Acupuncture against urge- and mixed type incontinence among older women in Sweden

Women with urge- or mixed type incontinence are commonly treated with bladder- training and anticolinergics. In spite of these treatments many of the women find their condition unsatisfactory. Some studies have been published which shows that acupuncture might have a positive effect when the bladder function is disturbed. There are also some animal experiments which shows that stimulation in an acupuncture-like way can affect the periurethral muscles. The purpose of this pilot study was to see if acupuncture can influence urgency, leakage and life quality.

Method: 15 women who were treated at the incontinence unit at Rosenlends Geriatric Clinic in Stockholm and with unsatisfactory outcome with standard treatments participated in this open study. As measurements we used a) subjectively scoring of the discomfort of urgency and leakage b) life quality measurement with the help of a structured interview c) registration of urination habits with the help of Inco-test (protocol over the volume of urine and frequency as well as the leakage in the form of weighting nappies). All these test ,were done before and after the treatments. Global scoring was also done after the treatments and at a follow-up three months later. Manual deqi acupuncture was performed twice weekly and the total amount of treatments was 12. The following acu-points were chosen: BL23, 31, 32, 33, KI3, SP6 and LI11, all bilaterally. At the first treatment we choose four of the above points and increased thereafter so that in the end all 14 points were used. Non-parametric statistics was used.

Results: Four of the patients had urge incontinence while the rest had mixed type. Mean age was 76,4 years (68-82 years). Mean duration of incontinence was 3,7 years (1-11 years). All completed the study. Globally clear improvements were seen at the 3-month follow-up among 8 of the 15 women. The scoring of the urge quality, urge intensity, leakage frequency and urination no the nights all showed significant improvements, p<0,05 even at the 3-months follow-up. Life quality improved significantly from the time before treatments to the 3-months follow-up, p<0,01. Objectively measuring of leakage also showed a significant reduction, p<0,05, at the 3-months follow-up.

Conclusion: Somatic afferent stimulation in the form of Acupuncture has in this open study shown positive results at follow-up 3 months after the termination of treatments. This study should be followed by controlled studies to see if the effects are unspecific or specific. More open studies should be done in order to investigate the duration of effects, the optimal frequency and number of treatments as well as the optimal point selection.

Abstracts of ICMART '97 International Medical Acupuncture Symposium