCTs are needed to validate these results.

Keywords: acupuncture; meta-analysis; pelvic floor muscle training; stress urinary incontinence; systematic review.