Electroacupuncture with Pelvic Floor Training Reduces Stress Urinary Incontinence Leakage

This was a randomized controlled trial evaluating electroacupuncture (EA) combined with pelvic floor muscle training (PFMT) for stress urinary incontinence (SUI). The study enrolled 128 women with mild-to-moderate SUI. The intervention was a combination of EA and PFMT, with comparators being EA alone, PFMT alone, and a waitlist group. The primary outcome was the change in 1-hour pad test leakage volume at a follow-up of 0.9 months.

The combination group (EA + PFMT) showed a reduction in 1-hour pad test leakage volume of 6.17 g (95% CI = 5.89-6.44). The EA-only group had a reduction of 4.53 g (95% CI = 4.26-4.81), and the PFMT-only group had a reduction of 2.13 g (95% CI = 1.85-2.41). The waitlist group had a minimal reduction of 0.38 g (95% CI = 0.11-0.66). Factorial analysis showed a main effect for EA with a mean difference of 5.35 g (95% CI = 5.15-5.54; P < .001) and a main effect for PFMT with a mean difference of 4.15 g (95% CI = 3.95-4.34; P < .001). There was no significant interaction effect between EA and PFMT (P = .686).

Key secondary outcomes included 72-hour urinary incontinence episodes and International Consultation on Incontinence Questionnaire-Short Form scores, though specific numerical results for these are not reported in the input. The study did not report on adverse events, serious adverse events, discontinuations, or tolerability, so safety data are unavailable.

These results suggest that both EA and PFMT independently contribute to reducing SUI leakage, with their combination offering the largest effect. The lack of an interaction effect indicates that the therapies may work through additive rather than synergistic mechanisms. Compared to prior landmark studies, which often focus on PFMT alone or surgical interventions, this trial provides evidence for a nonsurgical, multimodal approach.

Methodological limitations include the short follow-up period of 0.9 months, which limits assessment of long-term efficacy. The absence of reported safety data is a significant gap, as the tolerability of EA is not well-documented. The study population was limited to women with mild-to-moderate SUI, so results may not generalize to severe cases. The setting and funding sources are not reported, which could introduce potential biases.

Clinically, these findings support offering EA combined with PFMT as a promising nonsurgical alternative for SUI management. However, the short follow-up and lack of safety data mean that clinicians should interpret these results cautiously and consider patient preferences and comorbidities when discussing treatment options.

Unanswered questions include the long-term durability of the treatment effect, the optimal dosing and protocol for EA, and the safety profile in a broader population. Future studies should address these gaps to better inform clinical practice.