Randomized controlled trial of acupuncture at Zhongji (CV3) with different depths for the treatment of female stress urinary incontinence

To evaluate the efficacy and safety of acupuncture at Zhongji (CV3) acupoint with different depths for the treatment of female patients with stress urinary incontinence (SUI).

A total of 90 female patients meeting the inclusion criteria for SUI were randomly divided into treatment group 1, treatment group 2, and control group, with 30 cases in each group. Patients in treatment group 1 received acupuncture at CV3 to the anterior bladder space under CT guidance. Patients in treatment group 2 received acupuncture at CV3 to 10 mm below the abdominal wall. Patients in the control group received acupuncture at CV3 to the abdominal fat layer. All participants had needles retained for 25 min each time, with twice treatments per week for a total of 4 weeks. The patient’s 1-hour urine leakage volume was recorded pre-treatment and after 4 weeks of treatment. The international consultation on incontinence questionnaire-short form (ICI-Q-SF) score was administered at pre-treatment, after 4 weeks of treatment, and follow-up period (8 weeks after treatment completion). In the end, the efficacy was evaluated based on the 1-hour urine leakage volume. At the same time, the safety and feasibility of clinical treatment were assessed using the acupuncture discomfort visual analog scale (VAS) score, acupuncture tolerance score, and acupuncture safety evaluation.

After 4 weeks of treatment, the 1-hour urine leakage volume and the ICI-Q-SF scores were decreased in all 3 groups (P<0.05). The reductions were greater in treatment group 1 than that in treatment group 2 and the control group (P<0.05), and greater in treatment group 2 than that in control group (P<0.05). During the 8-week follow-up period, treatment group 1 and treatment group 2 both showed long-term efficacy (P<0.05), while the control group did not. The long-term efficacy of treatment group 1 was better than that of treatment group 2(P<0.05). The total effective rates were 90.0%(27/30) for treatment group 1 and 86.7%(26/30) for treatment group 2, both higher than control group (16/30, 53.3%, P<0.05). Meanwhile, both treatment group 1 and treatment group 2 caused no obvious discomfort during treatment and were easy to accept. No adverse events occurred in all patients during the treatment period.

All 3 treatment groups can reduce the 1-hour urine leakage volume and the ICIQ-SF scores in female SUI patients to a certain extent, and improve their urinary incontinence symptoms. Among them, acupuncture from the CV3 to the anterior bladder space yielded greater improvement than the other 2 groups and demonstrated better long-term efficacy. Acupuncture from the CV3 to the anterior bladder space and acupuncture from the CV3 to 10 mm below the abdominal wall caused no significant discomfort and were well tolerated, indicating that the regimens are safe and feasible.